Prescription for change

Access to universal health care is every Filipino’s dream. A future where anyone – no matter their income or background – can avail of the health services they need, whether it’s a simple checkup, life-saving surgery, or long-term treatment, without worrying about the cost.

We all know that getting sick is hard enough. But for many, the real struggle begins when the hospital bills arrive. Life savings disappear in an instant. Families are forced to make impossible choices – medicine or meals, treatment or tuition. These are not decisions anyone should have to make, especially in moments of vulnerability and pain.

Thankfully, we are beginning to see progress. In his fourth State of the Nation Address, President Bongbong Marcos highlighted a major milestone – the implementation of the zero-balance billing policy for patients admitted to public hospitals. This means that patients no longer have to pay out-of-pocket for covered services.

According to the Philippine Health Insurance Corp. (PhilHealth), the zero-balance billing policy applies to all Filipinos, not just the indigent, who are admitted to a basic or ward accommodation in a Department of Health (DOH)-listed hospital.

This is a truly promising development, especially for the elderly like me, who face more frequent and complex health challenges. It’s an important step toward truly accessible health care.

But while these strides are encouraging, we must also confront deeper, more persistent issues that continue to threaten the integrity of our health care system. From underfunded facilities and uneven access across regions to concerns around ethics and accountability, the road to universal health care remains long and challenging.

One example is the case involving a pharmaceutical company allegedly engaged in unethical practices with members of the medical profession. Last month, former lawmaker and long-time universal health care advocate, Atty. Erin Tañada, brought this issue back to life after calling for the suspension or revocation of the licenses of two doctors reportedly involved in a multi-level marketing (MLM) scheme.

Past Senate hearings have revealed troubling practices involving a pharmaceutical company allegedly inciting doctors to prescribe its products in exchange for financial incentives and lavish rewards. The more prescriptions they issued, the more points they accumulated – points that could be converted into luxury cars, foreign trips and other high-end perks. These hearings on this issue seem to have faded from public memory, so a resolution was never brought to light.

While MLM schemes are not prohibited by the law, such practice in the medical field raises serious ethical concerns. In health care, decisions are grounded in science and are made in the best interest of the patients. They should not be influenced by profits or personal gains. When doctors participate in MLM schemes, the line between professional judgment and commercial interest becomes blurred.

These practices threaten the very integrity of the medical practice and the health care system, eroding the trust of patients. Trust is replaced by suspicion, and patients begin to question whether their treatment is really necessary or prescribed simply because it is profitable.

The real danger is this: when people lose trust in the health care system, even the best reforms can fall flat. We can clearly see a tug-of-war here – on one side, efforts to make healthcare more accessible to the poor and on the other, individuals and groups who exploit the system for personal or corporate gain.

I have deep respect and admiration for our doctors and health care professionals, especially those who continue to serve the Filipino people with dedication, despite the many challenges they face. That’s why it is disheartening to see the reputation of this noble profession tarnished by the unethical actions of a few.

This situation should serve as a wake-up call for the government, especially the DOH, the Professional Regulation Commission and the Board of Medicine, to strengthen their oversight mechanism and establish clear regulations that prohibit profit-oriented prescriptions by physicians. I call on our legislators to explore the possibility of enacting a law that prohibits such unethical schemes.

But we must go beyond treating the symptoms – we must diagnose and address the root causes. Many doctors, especially those in public hospitals, endure long hours, low pay and inadequate resources. Doctors are expected to uphold the highest standards of ethics while working in a system that often fails to support them. There is an urgent need to address these issues that make these unethical practices appealing in the first place.

Universal health care must be holistic and work both ways – it must care for patients and support the providers. If we want to prevent corruption in the medical field, we must ensure that our doctors are fairly compensated, adequately equipped, and given opportunities for growth that do not come at the cost of their integrity.

At the same time, we must empower patients. Health literacy is a powerful tool. When patients are informed about their rights, understand their treatment options, and know how to ask the right questions, they can actively participate in their own journey to healing. An informed patient is less likely to be misled and more likely to demand accountability.

In light of all these we must ask ourselves: What kind of health care system and culture are we building? If we allow unethical practices to persist, we risk not only corrupting future generations of medical professionals but also weakening the very foundation of our public health system. The dream of universal health care will remain just a dream, unless we act with urgency.

Let this be our prescription for change: a system that heals with dignity, treats with fairness, and thrives on trust. In the end, a healthy nation is not just one free from illness but one built on care, ethics and hope.