Economic DisparityTori Johnson

One of my favorite experiences from our

trip was the day I spent in the

emergency department at

Jose Reyes Memorial Medical Center.

As I helped to transport a patient from the ER to another department, the nurse I was shadowing

explained the basics of the Filipino healthcare system to me.

He really wanted me to understand that he was proud of his country, his profession, and the

hospital, but he still hoped for many things that would make his patients more comfortable and

his life a little easier.

A developing country, the Philippine economy is in the midst of a transition, from an economy

based on agriculture to one based on services and manufacturing.

While their standard of living is improving, there are still issues of poverty and overpopulation.

With these issues in mind, it should not come as a surprise that their healthcare system is constantly

improving itself. However, there is still major disparities in supplies, medications, and staff.

Like the US, various health facilities care for the health needs of Filipinos. There are government run

hospitals, as well as privately owned hospitals.

The following presentation represents our experiences in government hospitals. The information may not be

relatable to private hospitals.

Government-run hospitals provide healthcare the same way private hospitals do. The main differences

are the facilities and technologies offered. Most of the public hospitals would not be equipped to the same

standard as the private ones.

Government run hospitals run on

“skeleton budgets”: they cannot put money towards

supplies and medications if they

won’t get money back. Therefore, they are

not able to keep many medications and supplies in stock. There are some

available, in case of an emergency.

Patients have to pay for medications out of pocket and supplies are used

sparingly by staff.

For example, gloves are not easy to come by. Sometimes staff may use just one glove or forgo gloves, whereas in

the US we use gloves constantly throughout the day.

Also, if your family member needed a medication, you would have to go down to the pharmacy, pay for it and bring it

back to the unit. In the US, the medications would be prescribed, the nurse would pull them out of a Pyxis

(medication dispenser) and they would be charged to your account.

In the Jose Reyes ER…EKG machine was missing pieces and we had to

search high and low for paper

Drainage tubes are old-fashioned, using glass jars and tubing. They still work well but are not as safe.

Wheelchairs are old and have been rigged to work well but are not comfortable. Same goes for beds. The beds in the ER, and in many other units, were

merely stretchers with mattresses on them. Not only are they uncomfortable but they are not made to be

adjusted for height or easy maneuvering.

The Philippines

Jose Reyes followed a fee-for-service payment system; Includes basic physician consultations, diagnostic tests, and drugs prescriptions

It keeps track of which departments a patient visited and which treatments they received

Before the patient leaves the hospital, they visit each department, as well as the finance department, to settle their accounts.

Most of the time, payments are made out of pocket, or the finance department works with social services and charities to make it work.

The United States

Hospitals cannot deny any treatment. However, services provided are not free and all of the treatments/consultations are charged to the patient’s account.

The patient’s account holds prescribed consultations, prescriptions, and therapies.

Patients are able to be discharged without paying, though payment plans are set up to cover the costs, usually those leftover from what health insurance covers. If the patient does not have health insurance, then…

As payments do not have to be made at the time of service, patients are able to budget in the cost of their experience at the hospital.

Their system is different than the US payment system. – Healthcare in the Philippines is affordable, if you have

the money.• If you are of an upper class, you are able to afford any

treatment, medication, and can even have a semi-private or private room.

• However, if you are of a middle or lower class, which accounts for a large amount of the Filipino population, then you will have trouble accessing what you need to improve your health. Example: burn unit

• Next time you’re at the hospital or your doctor’s office, keep a positive attitude, because somewhere in the world, someone does not have the same access to healthcare as you do.