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Two months old infant, afflicted with severe respiratory distress, candidate for mechanical ventilatory support got admitted under my care as a charity patient. Despite the severe respiratory distress, we did not provide mechanical ventilator but instead utilized less aggressive, less expensive and non-invasive nasal continuous positive airway pressure device. Instead of admitting the baby to the ICU, we admitted baby to the regular ward. We intentionally did these, not to shortchange the quality of service the baby badly needs, but to allay the medical bill that the baby will incur. Why, why am I acting as the guardian of this patient? Because I am not only the physician of this baby. I am also a steward as far as his health need is concerned. This baby is already the 3rd child of the mom from 3 different fathers, who works odd job irregularly and not earning regularly and steadily. When I was doing my regular history taking, I asked the mother if she has a medical insurance like PhilHealth for that matter. She said NONE. It was shocking to learn that a single mother, already with three kids, unsteady job, would not prioritize her and her children’s needs.
Nowadays, patients who get classified as charity or service case only avail of a free hospital accommodation and food and free physician’s services. Laboratory tests and medicines are for parents to provide. So what happens if a child with severe asthma would require reliever medicines but has no money to buy them, will she not be given those medicines? Technically, in accordance to hospital policies, YES. But due to compassion of health care providers often, this policy is overruled temporarily such that the child is given the needed urgent medications. But the parents/guardians are asked to buy the replacement prescriptions afterwards. Then the succeeding doses will have to be secured already by the parents otherwise, nothing will be given. Now, what if a boy needs a CT scan to identify he has brain tumor causing him severe headaches, seizures or paralysis, will it not be done if the parents cannot afford it? The answer again is a resounding YES. Unless of course, some donors have subsidized it. You cant blame or take this against this against hospitals, they survive on their own such that dole outs cannot happen. Even government hospitals have already withdrawn their subsidy for a free laboratory test and medicines. That’s the sad state of the health care system in our country.
When I talk to parents of these kids being referred and classified as a charity/service case, I am astonished when I see them holding a cellular phone. Now you might be wondering why on earth am I picking on their cellular phone, their right of communication? Allow me to explain why. The cheapest brand new cellular phone costs at the least 800 pesos. For them to connect, they need to subscribe to telecommunications network, costing them about 20 pesos daily on the average. Sum it up, they spend 600 pesos monthly on the average, or 7,200 pesos for the entire year. On the other hand, voluntary PhilHealth contribution for those who don’t have regular employment or working odd jobs will only force them to stash 100 pesos from their monthly cash, such that they’ll only need 1,200 pesos for their insurance; a 6,000 pesos shy of their communication expenses. Having health insurance usually enable them to have much more benefits, and it might even cover for the entire hospital bill in some cases. It could afford them the medicines and laboratory tests right away when needed. My patient ended up with 65,000 hospital bill at the day of discharge. So how could she afford this staggering amount being a single mom, with odd job, no steady income? I am not belittling her, but I am just underscoring now the importance of securing a health insurance policy to aid her in the future. I also am not saying communication is not that important, it is a basic right and need but given her situation, she should prioritize more her and her kid’s health care needs. I highly wish the mother realizes my “intervention.” Good news is, she sure did. The question is, will she act on it?