Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

Eighteenth Congress
First Regular Session

House Bill No, 2190

Introduced by Representative Gerardo J. Espina, Jr.

EXPLANATORY NOTE

The bill seeks to establish a dialysis unit in every province nationwide as well as to
provide free dialysis treatment for poor patients suffering from end-stage renal disease
(ESRD) or the last stage of Chronic Kidney Disease (CKD).

This is pursuant to the Constitutional mandate of the State to protect and promote the
right to health of the people and instill health consciousness among them. Article XIII, Section
11 of the 1987 Philippine Constitution declares that the State shall adopt an integrated and
‘comprehensive approach to health development which shall endeavor to make essential goods,
health and, other social services available to all the people at an affordable cost.

The increasing number of cases of kidney failure in the Philippines is quite alarming
It is 7th leading cause of death among the Filipinos According to the National Kidney and
Transplant Institute, One Filipino develops chronic renal failure every hour or about 120
Filipinos per million population per year. More than 5,000 Filipino patients are presently
undergoing dialysis. and approximately 1.1 million people worldwide are
on renal replacement therapy.

It is a financial burden of Filipinos afflicted with ESRD. In 2016, Philhealth declared
that CKD affects more than ten percent (10%) of the world's population. Majority of end-stage
renal disease (ESRD) among Filipinos is secondary to complications of diabetes, hypertension
and chronic glomerulonephritis. While most patients with end-stage renal failure need kidney
transplantation, renal replacement therapy with adequate dialysis helps replace sufficient
kidney function for a patient to survive. Their household income suffers when they struggle
with out-of-pocket spending, especially when the annual benefit limit provided by the agency
isused up given that ESRD patients also need to combat-related complications, such as anemia
and infections that further aggravate their situation when they are hospitalized for these.
Patients then cope by reducing the frequency of dialysis sessions prescribed to them, thereby
compromising their need for adequate dialysis.

Majority of end-stage renal disease among Filipinos is secondary to complications of
diabetes, hypertension and chronic glomerulonephritis. As of 2013, there are about 23,000
dialysis patients and only about 300 to 500 kidney transplants are performed annually. There
are 7,000 estimated cases of End Stage Renal Disease (ESRD) waiting for a transplant and
still escalating every year.


‘The optimum frequency of dialysis is three times a week, but due to its being costly and
inaccessibility mainly in the provinces, patients compromise their health conditions. The cost of
‘a kidney operation ranges from Php600,000 to 1 million pesos while a session of dialysis will
cost a patient more or less Php4,000.00. PhilHealth records show that in 2014, hemodialysis
posted the most number of filed claims among procedures at 691,489, with a total benefit
payment amounting to Php 4,666,806,642.

With the high cost and inaccessibility of the dialysis treatment centers in the province
to cater marginalized patients suffering from end-stage renal disease (ESRD) or the last
stage of Chronic Kidney Disease (CKD), it is high time for the government to provide a
dialysis ward procedure free of charge for every provincial hospitals throughout the entire
‘country.

In view of the foregoing, the approval of this bill is eamestly sought.

HON. GERAI J INA, JR.
resentaltve
Lone District of Biliran


Republic of the Philippines
HOUSE OF REPRESENTATIVES

Quezon City

Eighteenth Congress
First Regular Session
1190

House Bill No

Introduced by Representative Gerardo J. Espina, Jr.

AN ACT
PROVIDING FOR THE ESTABLISHMENT OF A DIALYSIS TREATMENT
CENTER IN EVERY PROVINCE NATIONWIDE, APPROPRIATING FUNDS
‘THEREOF AND FOR OTHER PURPOSES

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

Section 1. Short Title. This Act shall be known as the “Dialysis Center Act of
2019.”

Sec 2. Declaration of Policy. - It is the declared policy of the State to improve the
delivery of health care services to the people and to ensure hospital facilities are available,
affordable and accessible to the people.

Sec 3. Definition of Terms. — For purposes of this Act, the following terms shall mean:
a) “Secretary” shall refer to the Secretary of the Department of Health;

b) “Provincial Government Hospital” shall refer to a hospital operated and maintained either
partially or wholly by the provincial government or other political subdivision, or by any
department division, board or other agency thereof, and

©) “Indigent Patient” shall refer to a patient whose combined annually family incomes does not
exceed One Hundred Thousand Pesos (P100,000,00) annually.

Sec. 4. Identification of Provincial Government Hospitals. ~ The Department of
Health is hereby authorized to identify one provincial government hospital in every province
that shall establish and maintain a dialysis unit. The DOH shall consider the status and
capability of the hospital including its area and facilities for the establishment of the said
dialysis unit.

Sec. 5. Establishment, Operation and Maintenance of a Dialysis Unit. — Within
eighteen (18) months from the effectivity of this Act, the identified provincial government
hospital in every province is hereby required to establish, operate and maintain a dialysis unit


in its hospital. The dialysis unit shall be equipped with complete dialysis machine, equipment
and supplies to be managed by qualified medical personnel,

Sec. 6. Free Dialysis Treatment to Poor Patients. — Dialysis treatment in the identified
government hospital in every province and/or region shall be provided free of charge to
indigent patients as defined in Section 3 (c) hereof.

‘Sec 7. Penalty. - Any hospital chief, administrator or officer-in-charge who fails to
comply with this Act shall be punished with a fine of Fifty Thousand Pesos (P50,000.00) but
not more than One Hundred Thousand Pesos (P100,000.00).

Sec 8. Implementing Rules and Regulations, - The Secretary shall promulgate the
necessary rules and regulations to implement the provisions of this Act

Sec 9. Appropriations. -Such amount as may be necessary to implement the provisions
of this Act shall be included in the national government hospital's annual appropriations.

See 10. Separability Clause. - If any provision of part hereof is held invalid of
unconstitutional, the remainder of the law or the provision not otherwise affected shall remain
valid and subsisting.

Sec 11. Repealing Clause. - Any law, presidential decree or issuance, executive order,
letter of instruction, administrative order, rule or regulation contrary to or inconsistent with the
provisions of this Act are hereby repealed, modified or amended accordingly.

Sec 12. Effectivity. - This Act shall take effect fifteen (15) days after its publication in
at least two (2) newspapers of general circulation

Approved,