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 Bulatlat
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. Bulatlat
Table 1:
SCHOOLS IN TOP 1,000 CORPORATIONS (2003) |
School |
Rank |
Profit
(in P’000) |
% change
from 2001 |
Equity
(in P’000) |
Centro Escolar
University |
198 |
240,206 |
7.4 |
1,941,478 |
Far Eastern
University |
272 |
155,793 |
50.8 |
814,781 |
University of
the East |
517 |
63,262 |
(0.4) |
690,145 |
Manila Central
University |
785 |
30,735 |
8,231 |
111,315 |
Cebu Doctors
College |
845 |
26,734 |
68.1 |
352,516 |
Velez College |
987 |
20,256 |
10.2 |
50,746 |
Source: Top Moneymakers, Graphic
December 2003 issue US$1:PhP56 |
Table 2:
Average Passing Percentage in Licensure Exams
1997 – 2001 |
COURSE |
% |
Accountancy |
18.40 |
Chemical
Engineering |
39.40 |
Civil
Engineering |
30.00 |
Electrical
Engineering |
38.80 |
Electronics &
Communication Engineering |
48.20 |
Mechanical
Engineering |
41.00 |
Dental Medicine |
31.00 |
Medicine |
66.40 |
Nursing |
52.00 |
Occupational
Therapy |
60.40 |
Physical
Therapy |
25.40 |
Source: Professional Regulatory
Commission |
Sources:
Bulatlat.com
National Union of Students of the Philippines (NUSP)
Health Students’ Action-NCR
About the author
Mr. Charles Raiñer C. Marquez is the National President of Health
Students’ Action, a mass organization of health youth and students
catering national and international health issues and also renders
socio-civic works like medical missions and health training programs to
impoverished communities.
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