The Philippine General Hospital by virtue of being the largest government hospital serves more than 600 000 patients every year. Most of these patients are those who can’t really afford the high cost of health care in private hospitals and are left to duke it out with the limited beds and medical personnel in PGH. As big as PGH is and as enormous the government subsidy is for the hospital, the resources and manpower are definitely stretched to the breaking point. Despite having a steady supply of extra hands from the robust studentry of the UP College of Medicine and UP College of Nursing, logistical and financial limitations routinely frustrate both patients and health care providers.
Patients don’t have to pay doctors in PGH. Every patient who enters the hospital as a charity case will never be asked a professional fee no matter what the treatment for him/her will require. Even if one was to have an emergency surgery or spend weeks in intensive care, no doctor will ever get even one cent from any patient. Unfortunately, treatment requires more than having the doctor lay his/her hands on the patient. For every move the doctor makes, he will likely require a diagnostic test in the form of laboratory or imaging procedures. Relative to other healthcare delivery facility, the discounted rates in PGH are probably among the lowest in the country but a considerable amount of patients still find paying for this relatively cheap services challenging. I’ve been forced to shell out some money to facilitate labs and I’m pretty sure that this is a very familiar story for a lot of med students.
It doesn’t stop there. The medicine is obviously not dispensed for free. Doctors in PGH double as social workers and philantropists in an effort to maintain the best possible standard of care in the face of really trying financial dilemmas. I’ve seen residents shell out thousands of pesos to pay for a patient’s hemodialysis. Medical representatives unwittingly help patients when they give doctors free drug samples. These colorfully packed brochures with one or two tablets eventually find their way to the bedsides of needy patients.
Sadly, the story of costs and trials doesn’t end once patients leave the hospital. A good number of patients require life-long treatment and monitoring to ensure that their diseases will not worsen or further compromise their quality of life. Patients with end stage kidney disease would require hemodialysis at least twice a week just to clean the toxic off their blood stream. Once you put into consideration that each trip to the dialysis center would set you back 3000 pesos, the gravity of the problem becomes more apparent. It will be a big challenge for a middle-class family to even shoulder 18 000 pesos a month what more to a family that’s way below the poverty line?
I sometimes ask myself what’s in store for the poorest of the poor who don’t even have the ability to set aside extra cash for medical emergencies. It’s easy to say that this shouldn’t be the way things should go but the economic principles on which hospitals and drug companies operate on are simply contradict the goal of affordable health care for all. As it stands now and given the infrastructure of the drug industry, I am not a big fan of a more comprehensive form of socialized health care wherein the government shoulders much of the tab. PGH already receives over a billion pesos in state subsidy aside from millions of donations and contributions from politicians, alumni, charities and other organizations.
The price of care is anything but cheap. For the immunocompromised patient with a raging infection due to an aggressive pathogen, the antibiotics to be used may run up to more than three thousand pesos per dose. How many doses are needed? Three… PER DAY… FOR TWO WEEKS. That sends the grand total to well over a hundred thousand pesos – probably way more than what a poor family makes in an ENTIRE YEAR. This of course is just a small part of the medical regimen and the patient would probably continue to need specialized care and medications for ther rest of his/her life even if great sums are thrown to purchase antibiotics. Though I am very much sympathetic to the needs of patients, I just don’t think it’s right for the government to allocate that much money for the care of a patient with an unfavorable prognosis. I still believe that there should be equity in society. As cold as it is, I think that economic value should play a part in how much the government would be willing to spend for an individual. The mendicancy-driven system and the culture of enforced vampirism has to stop if we are to truly come up with a truly lasting and sustainable solution.
As cliche as it sounds, education has to be the solution out of this because if it isn’t then we’re truly helpless. I’m so tired of seeing poverty in my everyday stint at the hospital. I’m sick of being witness to patients dying because their families could no longer afford to buy medicine to prolong their lives. My heart and ears already too fatigued to the wails and cries of loved ones while we in the duty team try to revive a coded patient. I’m tired -and I’m not even a doctor yet.
