Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SIXTEENTH CONGRESS
First Regular Session

2629

HOUSE BILL No.

“Introduced by Reps. NERI J. COLMENARES, LUZVIMINDA C. ILAGAN,
CARLOS ISAGANI T. ZARATE, EMMI A. DE JESUS, ANTONIO L. ‘TINIO,
TFERNANDO HICAP and TERRY RIDON

AN ACT
PROHIBITING THE PRIVATIZATION OF PUBLIC HOSPITALS, PUBLIC HEALTH
FACILITIES AND PUBLIC HEALTH SERVICES

EXPLANATORY NOTE

‘This bill seeks to protect the right to health of the Filipino people especially the poor by upholding,
the public character of government hospitals and prohibiting any form of privatization of public
hospitals, public health facilities and public health services.

Article Il, Section 15 of the 1987 Constitution states that “the State shall protect and promote the
right to health of the people and instill health consciousness among them.” Further, Article XIII
Section 11 states that the “State shall adopt an integral and comprehensive approach to health
development and shall encleavor to make essential goods, health and other social services available
to all the people at affordable cost.”

The Right to Health is also enshrined in World Health Organization constitution and in various
United Nations’ instrumentalities,

Yet, according to Asian Development Bank Country Partnership Strategy: Philippines 2011-2016, six
out of ten Filipinos die without medical attention, and neatly half of health care costs are paid out of
pocket

Accotding to the Department of Health (DOH) in 2010, the poorest of the population ate the main
users of government health facilities, But public hospitals and health facilities have suffered
neglect due to the inadequacy of health budgets in terms of support for upgrading to expand
capacity and improve quality of services.

To address this, the DOH implemented health reforms which include, among others, the provision
of fiscal autonomy to government hospitals by allowing collection of socialized user fees for services
and converting these hospitals into government corporations. Upgrading of hospitals and health

a


facilities were targeted through different mechanisms including public-private partnership (PPP) and
income retention. These were consistently espoused in Health Sector Reform Agenda (1999),
Fourmula One for Health (2005), and Aquino Health Agenda (2010).

Officials of the Department of Health state that such reforms do not constitute privatization, But
the World Health Organization defines privatization in healthcare as “a process in which non-
governmental actors become increasingly involved in the financing and/or provision of healthcare
services.”* Based on this definition, privatization include the following: divestiture or outright sale
of public sector assets in which the state divests itself of public assets to private owners; franchising
or contracting out to private, for profi, or, not-for-profit providers; self-management, wherein
providers are given autonomy to generate and spend resources; market liberalisation or deregulation
to actively promote growth of the private health sector through various incentive mec

withdrawal from state provision, wherein the private sector yrows rapidly as a result of the failure on
the part of the government to meet the healthcare demands of the people (T'S Savas, “A taxonomy
of privatization strategies,” Policy Studies Journal, 1989, as cited by Peedell).

Instead of alleviating the burden of poor patients, the health reforms implemented by the DOH
contributed to further inaccessibility of health services, as previously free services and supplies in
public hospitals and facilities were subjected to “user fees”. Most poor patients who are not qualified
under the National Household Targeting System as sponsored PhilHealth members could not afford
the present standard fees in government hospitals. Even if patients are covered by PhilHealth, the
increasing cost of health services and non-availability of supplies, procedures and equipment in
public hospitals greatly increase the out-of pocke: payments of the people and result to their further
impoverishment.

For example, when radiology services in Jose R. Reyes Memorial Medical Center were subjected to
public-private-partnership with Himex Corp, previously free xray procedure was charged P150-300,
In San‘Lazaro Hospital where many dengue patients go for treatment, patients have to pay P150 for
every blood test and P1,200 per blood pack (2011) because these are not given free. Even barangay
health stations and district hospitals charge patients or ask for “fixed” donations for vaccinations,
and supplies like cotton, gauze, and syringes. These fees arc already difficult to bear for families who
earn minimum daily wage of P456 (in NCR), but more so for those who have no source of (regulu)
income, and yet are not considered “poorest of the poor” by the National Household Targeting
System and are not covered by PhilHealth sponsored programs for any reason.

Corporatized hospitals, or government-owned and controlled corporation (GOCC) hospitals, jet
the funds for maintenance and other operating expenses, capital outlay and personal services from
the hospital income. Service patients in these GOCC hospitals are required to pay for everything
except for doctors’ fees. As a result, in 2011, thousands of patients in Philippine Heart Center are
waitlisted for operations until they are able to raise the cost of patients’ share ranging from tens of
thousands to hundreds of thousand pesos. In the same yeas, it was reported that patients who are
not able to pay their bills in Philippine Children’s Medical Center are made to surrender their
valuables as collateral “pawnshop style” before they are allowed to go home. Hospital directors of

¥( Muschell, Technical Briefing Note on Privatization in Health, 1995, WHO/TPHE/TBN/95.1, as cited by
Peedell, huip://www.healthprofessionals4ahs.co.uk/wp-content/uploads/2012/01 /Peedell-privatisation is-
inevitable-bmj.d2996.full_ pdf)


GOCC hospitals for several years of budget deliberations are practically pleading for inereased
government allotment to better serve the patients especially che indigents. Despite these reports,
there arc persistent attempts to privatize public hospitals nationwide,

Health workers, patients, and health advocates opposing the PPP of Philippine Orthopedi¢ Center
(POC) raise concerns on the displacement of indigent patients comprising 80-90% of 190,000
annual patients of POC. Bid documents on the modernization of POC, indeed show that only 70
out of 700 beds will be allotted co indigents, an arrangement which incidentally, is in line with the
DOH policy of charity bed allotment for private hospitals (DOH AO 2007-0041),

When public hospitals are opened to private investors, in whatever degrees or forms, the
orientation of health care shifts from service to income and profit, When public hospitals are
privatized, the general public suffers.

