Cuba and Philippines: Common Colonial History, Different Gov’t Systems

“We are developing a Universal National System of Health that is accessible and free to all citizens up to the provinces and municipalities,” explained Jimenez. This system is being developed despite the economic blockade that has been imposed by U.S. and its allies against Cuba since 1959.

Cuba has 243 hospitals and 473 clinics which are all government-run. It has 21 medical schools (they had only one before 1959); one International Medical School where they train professionals from Latin America and in the world and one medical school for the Pacific Islands. Its Latin American School of Medicine in Havana has graduated 4500 physicians from other countries, added Jimenez, where the graduates exemplify “high scientific, humanist preparation and ethics that will allow them to act professionally and to be to of service to the neediest sectors in their nations.”

Cuba has been notable for its international health missions. While doctors from former colonies and developing nations are moving to industrialized countries due to very low salaries as well as the absence of benefits and professional development, Cuba has been able to send 100,000 health workers to more than 100 countries since 1963. Jimenez said these international missions constitute “a human feat that the U.S. and Europe could never accomplish as they lack the human capital to demonstrate which human rights they are really defending.”

Philippine health care system

The Philippine government has been reiterating its policy to protect and promote the rights of its people on health. It however remains as lip service with the existing realities and manifestations through different indicators of its health situation.

National Statistics Office (NSO) data as of 1999 show that the infant mortality rate is 54 deaths per 1,000 live births. The doctor-patient ratio is estimated by the Community Health Education, Services and Training in the Cordillera Region (Chestcore) at 1:10,000 to 26,000.

Like the budget on social services, the health budget is a least priority of the government. It is but two percent of the national annual budget which if translated it is only thirty five centavos per day per Filipino. The biggest piece of the national budget – nearly 40 percent annually – has been automatically and systematically appropriated by the national government for debt servicing, depriving Filipinos of funds for social services like health.

The national government passed on its responsibility for health services to the local government units by decentralizing health services. This policy of decentralization was imposed by the International Monetary Fund-World Bank (IMF-WB) as part of its structural adjustment program for Third World countries.

As a result, this policy has pushed local government units to adopt “revenue enhancement schemes” like imposing fees on patients in government owned hospitals. Poorer LGUs (local government units) are left suffering as they do not have the capacity to fund their health services.

Since 1995, when the Philippines acquired membership in the World Trade Organization (WTO) following the Senate ratification of the Uruguay Round of the General Agreement on Tariffs and Trade (GATT) – of which then Sen. Gloria Macapagal-Arroyo was a leading proponent – the Philippine government has embarked on a systematized privatization of most government-owned and -controlled corporations, including health institutions. The move denationalizes state-controlled industries, aggravating the ratio of government to private hospitals which now stands at 1:2.

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