Short discussion on the economic disparity, especially within the healthcare system, oh the Philippines seen during my travels in May of 2012

1. Economic Disparity
Tori Johnson

2. One of my favorite
experiences from our
trip was the day
I spent in the
emergency
department at
Jose Reyes Memorial
Medical Center.

3. As I helped to transport a patient from the ER to
another department, the nurse I was shadowing
explained the basics of the Filipino healthcare
system to me.
He really wanted me to understand that he was
proud of his country, his profession, and the
hospital, but he still hoped for many things that
would make his patients more comfortable and
his life a little easier.

4. A developing country, the Philippine economy is
in the midst of a transition, from an economy
based on agriculture to one based on services and
manufacturing.
While their standard of living is improving, there
are still issues of poverty and overpopulation.
With these issues in mind, it should not come as a
surprise that their healthcare system is constantly
improving itself. However, there is still major
disparities in supplies, medications, and staff.

5. Like the US, various health facilities care for the health
needs of Filipinos. There are government run
hospitals, as well as privately owned hospitals.
The following presentation represents our experiences
in government hospitals. The information may not be
relatable to private hospitals.
Government-run hospitals provide healthcare the
same way private hospitals do. The main differences
are the facilities and technologies offered. Most of the
public hospitals would not be equipped to the same
standard as the private ones.

6. Government run
hospitals run on
“skeleton budgets”:
they cannot put
money towards
supplies and
medications if they
won’t get money
back.
Therefore, they are
not able to keep
many medications
and supplies in stock.
There are some
available, in case of
an emergency.

7. Patients have to pay for medications
out of pocket and supplies are used
sparingly by staff.
For example, gloves are not easy to
come by. Sometimes staff may use
just one glove or forgo gloves,
whereas in the US we use gloves
constantly throughout the day.
Also, if your family member needed
a medication, you would have to go
down to the pharmacy, pay for it
and bring it back to the unit. In the
US, the medications would be
prescribed, the nurse would pull
them out of a Pyxis (medication
dispenser) and they would be
charged to your account.

8. In the Jose Reyes ER…
EKG machine was missing pieces and we had to
search high and low for paper
Drainage tubes are old-fashioned, using glass jars
and tubing. They still work well but are not as safe.
Wheelchairs are old and have been rigged to work
well but are not comfortable. Same goes for beds.
The beds in the ER, and in many other units, were
merely stretchers with mattresses on them. Not only
are they uncomfortable but they are not made to be
adjusted for height or easy maneuvering.

9. The Philippines
The United States
Jose Reyes followed a fee-for-service
payment system; Includes basic physician
consultations, diagnostic tests, and drugs
prescriptions
Hospitals cannot deny any treatment.
However, services provided are not free and
all of the treatments/consultations are
charged to the patient’s account.
It keeps track of which departments a
patient visited and which treatments they
received
The patient’s account holds prescribed
consultations, prescriptions, and therapies.
Before the patient leaves the hospital, they
visit each department, as well as the
finance department, to settle their
accounts.
Patients are able to be discharged without
paying, though payment plans are set up to
cover the costs, usually those leftover from
what health insurance covers. If the patient
does not have health insurance, then…
Most of the time, payments are made out
of pocket, or the finance department
works with social services and charities to
make it work.
As payments do not have to be made at the
time of service, patients are able to budget in
the cost of their experience at the hospital.

10. Their system is different than the US payment
system.
– Healthcare in the Philippines is affordable, if you have
the money.
• If you are of an upper class, you are able to afford any
treatment, medication, and can even have a semi-private or
private room.
• However, if you are of a middle or lower class, which
accounts for a large amount of the Filipino population, then
you will have trouble accessing what you need to improve
your health. Example: burn unit
• Next time you’re at the hospital or your doctor’s
office, keep a positive attitude, because
somewhere in the world, someone does not have
the same access to healthcare as you do.