This story
was taken from Bulatlat, the Philippines's alternative weekly
newsmagazine (www.bulatlat.com, www.bulatlat.net, www.bulatlat.org).
Vol. IV, No. 51, January 23 - 29, 2005
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 Goodpasture’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: |
||||
School |
Rank |
Profit |
% change |
Equity |
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: |
|
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.
© 2004 Bulatlat ■ Alipato Publications
Permission is granted to reprint or redistribute this article, provided its author/s and Bulatlat are properly credited and notified.