Just another form of pork

It’s the people’s money, so why do they have to beg for it?

Cardinal Pablo Virgilio David’s stinging words against the hefty increase in the Department of Health’s (DOH) budget for indigent patients that can be accessed only through guarantee letters from politicians, might well echo most people’s frustration. Why, and since when have government services become increasingly dependent on proximity to power, they ask.

The Caloocan bishop has spoken out strongly on the P51-billion budget for the DOH’s Medical Assistance for Indigent and Financially Incapacitated Patients program, in the 2026 national budget passed by the bicameral committee over the weekend. The House initially proposed a P49-billion allocation for Maifip but the Senate slashed it to P29 billion. At the bicam, the House panel urged the Senate to restore the cut, warning that the reduction would affect 1.1 million patients because the government’s zero balance billing program is not yet working.

Given the limited space in government hospitals, the increased funding would allow indigent patients to access medical care even in private facilities as long as they secure a politician’s letter of guarantee, justified the lawmakers behind the move.

But why “normalize a system that forces the poor to beg for what they are already entitled to?” the Cardinal said in his Facebook page. “When access to health care, education, or emergency assistance depends on a politician’s endorsement, a guarantee letter, or personal intervention, something deeply wrong has taken root—not only legally, but morally,” the Church leader added.

Electoral votes

As David further noted, such a requirement puts politicians “in control of who gets the assistance, how much, and when,” with health care being provided not as a “right,” but as a “favor mediated by political power—a classic system of patronage that turns illness into utang na loob (debt of gratitude).”

As most election results have shown, such gratitude can easily be converted to electoral votes. Recall how Sen. Bong Go established “Malasakit” centers for medical assistance, a program that could have been a decisive factor in his election campaign, notwithstanding that it was entirely funded by public funds from government agencies.

Without a doubt, the increased Maifip allocation is nothing but a form of pork barrel for shameless legislators. It contradicts a 2013 Supreme Court ruling that declared as unconstitutional the Priority Development Assistance Fund or “pork barrel.” The SC ruling also nullified laws that provided lawmakers with lump-sum allocations to fund their chosen projects, and prohibited the intervention of legislators in the execution of the national budget.

Guarantee letters

The Cardinal’s appeal to members of Congress to “restore dignity where it has been quietly eroded” and “[to] let compassion flow through institutions, not personalities” seems to have found receptive ears in the conference committee. Already, its leaders have intimated that they’d do away with the guarantee letter from politicians. As well, Senate President Pro Tempore Panfilo Lacson has declared that he would not sign the 2026 budget if the committee pushes through with controversial fund allocations, including that for Maifip.

Given the strong public pushback, several lawmakers have proposed alternatives to the Maifip, including funneling the increased funding directly to the Universal Health Care program of the Health department.

Enacted in 2019, the Universal Health Care law aims to provide all Filipinos with access to quality health-care services through automatic enrollment in the state insurer Philippine Health Insurance Corporation (PhilHealth).

PhilHealth, as its implementing arm, should then use these funds to expand its zero billing policy with more government hospitals covered, and more benefits given its members. The House members’ argument that the zero billing policy is not yet effective is such a lame excuse to perpetuate the patronage system that keeps them in power.

Deplorable record

Burdened with a deplorable record over anomalous billings, fraud, and dubious partnerships with private hospitals, PhilHealth must however prove itself worthy of this largesse.

Another suggestion worth considering is how beneficiaries of the government’s Pantawid Pamilyang Pilipino Program program must be automatically considered as “indigent patients,” thus rendering unnecessary the guarantee letter’s endorsement of a patient’s economic status.

Malacañang for its part expressed support for the use of Maifip funds for zero balance billing that would be expanded from 87 DOH hospitals to hundreds of qualified hospitals in local government units. “The funds will not pass through politicians,” Palace press officer Claire Castro said, but “will go directly to the LGU hospitals, with the DOH itself implementing the program.”

Reassuring words those. But unless the 2026 budget is signed without the Maifip funding being made available at the behest of legislators, we’re hedging our bets, and looking to health reform advocate Dr. Tony Leachon’s vow to elevate the issue to the high court otherwise.