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Medical costs erode nurses' small pa$
Ey Jovic Yee
@jovicyeelNQ
For more than a decade, Bryan,
a nurse, had been taking care of
patients whg had the means to
be confined almost indefinitely
in q private hospital.
IJut when members of his
fanrily fell ill, Bryan was hard-
prcssed to find ways of paying
for their hospitalization.
In fact, he is tied for the next
two years to the Manila hospital
he is working for as he pays in
installment the remaining
Pso,ooo bill for one of his two
chiltlren who is coping with a
kidrcy illness.
Ol the totalPgo,ooo bill,
abolrt l)4o,ooo was shouldered
by liryirr's employer as part of
his bcncl'il.s.
With just a monthly income
of a little over P21,ooo, Bryan
said he couldn't afford to have
any of his family offour get sick.
"We're lucky that one of our
belcfits is that when someone
in t hc family gets sick, we are
ablc to set the payment terms in
th| lrospital. Without that, get-
House Bill No. 3478, which sets a
minimum monthly salary of
P3o,ooo for nurses in both public
and piivate hospitals.
The bill runs in line with the
supreme Court ruling lastwr-6ek,
which affirmed that govern-
ment nurses are entitled to a
monthly pay of up to P3o,ooo,
or about the maximum pay of
Salary Grade 15, according to
the Philipplne Nursing Act of
2oo2 (RepublicAct No. 9173).
In their explanatory note,
Makabayan bloc lawmakers
said increasing the salary of
nurses was "long overdue." The
lawmakers include Bayan Muna
Representatives Ferdinand
Gaite, Carlos Isagani Zarate and
Eufemia Cullamat, ACT Teach-
ers Rep. France Castro, Gabriela
Rep. Arlene Brosas and Ka-
bataan Rep. SarahJane Elago.
Another lawmaker, Sen. Clrr-
thia Vi ar, said in a mdio inter-
view on Sunday that the Depart-
ment of Health (DOH), in accor
dance with the Supreme Court
ruling, could tap its "unpro-
grammed accounts" for tlre man-
dated pay for government nurses.
Even Health Secretary Fran-
cisco Duque III supports calls for
renationalization, after medical
practitioners have observed
over the years how health pro-
grams and services become
"compromised" when local offi-
cials do notgive them priority.
Under RA 7160, the Local
covernment Code (LGC), the
delivery and promotion of
health services are devolved to
provincial and local officials.
"we need to review the Lo-
cal Government Code and see
what its impacts are after I28l
years. We need to do an assess-
NURSES'PLIGHT Nursing graduates take their oath as new ment. Did it do good in the
professional nurses. Most nurtured hopes of high pay in the health outcomes of our peo-
profession when they took up the course. -tNQurR€R Fl!E PHoro ple?" Duque said.
"This is to me the time. If
there's an indication to rena-
had been one of the reasons the inside." tionalize, Iet's renationalize," he
why they sought work opportu- "One time, there was [an ap- added.
nities abroad. plicantl who only had a year of Duque pointed out thatifed-
The rates are competitive in experience, yet was given a per- ucation wasn't devolved to the
Southeast Asia alone. Thailand manent position even if there local governments,- the more
pays its nurses a minimum were Iothers with more experi- health serviccs should notbe.
Ps5,93o. The starting sa13ry in ence]," she said. lle said there could be better
Malaysia is P82,ooo. Singapore Joy accepted a job order, as manngemcttt of heilltll centers,
offers its nurses nearly P112,ooo- the work offer is called, at a ter- esp('cially whcn it (:orrcs to im
Bryan said that even with tiary government hospital for a rllluizatir)ll, il' h(',rlllr services
if rhd r hlw Lirlarv u,,',,, rh,' nf tho
l Tr'r'WW.INQUIRER.NEI
primary health care as local
governments can tailor-fit thelt
programs to the needs of thf
community. i
But this has not been the casf
over the last two decades due td
priority and funding probibms. i
This was the gap that Duqut
said the Universal Health Cart
(UHC) Act sought to close by in.
troducing the health car€
provider network system.
