The Reality of Healthcare

One of the Urban Health Centers I visited.

Today, I went with Dr. Lopao to some of the nearby Urban Health Centers. This health center serves about 27 barangays, which is a population of approximately 40,000 to 50,000. It is staffed by one doctor and on average, sees about 50 patients each day between 8 am and 12 pm. The facility is poorly maintained by the public as evidenced by the gaping holes in the ceiling and lack of any central air conditioning system. It is clear that the clinic is understaff, overworked, and underpaid. When talking with the local resident doctor, I learned a little more about the national health insurance system. All physician consults here are offered at no cost and majority of the medication is also free. This particular clinic sees general consults in the morning and the afternoons are devoted to family planning, prenatal visits, and treatments of patients with tuberculosis. Some of the barriers to healthcare include an inability to take off from work to come and see the doctor as the clinic runs from 8 to 5. Another barrier is simple the mindset and attitude of the Philippine population. They are strong and resilient and tend to blow off a minor cough and think they will be able to get better on their own without having to consult a doctor. It was also interesting to note how a full record was taken on the patient’s history, including family illnesses, typical diet, and living conditions. It is clear that importance was given to the social determinants of health and not just the surface level symptoms that were present. 

In the afternoon, I was able to sit in on a meeting between the Department of Health and Human Resources and the Department of Health Justice as they discussed the possibility of writing a bill in the future that would detail a “Return for Service Agreement.” Currently, the health system is moving towards a Universal Health Care point and with that, legislators and policy makers are trying to find innovative ways to incentive doctors to go and serve in impoverished areas and also encourage them to stay there even after they have completed their commitment. There are many potential challenges that arise with this bill. Although it is ideal and commendable in intention, the implementation and execution proves to be more problematic. It was quite a privilege to be able to sit and watch people of great influence sit in a room and just brainstorm ideas on how this might be possible. To be able to see the very initial stages of a hopefully incredibly impactful piece of legislation was truly an eye opening experience.