Healthcare Gone Awry. Dissecting the Hospital Detention Law

The Right to Health of everyone is guaranteed both in international conventions and domestic laws. However in spite of these state guarantees and conventions, quality and affordable healthcare remain elusive for Filipinos.

Suffering from prolonged labor, Marites was admitted in Bukidnon Provincial Hospital in Maramag on the 12th of July in 2007. She was then pregnant with her 7th child. Without sufficient finances to settle hospital obligations, Marites and her baby still remain admitted almost a month after she was hospitalized. Marites was just among the 18 patients who lay languishing in carton mats in a ward resembling an unsanitized and cramped detention ward in the Bukidnon Provincial Hospital in August of 2007.

Under the Republic Act No. 9439, popularly known as the Hospital Detention Law, patients without the financial capacity to settle their hospital obligations but has fully or partially recovered are allowed to leave the hospital or medical clinic upon the accomplishment of a promissory note. The promissory note covering the patient’s hospital expenses should be guaranteed by a mortgage or a co-maker who will be similarly held liable for the unpaid hospital dues. The Hospital Detention Law, however, does not apply to patients who opted for private rooms, thus prioritizing indigent patients.

As the Hospital Detention Law gained praise for its pro-poor principles, its passage threatened hospital owners as well as doctors and nurses. The Private Hospitals Association of the Philippines (PHAP) began publicly airing their opposition to the law. PHAP argued that without the payments from
hospital fees, the funds of hospitals will not suffice for medicine and equipment expenses as well as the salaries of hospital employees. With these arguments, PHAP threatened to conduct a nationwide Hospital Holiday in which PHAP member hospitals will close down two to three times a month except for the emergency ward. The Hospital Holiday will continue until 2008 or until the law is amended or a reasonable Implementing Rules and Regulations (IRR) are formulated. The Department of Health (DOH) responded to the appeals of PHAP, Undersecretary Alexander Padilla invited PHAP in the formulation of the Implementing Rules and Regulations of the Hospital Detention Law. DOH Secretary Francisco Duque III also contested the arguments of the possible decrease in the private hospitals’ profits, saying that these hospitals are actually receiving sufficient funds from PhilHealth, 70% of PhilHealth reimbursements go to private hospitals, only 30% was reimbursed to government hospitals.

While sincerely attempting to resolve the accessibility and affordability issues of health care, the passage of the Hospital Detention Law, has just merely transferred the state’s obligations to the private sector. Patients are then forced to make out-of-pocket payments, driving them to the mercy of private hospitals that are charging fees beyond the patients’ financial means.

Until comprehensive and systematic reforms in the various aspects of the healthcare system in the Philippines are implemented, the passage of the Hospital Detention Law will only remain a symbolic gesture of the state’s attempt to fulfill its Right to Health obligations to the Filipinos.