Yet in the UHC'S implement'
ing rules and regulations, mu'
nicipal and component cities
still "retain their existing funct
tions over their respectiv€
health facilities and personnel,'
as provided by the LGC.
What this means is that th€
provincial health board that will
be created for the UHC will ont,
have "superyision, not control'
over health facilities, services
and personnel.
Local officials can also opl
not to pool their resources tc
the special health fund for th{
province. But if they decide sol
they would also be "required td
provide counterpart funding''
for their area.
For now nrrrscs likp Brven

By Jovic Yee
(DjovicyeelNQ
For more than a decade, Bryan,
arurse, had been taking care of
p tients whg had the means to
bc confined almost indefinitely
ir a private hospital.
llut when members of his
larrrily felt iU, Bryan was hard-
prcssed to find ways of paying
[or t lleir hospitalization.
lD fact, he is tied for the next
two years to the Manila hosPital
hc is working for as he pays in
inslallment the remaining
Pqo,ooo bill for one of his two
children who is coping with a
ki(lIlcy illness.
of the total Pgo,ooo bill,
alx)ut P4o,ooo was shouldered
by llryan's employer as Part of
lr is l)enefits.
With just a monthly income
ol little over P2looo, Bryan
sirirl he couldn't afford to have
any of his family of four get sick.
"We're lucky that one of our
bcncfits is that when someone
irr the family gets sick, we are
in
al)lc to set the payment terms
thc hospital. Without that, get-
tilll sick would really be a bur-
dcn. This wasn't what I envi-
si0rrcd when I took up nursing,
whcn there was a promise of
high pay lin the profession],"
s:ri(l Lhc a3-year-old.
Minimum monthly pay
Just a few years ago, Bryan
hird to ask two of his younger
siblings to pool their money for
thc medical costs oftheir moth-
er who twice suffered a stroke.
1'his is why he is pinning his
hopes on President Duterte's pri-
oritizing the Makabayan bloc's
House Bill No. 3478, which sets a
minimum monthly salary of
P3o,ooo for nurses in both public
and piivate hospitals.
The bill runs in line with the
Supreme Court ruling lastweek,
which affirmed that govern-
ment nurses are entitled to a
monthly pay of uP to P3o,ooo,
or about the maximum PaY ot
Salary Grade 15, aacording to
the Philippine Nursing Act of
2oo2 (Republic Act No. 9173).
In their explanatory note,
Makabayan bloc lawmakers
said increasing the salary of
nurses was "long overdue." The
lawmakers include Bayan Muna
Representatives Ferdinand
Gaite, Carlos lsagani Zarate and
Eufemia Cullamat, ACT Teach-
ers Rep. France Castro, Gabriela
Rep. Arlene Brosas and Ka-
bataan Rep. SarahJane Elago.
Another lawmaker, Sen. Cyn-
thia Viilar, said in a Iadio inter-
view on Sunday that the DepaLt-
ment of Health (DOH), in accor-
dance with tlle Supreme Court
ruling, could tap its "unpro-
grammed accoutts" for the man-
dated paY for government nurses.
Pay in SoutheastAsia
When Bryan started his ca-
reer in 2oo9, he had a monthly
salary of P8,ooo. Of the original
4o in his group, only two opted
to stay in the hospital where
they started.
To his knowledge, the mini-
mum PaY now at that hosPital is
around P12,ooo,just a little above
the minimum wage of P1184.
Should the minimum pay be
raised to P3o,ooo, he said that
this may somehow encourage
nursds to stay on, as low PaY
\
NURSES'PLIGHT Nursing graduates take their oath as new
professional nurses. Most nurtured hopes of high pay in the
profession when they took up the course.
had been one of the reasons
why they sought work oPPornr-
nities abroad.
