Building a legacy for health

Alvin Manalansan, Fellow for Health of the Stratbase ADRi

The Malasakit Center Act (Republic Act No. 11463) is probably one of the fastest legislative measures that has been passed and signed under the 18th Congress. It took only five months since the bill was filed in both Houses of Congress, and thereafter was signed by President Rodrigo Duterte on Dec. 3, 2019. As of this writing, a total of 61 Malasakit Centers have already been launched and are operational nationwide even as the first public consultation on its draft implementing rules and regulations (IRR) just started on Jan. 30, a few days ago.

There was really nothing wrong in the speedy passage of the Act. It is actually very advantageous to Filipinos, especially those who are indigent and financially incapacitated, who direly need assistance. The Law fulfills the government’s commitment to institutionalize the establishment of a one-stop shop in all public hospitals wherein patients can avail the medical and other financial assistance provided by different agencies such as the Department of Health (DoH), PhilHealth, Philippine Charity Sweepstakes Office (PCSO), and the Department of Social Welfare and Development (DSWD). The said Law would definitely help patients to easily access the available support without queuing repeatedly for long hours from one agency to another just to receive less than sufficient assistance.

Having said the good intentions of the Act, the purpose of the public consultation was to gather different stakeholders and have an opportunity to hear their thoughts and suggestions on how to improve the implementation of the “Malasakit” program. It is also proper to take into consideration the inputs of individuals who have first-hand experience in the operation and have actual engagements with patients availing the services.

Among those who shared their vital experiences during the consultation last week was Dr. Gerardo Legazpi, the current medical director of the University of the Philippines–Philippine General Hospital (UP-PGH). He explained that their hospital can actually cover around 56% of the total bills of their patients, the majority coming from PhilHealth reimbursements and, if the benefit package from PhilHealth is not enough, they have a system that can automatically assign the next available assistance to cover the patient’s bill.

He said that their system can minimize the manpower requirement in operating the Malasakit Centers and that, “streamlining the business process would actually save the government a lot of resources.”

However, in a response from the DoH, Undersecretary Roger Tong-An said that this may not be applicable to all government hospitals and pointed out that there should be an adequate number of personnel to ensure the monitoring of the assistance that may be availed by the patients.

It is unfortunate that not all government hospitals have the same status as the PGH. However, this can be addressed through collaboration with either public and private stakeholders. As long as transparency is ensured, this has been proven to be an effective and viable strategy in the implementation of different health programs. As in the many Public-Private Partnership projects driving major infrastructure and public services projects of this administration, partnering with the private sector would greatly supplement the limited resources of the Government.

The Pharmaceutical and Healthcare Association of the Philippines forwarded its intent to offer various special-access schemes of drugs and medicines, but noted that the process on how to integrate these with Malasakit Centers is not yet clear.

Dr. Israel Francis Pargas, Senior Vice-President for Health Finance and Policy Sector of PhilHealth welcomed the expression of support and agreed to quickly establish a clear process flow and guidelines on how to access these schemes, which should be subject to current rules and regulations.

To briefly illustrate how the Malasakit Center works, if you are an indigent and financially incapacitated patient, you are qualified to avail of financial and medical assistance. Let’s say you’re an in-patient case, the hospital less the Philhealth benefits can be covered by the health programs of other agencies such as the PCSO, DSWD, and DoH. The Malasakit Center then processes your request so that the balance of your bill may be covered, and you will be cleared to go home.

The supporting agencies are: the DoH which provides medical assistance to indigent patients, the DSWD which provides financial assistance based on existing Assistance to Individuals in Crisis Situations (AICS) guidelines, and the PCSO which provides medical assistance to indigents and financially incapacitated patients.

Also, there will be other Medical and Financial Assistance Programs that may be provided by other government agencies, LGUs, NGOs, and, let’s not forget the potential support of private institutions and individuals.

It is only right to commend the efforts of the members of the Technical Working Group (TWG) and DoH’s Steering Committee for working very hard in facilitating the Malasakit IRR, now targeting formal signing on Feb. 19. All government TWGs should work as fast and efficiently.

We hope that the scope of Malasakit Centers will expand beyond its present mandate in public hospitals, and its spectrum of funding resources will be expanded to integrate both government and private institutions. This will be a strategic element in the full realization of an extensive Universal Health Care program. A legacy that would go beyond myopic political timelines.

This article was originally published in BusinessWorld. Image Source: Philippine Information Agency.