Public hospitals and public health facilities were built to serve the public. People’s taxes should be
rewumed to the people in terms of adequate and free social services including health services
especially for poor patients, Public hospitals and public health facilities should be allotted
adequate budget to fully cover the expenses for maintenance and other operating expenses,
personal services and capital outlay so that they can fulfill their mandate of serving the public
especially the poor,

Health care must be made accessible, affordable, and appropriate to the needs of the people.
Public hospitals, as part of the public health care delivery system, must be fully developed and
strengthened by the government, not privatized.

‘This Bill is a major step to address the inaccessibility and inequity in health care made worse by
privatization of public health services. As legislators, we are duty-bound co uphold the health and
well-being of the people. In order to have a comprehensive and integrated health care delivery
system as mandated by the Constitution of the Republic of the Philippines, the urgent approval of
this bill is earnestly recommended,

Apprfoed,
: a sak
Rép. NERIJ. COLMENARES Rep.CARTO} TZARATE.
sayay] Muna Partylist Bayan Muna Pethlist

Pernt rl, C-
Rep. EMMI DEJESUS Rep.. VIMINDA ILA‘
Gabriela Women’s Parbplist Gabriela Wonen's Partytist


‘ACT Teachers Party-ist “Andkpavis Part-list

Rep. THRRY RIDON,
Kabyjaan Pargy-list


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SIXTEENTH CONGRESS
First Regular Session

HOUSE BILL No._2620

Introduced by Reps. NERI J. COLMENARES, LUZVIMINDA C. ILAGAN,
CARLOS ISAGANI T. ZARATE, EMMI A, DE JESUS, ANTONIO L. TINIO,
FERNANDO HICAP and TERRY RIDON

AN ACT
PROHIBITING THE PRIVATIZATION OF PUBLIC HOSPITALS,
PUBLIC HEALTH FACILITIES AND PUBLIC HEALTH SERVICES

Be it enacted by the Senate and House of Representatives of the Philippines in Congress ascembled:

SECTION 1. Title. This act shall be known as the “Anti-Privat
Health Facilities and Health Services Act of 2013.”

ation of Public Hospitals,

SECTION 2. Declaration of Poligy. \tis the declared policy of the State that it shall protect and
promote the right to health of the people and instill health consciousness among them. Furiher, the
State shall endeavor to make essential goods, health and other services available to all the people
at affordable cost

SECTION 3. Definition of terms. For purposes of this act, the following terms shall mean:

a. Public hospitals — all Department of Health (DOH) -retained and national hospitals, and
provincial and regional hospitals under the local government.

b. Public health facilities - Health centers, lying-in, and barangay health stations under the
national or local government.

©. Public health services ~ all diagnostic, laboratory, medical, surgical, and health-related
services provided by public hospitals and public health facilities to indigent, service or poor
patients,

d. Indigent/service /poor patients — those who have no source of income, or whose family
income are below the mandated minimum daily wage and/or below the minimum monthly
cost of living as set by appropriate government agencies.


SECTION 4. “Privatization” so defined. As used in this Act, the term “privatization” shall mean
the process in which non-government actors become increasingly involved in the financing and/or
provision of health care services. This includes, but not limited to, the following:

outright sales
public-private partnership;

contracting out of equipment and services;
joint venture;

franchising;

management control and/or corporatization;
leasing; and

user-charges,

FeseaogD

SECTION 5. Prohibition of Privatization of Public Hospitals, Public Health Facilities, and
Public Health Services = No public hospital, public health facility, and public health services shall
be privatized. Likewise, under no circumstances shall any person, whether natural or juridical,
initiate, cause, and approve the privatization of any public hospital, public health facility or public
health services.

SECTION 6. Bed allotment for indigent/service/poor patients in public hospitals. At least 90%
of the total bed capacity of all public hospitals shall be allotted for indigent/service/poor patients,

SECTION 7. Liability and Accountability~ Any person, whether natural or juridical, who initiate,
cause or approve the privatization of any public hospital, public health facility or public health
services is liable under this Act

SECTION 8. Penalties Any person who violates any provisions of this Act shall be penalized
accordingly:
a, “First Offense” A fine of not less than one hundred thousand pesos (P100,000.00)
but not more than two hundred thousand pesos (P200,000) and suspension of one year
to two years from public office;

b. “Second Offense”- A fine of not less than two hundred thousand pesos (P200,000) bue
not more than five hundred thousand pesos (P500,000) and temporary disqualification
from holding any publie office of not less than three years but not more than six years
and

©. “Third Offense” A fine of not less than five hundred thousand pesos (P500,000)but
not more than eight hundred thousand pesos (P800,000) and. removal from public
office and perpetual disqualification from holding any public position or office.

SECTION 9. Separability Clause-f any provisions of this Act is declared invalid or
unconstitutional, other provisions hereof which are not affected thereby shall continuc to be in full
force and effect.

SECTION 10. Repealing Clause ~ All provisions of laws, orders, decrees, including rules and
regulations inconsistent herewith are hereby repealed or modified accordingly.


SECTION 11. Effectivity Clause~This Act shall take effect (15) days following its publication in
the Official Gazette or at least two (2) national newspaper of national circulation.

Approved,