Medical Schools Rake in Profits – but Health System is in Crisis

There are dire signs that if the exodus of Filipino health professionals continue over the next three years, the Philippine health care system will be in crisis.

By Charles Raiñer C. Marquez
Contributed to

In the past two years, there have been half-a-million students enrolled in about 30 medical schools, 140 nursing schools, 113 midwifery schools and 17 dentistry schools in the Philippines. Every year, around 10 percent or 50,000 of these health students eventually graduate as medical doctors, nurses, dentists and other health-related professionals.

Despite the big number of health professionals produced every year, why is the country’s health system sick?

Latest statistics show that seven out of every 10 Filipinos die without even seeing a doctor. Nearly 75 percent of the population lives below poverty line, most of them in the rural areas. These are the people who have no access to the most basic health and medical care services. Very few of the health professionals produced every year opt to serve the people in the rural areas. Most of them prefer to work in private hospitals or in the cities. A big number eventually work in other countries.

There are dire signs that if the exodus of Filipino health professionals continue over the next three years, the Philippine health care system will be in crisis.

Commercialization, deterioration

Concerned health organizations and other observers believe that part of the reason for the current state of the health system is the increased commercialization of health science amid the deterioration in the quality of health education.

One of the most lucrative businesses today is health science education. Here, only the rich can afford sending their children schools that offer medical, nursing, dentistry, physical therapy and other health sciences courses.

In fact in 2003, six private higher education institutions (HEI) that offered health science courses were listed in the Philippines’ top 1,000 corporations. These HEIs recorded a combined profit of around P537 million. (Please see Table I below this article.) Most of them are owned by Filipino-Chinese taipans.

Among the six schools, the Centro Escolar University (CEU), ranked No.198 and had the biggest equity (assets minus liabilities) amounting to P1.941billion (US$ 34,669,250). The CEU ranked No. 1 among HEIs in 1999 and 2000. The Manila Central University (MCU) in Caloocan City, Metro Manila registered the biggest increase in profit by more than 8,000 percent from 2001.

Another consistent member of the Top 1,000 corporations in the country is the University of the East (UE), which is now owned by Lucio Tan, has campuses in Manila and Caloocan. It ranked 517th in 2003, rising from 867th in 2000 and 935th in 1999. Far Eastern University (FEU) also remained in the list of top earning corporations.

With the high cost of health education, private colleges and universities are priming up to cater to the large number health sciences students for profit. Every year, they accept big numbers of students.

College tuition for a course in medicine ranges from P55,000 to P85,000 for a semester in Metro Manila. Clerkship would entail another P100,000. State universities that are supposedly subsidized like the University of the Philippines (UP) and Pamantasan ng Lungsod ng Manila (PLM), charge P15,000 to P18,000. Nursing and Physical Therapy courses cost at least P25,000 every semester.

In addition, textbooks cost a student around P10,000 – P25,000 per year. Burdening students further are miscellaneous fees, amounting from P5,000 – P15,000. And then there are expenses for medical diagnostic sets and other gadgets.

The high costs of health education greatly influence the values of health sciences students: They now have to set their eyes on working abroad or in big hospitals and companies who offer lucrative income rather than go to the communities where they are most needed.

School owners together with the state Commission on Higher Education (CHED) justify the high cost of health education claiming that it guarantees quality education. Yet their claims are refuted by surveys and studies.

In its Oct. 2002 report, the Asian Development Bank (ADB) warned about the decline of tertiary education in the Philippines in contrast to its reputation during the 1970s as one of the leading education centers of Asia.

Two years earlier, an Asiaweek survey of 77 best universities ranked the University of the Philippines, the country’s premier state university, No. 48. Only three private schools made it to the list. De La Salle University was ranked 71st, Ateneo de Manila University, 72nd, and the University of Santo Tomas, 74th. None of the top-earning schools made it to the list.

The decline in the quality of health education took its toll on the performance of health sciences graduates in board or licensure exams. From 1997-2001, only 25 percent of graduates passed the board examinations for physical therapy and 52 percent for nursing. The highest average passing percentage in licensure exams is in medicine – only 66 percent. (Please see Table 2 below.)

Further compounding the decline in the quality of health education – for that matter, in the whole educational system – is that every year huge chunks of the education budget are sliced in favor of debt payment to the IMF-WB. Debt payment represents at least 40 percent of the national budget. Defense expenditures are prioritized over education, health and other basic services. Furthermore, government bureaucrats are siphoning off the rest of the public fund through graft and corruption. Around P100 million is looted from the public fund by government officials every day, reports show.

Apparently, foreign monopoly capitalists also benefit from the health education system. The current dependence on “technology” inculcated by the western-oriented curriculum benefits the multinational corporations (MNCs) – it is they who produce medical equipment, textbooks, diagnostic sets, and other foreign technology. Under the GATT/WTO and intellectual property rights, cheaper textbooks reprinted in newsprint are no longer allowed.

The Philippine health education remains western-oriented. Most textbooks and knowledge imparted among the health science students are foreign. Because of this, textbooks with Filipino authors are often ridiculed or labeled. Consequently, students are required to pay more attention to diseases and diagnostic procedures that are scarcely found in the Philippines. Instead of studying tuberculosis, malaria, and scabies which are very prevalent in the country especially in the rural villages, there is much emphasis on foreign diseases like Good pasture’s syndrome, Lyme disease, cystic fibrosis or Infectious mononucleosis that are also rarely found in the country. Students are trained on a curative and hospital-based health system – instead of a preventive and community-based one.

Health students are trained for the world workforce market, especially for the United States and other industrialized countries. This adversely affects Philippines health services given the insufficient number of health professionals left in the country.

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