The wretched condition of the public health system was pushed into public view at the onset of the pandemic. Overburdened by yearly budget cuts especially during the Duterte regime, public hospitals bled from lack of equipment and personnel. The nurses, whose number was cut down by at least 7,000 in 2019 due to budget deficit, were offered Php 500 for allowance as volunteers in Covid-19 designated hospitals. The dismal 1:33,000 doctor-patient ratio took its toll as health professionals and Covid-19 and non-Covid patients battled for their lives.

Budget cuts disastrously affected the public health system during the past regimes but more so during Duterte’s reign in favour of the regime’s war chest and the graft-ridden ‘build-build-build’ projects. Health workers relied on private donations—from personal protective gears to hospital equipment as the Duterte regime refused to realign its intelligence and military funds for the use in the fight against COVID-19. Worse, the country relied on imported testing equipment, personal protective gears, including face masks and shields and other hospital needs.

Suddenly, health workers were thrust into a war without armaments, fighting both the virus and the bureaucratic mess and corruption cases that rocked the health department and the Philippine Health Insurance Corporation (PhilHealth) even before the pandemic started.

It was in the 1990s when privatization of the healthcare system was implemented as part of the neoliberal policies imposed by imperialist institutions like the World Bank and the International Monetary Fund. With privatization, health care became a profit-making venture, becoming more costly and inaccessible to the Filipino people, especially the poor. Meanwhile, public health facilities deteriorated under yearly budget cuts while the government and private sectors jointly peddled the line that public services and utilities are better off in the hands of the big business.

The so-called universal health coverage of the government through PhilHealth, aside from being riddled with corruption, has limited patient enrolment and insufficient subsidy, again especially among the poor. In fact, in the countryside, peasants have no access to PhilHealth or hospitals. PhilHealth became not only a milking cow of the corrupt public officials but also of the greedy capitalist hospital owners.

This worsened the impact of the pandemic in rural areas and in remote mountain villages. Even before the pandemic, the public health care has been concentrated in urban centers and almost nil in rural areas. Even without the pandemic, majority of the poor, especially in the countryside die without seeing a doctor. This was doubly disastrous when an ill-conceived balik-probinsiya (back to the provinces) program was implemented, carelessly driving away Metro Manila residents back to the provinces in a bid to ease the already overwhelmed hospitals in the National Capital Region.

Undoubtedly, the government failed to protect the public from the health crisis. The Duterte regime stubbornly delayed barring entry into the country of suspected COVID 19 carriers, and when finally the pandemic hit our shores, it simply left the responsibility to individuals to fend for themselves. It refused to test, isolate, and immediately and properly treat those infected. The national government kept on passing the responsibility to individuals and the local government units without owning up to its accountability in the spread of the virus and its impact on the already beleaguered Philippine economy. ###