November 18, 2020
Opening Statement of Senator Pia S. Cayetano
Sponsor, Senate Finance Committee Vice Chair
On the proposed 2021 budget of the Department of Health & its attached agencies
Mr. President, it is my honor to take on the herculean task of sponsoring the budget of the Department of Health and its attached agencies, including PhilHealth.
Our country’s people are its biggest resource. Thus their health should be a priority. COVID-19 pandemic has exposed gaps in our country’s healthcare and response system. As we deliberate on our national budget, our vision should be geared towards closing these gaps.
Investments in healthcare should help us build back better, guided by the principles of sustainable development and futures thinking.
This requires that we focus and further strengthen Primary Health Care, pursuant to the principles of the Universal Health Care Law.
These initiatives also form part of the country’s commitments under SDGs, [particularly] SDG 3 (Good Health & Wellbeing).
Mr. President, I thought it wise, and in my interest to save time, I would like our colleagues to take note of some of the facts and data that I will share now because they may be relevant to the questions you may ask. So I will spread it on the record now.
On the COVID-19 Vaccines:
According to the World Health Organization, at least 60-70% of the population needs to have immunity to break the chain of transmission. This means around 65 million Filipinos (60% of our current population) need to be vaccinated.
At present, the Department has identified priority groups of around 24M vulnerable Filipinos, which make up around 20% of our population. This includes frontline health workers, senior citizens, indigent population, and uniformed personnel.
They also have a tier 2 of priority, but this is 20%. Why do I mention 20%? Because as I will explain a little bit more later in the course of interpellation, since we are part of the COVAX, we have the assurance of getting vaccines for 3-20 percent of our population.
So how much do we have to allocate to cover these priority groups? Based on the costing of DOH, we need to allocate at least Php 15 billion if we purchase Aztrazeneca vaccine, which is the cheapest at around Php 610 per person. Or on the other extreme, Php 436.3B for the Sinopharm vaccine, which is the highest priced at around Php 17,690 per person for two doses, while the others fall in between. For the record, may vaccine na ganoon kamahal. The other vaccines fall in between.
Experts recommend that we purchase from various suppliers. Why? Well, given that there may be possible side effects, we would rather spread out our risk throughout the population and minimize the chances that we are all exposed to one particular vaccine and any particular side effects they have. For the record, I am a vaccine advocate. And lahat naman meron, hindi naman ho tayo pwedeng matakot sa side effects, pwedeng masakit ang ulo, pwedeng ano pa man. Normal naman po yun, huwag lang ang masama at malalang side effect.
It cannot be overemphasized that these amounts only cover the cost of vaccines and do not include consumables and other logistics that go into delivering the vaccine to the individual that needs it.
Apart from the vaccines, there are other expenses:
Cold Chain or Supply Chain, which keeps vaccines in tightly controlled temperatures before administered to a person; Training & PPEs for vaccinators; Needles, syringes & other critical equipment.
These are things that have to be purchased in advance, considering that the entire world is also trying to get hold of them during this global crisis.
Take for example syringes. I am told that we do have a manufacturer here in the Philippines in one of our industrial zones. But their entire production is already committed to Japan. So paano? Sayang, ano? We are making it here pero hindi tayo makakuha. I think magiging available daw after six months. So pwede, baka pwede din tayong pumila for that second batch of syringes.
But, there’s also another company that manufactures syringes, and they are waiting for us to communicate and negotiate with them so we can get hold of this most important component in the vaccination process. I don’t think that we have started this process yet, Mr. President.
Further, considering that the DOH may not be equipped to handle the Supply Chain requirements of COVID-19 vaccines, the government should be outsourcing, discussing, negotiating with private companies that are already equipped to handle such vaccines. Wala naman hong masama na magtulong-tulong tayo. Whole-of-society, whole-of-nation dapat ang approach natin.
Meanwhile, aside from the vaccine, there is progress being made in therapeutic medicines that can be used for COVID infected persons. We should also pay attention to this because COVID-19 will not disappear right away. So meanwhile, the development of these therapeutic medicines is also important, and we should continue the ongoing WHO Solidarity Trials for these therapeutic medicines.
As Vice Chair of the Finance Committee handling the budget of our health sector, we have also taken on the task of defending PhilHealth’s budget.
Philhealth has been the subject of many investigations, including the one recently conducted by the Senate. We are cognizant of our fellow senators’ concerns on the need to address PhilHealth’s inefficiencies and alleged fraudulent actions. Nevertheless, we are ready to defend its proposed budget for the next year, with the vision towards the full implementation of the UHC Law to benefit all Filipinos, but mostly those who have less in life.
One of their biggest budgetary needs is the funding of Konsulta – the outpatient package. This representation has been awaiting the roll-out of such a package for years. Health experts agree that a sustainable health system must focus on preventive health care, not a hospital care type of package, which is what Philhealth is all about right now. Preventive health care is not only much cheaper, it is more efficient. Most ailments can be treated with lifestyle modification, possibly medicines and home rest, instead of expensive hospital stays.
But despite my full support for outpatient care, at its present stage, we do not believe that Philhealth is ready to roll out a P68.8-billion plan. Much ground work needs to be done before launching. Instead we recommend pilot testing so that a year from now, Philhealth can present to us more details and we would be in a better position to grant the same
So for the actual budget breakdown:
The budget of DOH (Office of the Secretary) and its attached agencies for fiscal year 2021, with a total budget of Php 212,732,450,000, broken down as follows:
DOH OFFICE OF THE SECRETARY with total new appropriations of Php 136,086,935,000. This is Php 35 Billion higher than the 2020 GAA amount, but Php 25 Billion lower than the adjusted 2020 budget considering Bayanihan 1 and 2.
DOH’s ATTACHED AGENCIES AND CORPORATIONS, including:
NATIONAL NUTRITION COUNCIL (NNC) with total new appropriations of Php 488,021,000
PHILIPPINE HEALTH INSURANCE CORPORATION (PHILHEALTH) with total new appropriations of Php 71,353,360,000
LUNG CENTER OF THE PHILIPPINES with total new appropriations of Php 504,997,000
NATIONAL KIDNEY AND TRANSPLANT INSTITUTE with total new appropriations of Php 1,272,442,000
PHILIPPINE CHILDREN’S MEDICAL CENTER with total new appropriations of Php 1,094,375,000
PHILIPPINE HEART CENTER with total new appropriations of Php 1,787,827,000; and
PHILIPPINE INSTITUTE OF TRADITIONAL AND ALTERNATIVE HEALTH CARE with total new appropriations of Php 144,493,000
Dear colleagues, we hope to continue working with all of you in passing a budget that can support the health needs of our people and plug the gaps, which have also given rise to inefficiencies and could possibly lead to patterns of fraud within the healthcare system.
Maraming salamat. I am now ready to accept questions.