MY friend’s grandfather recently had a stroke. His family spent several hours in an ambulance searching for a hospital that had space to admit him. After hours, they found one, but it didn’t have the needed medical equipment. Only one expensive hospital had the necessary equipment and available space, which happened to be a private room. After a week, he recovered enough to be discharged. Here’s the problem: the hospital’s policies apparently dictated that the patient could not be released unless there was full payment of the bill. The bill cost over P300,000. No promissory notes and no installment payment allowed.
The family asked what would happen if they couldn’t pay the entire bill yet, and they were informed that the grandfather wouldn’t be released. He would be allowed to stay in his room, where he wouldn’t be regularly checked anymore except in cases of emergency, but they had to pay the P3,000-plus bill per day of stay. All this, despite the pandemic, which has affected not only health but also finances.
Stories like this give rise to the question on whether policies like that should even be allowed. Of course, we have Republic Act 9439, which essentially makes it unlawful for any hospital to detain recovered patients for reasons of nonpayment of hospital bills. However, this law does not cover patients who stayed in private rooms. Perhaps the legislators assumed that those in private rooms are financially capable of paying six-figures for a few days stay so they were exempted from the coverage of the law, but what was not foreseen was the possibility that there will be emergencies where only private rooms are available, and the choice of a private room was not voluntary.
To the financially privileged, it’s easy to say that people can figure out how to pay bills that big anyway. Kung gusto may paraan. But this is all easier to say in theory. I shared the story to our house helper, and his response was he’d rather die than let his family deal with bills that big. Other responses were more optimistic, saying there are many kind people and government agencies that can donate. But in the case of my friend’s family, they had to borrow money to pay off most of the bill, since the hospital didn’t accept DSWD assistance. Plus, in a pandemic, donating five or six-figures in cash isn’t so easy.
It’s really a take it or leave it situation. It’s so capitalist and so heartless. It may be argued that hospitals have to do this to keep running, and the interests of the patients should be balanced with the financial interests of the hospital. But should monetary interest and a life be balanced in the first place? Isn’t one clearly more important than the other? Anyone with empathy would agree that health care shouldn’t be a privilege anyway. Especially in a pandemic.
These stories give rise to related questions. How much should healthcare professionals, who risk their lives daily, be paid, considering that one patient’s hospital bills for one week can reach over P300,000? Are the current rates proportional?
We can’t place absolutely all the blame on hospitals. Some of them do try to help those in need, pay their professionals well, and are more lenient with company policies to accommodate patients. Maybe hospitals in the Philippines didn’t create this for-profit health-care system and there are bigger factors that resulted to this. Still, whatever the cause, this is how it is right now.
Maybe the “full payment” business model worked in the past, when hospitals had more available spaces and the economy wasn’t down. Before the pandemic, expensive private rooms not covered by the anti-hospital detention law were mostly for those who voluntarily chose those private rooms. The “full payment” model guaranteed payment for the hospitals, and high prices were fit for the intended market that could handle full payment immediately. It was more of a fully consensual transaction where patients could choose hospitals based on financial capabilities.
But today, the model is outdated. With the virus, struggling economy, and packed hospitals, people don’t really have a choice when it comes to which hospital and which room to avail. It’s no longer a purely voluntary transaction: patients are at the mercy of whichever hospital has the space and necessary equipment. There are really only two choices: bear the huge medical bills, or completely forego medical treatment at the risk of losing a life. The factors that were considered in making the business model are no longer present. If anything, the model that used to be relatively appropriate is now arguably exploitative, even if unintended.
Special thanks to my siblings for this piece.
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