In last week’s Yellow Pad column (“Scanning the health legislative agenda,” Oct. 30), we tackled the Executive’s legislative agenda for health. This time, we dwell on the measures exuded from the President’s priorities but which we nevertheless believe are as important and which the Department of Health (DoH) itself upholds.
We acknowledge that the priority bills like the creation of the Center for Disease Control (CD) and Virology Institute, the establishment of a Medical Reserve Corps, and the Magna Carta for barangay health workers (BHW) will help improve our health system and will complement the provisions of the Universal Health Care (UHC) Act.
While the Magna Carta for the barangay health workers will provide additional manpower in the provision of primary care and the medical reserve corps bill will address the need for reserves and quick deployment in case of health emergencies, the bigger problem of workforce supply is not addressed in any of these measures.
In creating the CDC and Virology Institute, we should recognize that an equivalent health human resource (HHR) requirement is necessary. For example, we need epidemiologists to be in the proposed CDC and medical experts for the development of vaccines.
Everyone recognizes the importance of the health human resources. Without them, the achievement of UHC is almost impossible. This is why the UHC law includes a whole chapter solely intended to address the problems related to HHR — from recruitment and retraining, to retention.
We need to expand scholarships, which will include allied and health-related degrees, have return of service agreements with priority given to deployment in underserved areas for three years, and, more importantly, provide the guarantee of permanent employment and competitive salaries. But we have yet to see the effect of the full implementation of these provisions and whether they will actually increase the supply of our HHRs.
The government must, in aid of implementing the HHR provisions, ensure sufficient investment in health human resource mainly with regard to their salaries and benefits. The lack thereof is the main reason cited for migration of our health workforce to other more developed countries especially now that the dollar is strong.
In this light, the increase in sin taxes — alcohol, tobacco, e-cigarettes, and sugar sweetened beverages — gains relevance. These taxes are also known as “health” taxes because they will not only sustainably fund the needs of our HHR and UHC but will also help restrict consumption and thereby lower the incidence of diseases associated with the use of these harmful products. The imposition of these taxes is likewise politically appropriate since the majority of the Filipino population supports said taxes. Surveys bear this out. To date, several bills have been filed in Congress to increase sin taxes particularly on alcohol and e-cigarettes.
The examples above are legislative proposals that policymakers and legislators must support, despite not having been included in the Executive’s priority measure.
We likewise cite other measures that will address HHR concerns. According to Antonio Dans, MD, our government must consider forging a treaty with countries that recruit our health professionals. The goal is to compensate the government for the investment in honing and training our health workforce into capable and dependable workers who serve not our country but theirs. The compensation can then be used to invest in our HHR.
Additionally, we need policies to address airborne transmission of disease. The issuance of Executive Order No. 7 making the wearing of masks voluntary even in indoor settings suggests that the government is indifferent about the issue of airborne transmission. This was issued even though there is no other existing policy on proper air ventilation and other measure that will address COVID-19 transmission or infection. While the Department of Labor and Employment has issued guidelines on ventilation in the workplace and public transportation, we sadly observe that this is not being implemented effectively. There is absence of actual monitoring in workplaces.
The doctors, health professionals, and others believe that addressing airborne transmission will be beneficial in addressing the spread of not only COVID-19 but also other airborne diseases such as tuberculosis (TB), measles, influenza, and the common cold.
We need to have basic safeguards in place like proper air ventilation and masking, principally as businesses, factories, and schools are back to normal operations. Several practical and cost-effective steps can be adopted to protect us from airborne transmission such as the use of CO2 monitors, which are affordable and user friendly. This can be required in schools and workplaces, together with the requirement of door or window opening, among other measures.
Our health problems are complex, and the obstacles are big. But being able to make small changes, like the installation of CO2 monitors, will have a huge impact on our overall health system requirements.
These changes, nevertheless, will have to be translated into policies, including legislation.
While we look forward to the passage of the health priority measures that the President has endorsed, we hope that he and the whole Executive will also give attention to the passage of other equally important health legislations that address the workforce deficit, the increase in health funding through sin taxes, and prevent the surge of illnesses.
Paula Mae Tanquieng, a lawyer by profession, provides legal guidance to Action for Economic Reforms in pursuit of legislative reforms on health.