The rates are competitive in
Southeast Asia alone. Thailand
pays its nurses a minimum
P55,93o. The starting salary in
Malaysia is Ps2,ooo. Singapore
offers its nurses nearly Puz,ooo.
Bryan said that even with
the prospect of higher PaY, he
already gave up his goal of go-
ing abroad since in the two in-
stances he did so, "something
bad happens." Case in point was
his mother's stroke.
He would have wanted to
work in a government hospital,
where he saidthe pay was a little
better. But landing a permanent
post wasn't easy if You didn't
have the dght connections.
According to Joy, a nurse in
Bicol, "lt's really hard to get a
permanent position, especially
ifyou donlt know anybody from
FAg€ - Abl
FILE PHoro
-lNQulRER
the inside."
"One fime, there was {an ap-
plicantl who only had a year of
experience, yet was given a per-
manent position even if there
were lothers with more experi-
encel," she said.
Joy accepted a job order, as
the work offer is called, at a ter-
tiary government hospital for a
year, even if the monthly salary
was only P8,ooo-barely half of
the lowest possibld mandated
salaryfor nurses of P19,845-be-
cause her previous employer, a
private hospital, paid her only
about P6,ooo.
'Let's renationalize'
Nurses' organization Fil-
ipino Nurses United said there
should be a "renationalization"
of trealth services, especially
since the current devolved sys-
tem had already led to the
"politicization of health."
I
Even Health Secretary Fran-
cisco Duque III supports calls for
renationalization, after medical
practitioners have observed
over the years how health pro-
grams and sewices become
"compromised" when Iocal offi-
cials do not give them priority.
Under RA 7160, the Local
covernment Code (LGC), the
detivery and promotion of troducing
health services are devolved to
provt[ial and local officials.
"we need to review the Lo-
cal Government Code and see
what its impacts are after I28l
years. we need to do an assess-
ment. Did it do good in the
health outcomes of our peo-
ple?" Duque said.
"This is to me the time. If
there's an indication to rena-
tionalize, let's renationalize," he
added.
ifed-
Duque pointed out that
rrcation wasn't devolved to the
local governments, the more
health services should notbe.
He said there could be better
management of health centers,
especially when it qomes to im-
munization, if health seryices
were the responsibility of the
national government.
if you
"Because right now
would meddle, you would be
told that it's no longer your juris-
diction," the heatth chief said.
Devolution
In a devolved public health
care system, the DOH Procures
medicines and vaccines, but lo-
cal officials are the ones respon-
siblE for distribution of these to
the people.
fDevolrrtion should've also
resJted in better delivery of
primary heatth care as locz
governments can tailor-fit thej
prograins to the needs of th
community.
But this has notbeen the cas
over the'last two decades due t
priority and fu nding Problems.
This was the gap that Duqu
said the Universal Health Car
(UHC) Act sought to close bY ir
the health car
provider network system.
Yet in the UHC'S implemenl
ing rules and regulations, mt
nicipal and component citi€
still "retain their existing fun(
tions over their respecti!
health facilities and personirel
as provided by the LGC.
What this means is that th
provincial health board that wi
be created for the UHc will onl
have "supervision, not contro
over health facilities. servic(
and personnel.
Local officials can also otr
not to pool their resources t
the special health fund for th
provincd. But if they decide sr
they would also be "requAed t
provide counterpart fundint
for their area.
For now, nurses like Brya
andJoy hope that as the goverl
ment aims to provide bett(
health services to the public,
wouldn't forget to look after th
welfare of the people who ar
delivering these programs.
"We should also be givenpr
ority. Right now it feels like $
are not being given imPortan(
even if we're t}Ie ftontliner
They have a lot of budget for tt
things they.want, so it's imposs
ble that they don't have tt
funds for us," Bryan said. -wn
A NEPORT FROM MARLON RAMOS IN