The Sad Realities

Dear Folks,

Some of you have responded immediately to my email concerning my niece's son's medical problems. Thank you so much and I really appreciate it.

Your personal experiences have just confirmed how in the Philippines medical care has worsened and I just wonder if there's any way this could be changed.

Not unless, like I always say...let's do something about it. By getting ourselves involved.
Election of new leaders is fast approaching and this is the right time to vote for the new breed of leaders. No trapos please! Never again.

I just picked Manong Fred's comment because there's a story of two doctors who happened to work in Manila and now migrated in the U.S. Their version is very interesting.

And we will learn the other side of the coin. We can't blame them either. It's the system itself to be blamed once and for all, I guess.

Please read below:

Thanks Manong Fred.

Susie

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Susie's story of her grandnephew who was almost denied medical care is commonly known in the Philippines. Why did it happen? When you come down to the ultimate bottom line it happened because of the poor economy of the country.

A poor economy can inspire corruption. Stories had been told of extremely poor families selling their daughters into prostitution. Crooked cops extort from jeepney drivers. Jeepney drivers resort to bribing cops so they can get away with traffic violations. Crooked politicians steal one way or another to maintain their power. Ad nauseam...

But what about the medical establishment in the Philippines? Why would it allow Susie's grandnephew to suffer because the poor kid's relatives are poor?
Economics again!

I met a young couple at a wedding recently in Chicago. The wife is a pretty girl in her mid-twenties. She and her husband turned out to be newly arrived doctors doing internship at a Chicago hospital. We came to talking about the anomalous stories about patients not getting proper care because of money - or the lack thereof - in the Philippines.
Here is her side of things. Let's call her Dr. Linda to preserve her privacy.

Before coming to the United States Dr. Linda was already a licensed physician working in an ER unit at a Manila hospital. When a patient is ushered into the ER, she, or any other doctor in charge at the moment, would administer emergency care.
So far so good.

Then non-medical number crunchers of the hospital (social workers, accountants, hospital administrators, etc.) will take over to determine who would pay for the patient who might be a poor sampaguita vendor or a reckless jeepney driver or, well, anybody who cannot afford medical care.
Crisis!

The first few times Dr. Linda and her fellow doctors did not complain when the accountants deducted something from their salaries for "unapproved" care they rendered. Then, henceforth, they had to get permission first before they touch a patient writhing in pain. Doctors, in spite of their Hippocratic Oath, have to live on their salaries, too, and they cannot forever subsidize indigent patients for the sake of hospital profitability.

But wait. The hospital, unless amply supported by the government, cannot maintain its physical plant and equipment, cannot pay its accountants, its nurses, its social workers, its janitors, its sanitation engineers (bedpan attendants) etc. unless there is enough revenue from patients. Hospitals cannot afford to lose doctors by deducting from their salaries for "unauthorized" services they rendered.

This Catch 22 scenario is, here we go again, the result of a very poor economy where people do not earn enough to buy food, shelter AND MEDICAL CARE.
Now you can understand why Dr. Linda and her husband, also a doctor, immigrated to the United States where they can use their hard training in getting people well without some bureaucratic hospital director and his accountant deducting something from their paycheck. In a few years, they can drive Jaguars and not feel guilty because they deserve it.

Who is to blame in the sad state of health care affairs in the Philippines?
Maybe it's the crooks who bleed public coffers dry. Maybe it's the people who resort to bribery to get ahead of the line. Maybe it's the macho boot black who, when told that he should not get married until he has a steady income, says "bahala na" and then proceeds to make a dozen babies in a dozen years.

Maybe it's the population that constantly changes its leaders without changing itself.
So it boils down to the complexity of economic problems where no simple solutions can be hammered out. But to go back to Susie's grandnephew the immediate solution was to scrounge for help from wherever it can be found. Not ideal but, hey, it is not a perfect world. We just know that there are countless Susie's all over. Thank God.

Fred NatividadLivonia, Michigan