wrote in his column “Pinoy Kasi” in thePhilippine Daily Inquirer on September8, “The suicide rate in the Philippines isrelatively low compared <strong>to</strong> other countries’.This is explained by the fact that the countryhas a Catholic majority population. Althoughmost major religions look negatively atsuicide, the Catholic Church tends <strong>to</strong> be themost judgmental, with threats of eternaldamnation and some Catholic priestsrefusing a church burial.”But as <strong>to</strong> cases of depression, theWorld Health Organization, says otherwise.The Philippines has the highest incidence ofdepression in Southeast Asia. In 2004, therewere over 4.5 million cases of depressionreported in the country and 3 per cen<strong>to</strong>f Filipinos were clinically diagnosed asdepressed. However, of the 90 depressives,only 30 will seek help. The other 30 willsuffer the symp<strong>to</strong>ms but will be ashamed <strong>to</strong>seek help because of the stigma associatedwith the illness. These symp<strong>to</strong>matics wouldrather keep it <strong>to</strong> themselves and suffer inpain and in silence. The other 30 will sufferthe symp<strong>to</strong>ms not knowing what is wrongwith them.Knowing what depression is allabout is already a big step in managingthe illness. There is an urgent need <strong>to</strong>empower individuals suffering from theillness with resources, professional helpand organizational linkages that can opennew doors and bring light in their journeyof suffering and pain <strong>to</strong> that of positive selfdiscoveryand well-being. The families andfriends of people suffering from depressionare equally important and they need <strong>to</strong>know and understand the illness <strong>to</strong> enablethem <strong>to</strong> respond and provide constructivesupport <strong>to</strong> their loved ones during thesedifficult times.On September 9, a day ahead ofthe World Suicide Prevention Day, the <strong>DOH</strong>joined the Natasha Goulbourn Foundation- a non-government organization thatadvocates for better understanding ofdepression, in several activities targeting theyouth in leading schools and universities,particularly holding lectures and discussionson depression and suicide.6 PhilHealth Schemes and ThingsOne of the two health issues thatmade it <strong>to</strong> the second State of the NationAddress of President Benigno S. Aquino IIIon July 25 is the enrolment <strong>to</strong> PhilHealth’sThe Department of Health and PhilHealth advise all eligible Filipinos <strong>to</strong> enrol in the national socialhealth insurance program and use their benefits. (Pho<strong>to</strong> from PhilHealth)insurance program of 5.3 million poorfamilies identified in the Department ofSocial Welfare and Development’s NationalHousing Targeting Survey for Poverty Reduction(NHTS-PR). (The other health issue isimmunization which the President utteredtwice in passing.) PhilHealth enrolmentand its consequent utilization of benefitsby indigent families are considered thecenterpiece of the Aquino Health Agenda’sKalusugan Pangkalahatan (universalhealth care) within three years. That’s byJune 2013 already, and time is ticking fast.Effective September 1, the <strong>DOH</strong>and PhilHealth implemented the case ratesscheme for in-patient treatment of 22common medical and surgical conditions.Simply put, Health Secretary Enrique T. Onasaid that this scheme is akin <strong>to</strong> a “pakyaw,”or wholesale system where all the fees arefixed, but for 22 most common cases onlyand not for all types of cases which willbe paid directly <strong>to</strong> both government andprivate hospitals and clinics.The case rates payment covers:dengue 1 (P8,000); dengue 2 (P16,000);pneumonia 1 (P15,000), pneumonia 238 HEALTHbeat I <strong>No</strong>vember - <strong>December</strong> <strong>2011</strong>
(P32,000); essential hypertension (P9,000),cerebral infarction cerebro-vascular accidenthemorrhage 1 (P28,000); cerebro-vascularaccident hemorrhage 2 (P38,000); acutegastroenteritis (P6,000); asthma (P9,000);typhoid fever (P14,000); and newborn carepackage in hospitals and lying-in clinics(P1,750).On the other hand, the surgicalprocedures include radiotherapy (P3,000 persession); hemodialysis (P4,000 per session);maternity care package (P8,000) coupledwith the normal spontaneous delivery (NSD)Package in Level 1 (P8,000) and Levels 2<strong>to</strong> 4 hospitals (P6,500); caesarian section(P19,000); appendec<strong>to</strong>my (P24,000);cholecystec<strong>to</strong>my (P31,000); dilatationand curettage (P11,000); thyroidec<strong>to</strong>my(P31,000); herniorrhaphy (P21,000);mastec<strong>to</strong>my (P22,000); hysterec<strong>to</strong>my(P30,000); and