For education to work out and provide the new generation with greater opportunities for economic mobility, we have to swallow the bitter pill that the older generation is beyond salvation. Aside from being the ticket of politicians to their respective elective posts, they will also be no longer competitive in the economic game even if they were to get their due. Resources are limited and it will be far wiser to invest those who could help us more in the long run. The older generations are products of the systems of yore – one of patriarchy and shameless cronyism. The rhetoric over the years regarding the poor having more in law along with the church’s poverty-affirming message further made these people exhibit a combination of beholdness with an air of entitlement and pride with a sense of jadedness. It’s not exactly their fault but they’re definitely beyond reform. They have lived this way for so long to the point that a paradigm shift will not sit well with them.
I know this is not the wide-eyed optimistic perspective that most people would expect from a young blogger such as myself but I have never been a populist. We have to be pragmatic in solving the problem and unfortunately, we can’t save everyone. We can’t afford to be a aggressive in our treatment every single time. In medicine, there are times when palliative care as opposed to life-saving therapy is warranted.
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This is my official contribution for Blog Action Day. Do you have something to say about POVERTY? Blog about it TOMORROW! (15 October 2008)
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Basta ako I let people believe what they want.I may ask questions ,but I won’t go to the extent of trying to change what they believe in.
I am not that old,am younger than MLq3 but older than Mikey but I don’t believe that arrogance leads to innovation.IT is not non sequitur,I just beg to differ.
Arrogance by younger guys will be met by arrogance of the older guys,just watch House MD.
if you mean that you can’t teach old dog new tricks,many will disagree.
as to a weak generation replaced by a weaker generation; I heard that before,it is called by beign0 as a degenerative culture.
I watch the WWE and the Degeneration X just reunited as a one time promo.
@thehighpriestofsmokes – Yeah I’m a mortal and probably will die early because of smokers who destroy mother nature while puffing and puffing like there’s no tomorrow. And yes, I have no brains (or my brain cells have probably melted) and I don’t care what you wrote.
I was addressing the joke to benj not you. Smoking effects FTW!
ktnxbai.
in all fairness to benj and all like-minded individuals here, the issue that he has presented in this post is an example of the classic moral dilemma that has been with humanity for ages. it is a variation of the hypothesis: if faced with the choice of saving your wife or your beloved only daughter in a situation where you can only save one, who will you choose? it calls for a choice of the proverbial “lesser evil”. but the question remains, which one is the lesser evil?
the trouble is, in trying to defend his choice, benj had to resort to bellicose rhetoric against the whole “old generation”, betraying a less than compassionate attitude towards elderly folks (including, perhaps, his parents).
Benj,
Generation upon generation of Filipino doctors have passed through PGH, to look at horror bare, as it were. But, believe it or not, there are even worse places!
You ain’t seen nothing yet, so pluck up your courage and turn your face to the wind. Bid farewell to the fears of childhood, and take your place on the Ship of State.
Just wait till you have to raise a family all your own.
The word “context” will take on a whole ‘nuther meaning.
all of you,
what ship of state are you talking about djb? there’s no proverbial ship of state? I noticed here in Manila, political writers always go back to that allegory written by Rizal some centuries ago. We don’t live in that milieu of Rizal. We’re in the 21st century, djb.
Simple–there is no superior generation. There is an ascendant generation and we are it. Our predecessors will not, in any way, be better than us. Why? Because we’ll not let them. For example, will I allow a younger candidate to defeat me in the polls? Obviously not. Voters always prefer old guys like me. In the same vein, will I allow a younger barrister to make mince meat of me before the courts? Again, obviously, not.
The point is–here in this country, the younger generation is always inferior than those before them, simply because we allow them to.
By the way, let me answer this “if you’re alone in the island, who will you choose” kind of question.
Men choose not on the basis of “lesser evils”, but on the basis of their personal biases. It may be that it’s not the lesser evil to choose one’s wife over one’s daughter, since you can’t have sex with your daughter to create another daughter (that would be incest); yet you can always choose your wife since she can make another daughter anyway. so, it’s not the lesser evil. and is the daughter or the wife, evil? Not!
you got it all wrong, mr. highpriest (or whatever). when i say “lesser evil”, it is the evil of abandoning (or not saving) the wife over the daughter and vice versa. if, as in your example, you decide to save your wife because you can “make” (i would say procreate) another daughter, then that is the lesser evil, at least in your mind.
High Priest,
Blogging and anonymity have the same effect on some people as alcohol: uninhibited giddiness. Get a grip, man!
that kind of question is really tiring if you have the choice between saving 2 lives then its a gimme you sacrifice your life to save the 2. the gall of somepeople.