cataract surgery (P16,000).This is much different from the originalscheme of PhilHealth which was <strong>to</strong> payfor services where rates were based on thecategory of hospital, length of stay at thehospital, kind of illness and complications,among others.An added feature <strong>to</strong> the new caserates scheme is the “no balance billing forNHTS-PR PhilHealth members admitted ingovernment hospitals for these conditions.This is why Ona encourages indigents <strong>to</strong> go<strong>to</strong> government hospitals instead because thescheme does not cover private hospitals.The Private Hospitals Associationof the Philippines (PHAP) was up in armsover new regulations and warned thatpatients’ bills would go up. They alsothreatened <strong>to</strong> remove themselves from thelist of PhilHealth-accredited hospitals.In an ABS CBN news report, Dr.Rustico Jimenez, PHAP president, was quotedas saying, “Ang dengue, tests pa lang ubos naang P8,000. Paano pa yung professional feesng mga duk<strong>to</strong>r? Ang tatamaan ni<strong>to</strong> yungordinaryong tao.”<strong>DOH</strong> and PhilHealth maintainedtheir position saying that they have <strong>to</strong> puta ceiling on payments <strong>to</strong> protect the fundsof members and ensure hospitals do no<strong>to</strong>vercharge.Also in September, the <strong>DOH</strong> andPhilHealth announced its public-privateinitiative <strong>to</strong> encourage more people <strong>to</strong>become part of PhilHealth and <strong>to</strong> assistPhilHealth in improving its services.Members are now entitled <strong>to</strong> discounts formedicines and other health services in someparticipating pharmacies and shops.5 Plight of the ‘Nightingales’In <strong>December</strong> 2010, Dr. LeahPaquiz, founding president of “Ang Nars”<strong>to</strong>ld ABS CBN “Bandila” that the governmentshould look in<strong>to</strong> the practice of hospitalsthat require registered nurses <strong>to</strong> pay fortheir training. She revealed, “Nag-o-onthe-jobtraining (OJT) volunteerism, sila paang nagbabayad, tapos ‘yung certificate,hindi naman po siya qualified magingemployment certificate.” Paquiz also saidmore than 500,000 nurses in the country areeither jobless or underemployed.The news report also showedinterviews of partly-hidden nurses narratingtheir sad plight and showing proofs ofpayment they made as volunteer nurses inundisclosed hospitals.On the other hand, GMA newsreported Dr. Rustico A. Jimenez, presiden<strong>to</strong>f the 600-member Private HospitalsAssociation of the Philippines (PHAP), assaying his organization has asked volunteernurses and their supporters <strong>to</strong> showevidence so they can investigate the issue.He said, “If we cannot see any written proofsuch as receipts or contracts, we cannot actaccordingly,” Jimenez said. “We want <strong>to</strong> seecontracts that say nurses were made <strong>to</strong> workin a hospital and yet were even asked <strong>to</strong>pay instead of the hospitals paying for theirservices rendered.”Nevertheless, in the first halfof January, the legisla<strong>to</strong>rs were quick<strong>to</strong> investigate the sad plight of nurses,particularly on some OJT nurses who arereportedly made <strong>to</strong> pay between P5,000 <strong>to</strong>as much as P10,000 for their certification inthe course of their “training period” or “workexperience” with a hospital, which may lastfrom 6 weeks <strong>to</strong> 8 months.On January 17, the Department ofHealth, in coordination with the Departmen<strong>to</strong>f Labor and Employment (DOLE) andthe Department of Social Welfare andDevelopment (DSWD), announced the star<strong>to</strong>f recruitment of 10,000 registered nursesfor its “RNheals” program. RNheals, anacronym for Registered Nurses for HealthEnhancement And Local Service, is expected<strong>to</strong> address the shortage of skilled andexperienced nurses in 1,221 rural and farflungcommunities.Nurses would undergo trainingand development, and a certificate ofcompetency and employment will be givenby the <strong>DOH</strong>, DSWD, and the ProfessionalRegulation Commission – Board of Nursing<strong>to</strong> those who will satisfac<strong>to</strong>rily completerequirements. While on deployment, thenurses would be given an allowance ofP8,000 a month by the <strong>DOH</strong> while the localgovernment unit where they are assignedshall supervise them, ensure their safetyand security, and provide modest boardand lodging. LGUs were also encouraged <strong>to</strong>provide additional allowances and benefits<strong>No</strong>vember - <strong>December</strong> <strong>2011</strong> I HEALTHbeat 39