Affordable and Quality Healthcare

Poor are treated as consumers and given the dignity of buying and choice

Affordability:  Affordable word-class products and services for all people including the poorest of the poor.  The poor are treated as consumers and given the dignity of buying and choice.   

Reforms are needed to improve the quality of care and the experience of consumers of healthcare products and services.

The same quality and quantity at 1/10th, 1/20th, 1/50th the price.  Those are the kind of innovations and reforms that are needed if we are to achieve breakthrough innovations. Below are just some of the things that has been quite successfully done in India, something we can definitely learn from

Aravind is able to offer eye surgeries for US$30 or less than PhP1,500.  Philhealth pays PhP 16,000 per surgery.  No wonder, PhilHealth is spending so much more than it should and some health practitioners are taking advantage of the system.

The cost of ECG can be quite expensive and the majority of those who needs the test simply just can't afford it in the Philippines.  In India, the service is brought to the homes and cost less than $2 or PhP100.

345,000 babies are born premature in the Philippines every year.  Families who could afford pay a lot of money for the use of infant incubators.  For most families however, they simply try to just do whatever they can and hope the infant will survive.  With the infant warmer it will cost around PhP 1000 to provide incubation and in addition the bond between the mother and child is not interrupted.

It's amazing what they are able to accomplish at Narayana Health.  We need to somehow attempt to replicate their success for your countrymen.

Sendong 2011 Revisited:

When typhoon Sendong or international code name Washi devasted parts of Cagayan de Oro and Iligan City, it left us with images of suffering and human drama that gripped the nation and the world.  A simple Google search brings a flood of emotions of human suffering & sacrifices captured in photos as if frozen in time.  My brother, his wife and two children were living at the heart of the affected area very close to the Bell Church.  At around past 10 pm he was heading downtown to bring some pillows and blankets for friends staying at a chapel for the night due to flooding in other parts of the city, when he saw the level of water drastically rising.  He hit reverse and pulled inside the gate. As he was closing the gate, he realized that many of the neighbors in single story houses and huts might be in trouble if the flooding continues.  He got his wife and kids to the second floor of their rented apartment while he went around and woke up the neighbors to warn them of the pending danger.

In matter of minutes and in darkness the neighbors piled into their apartment as the waters continue to rise and the rushing waters covered the second floor.  They tore up a portion of the roof and the families seeking shelter with them were slowly lifted into the slippery roof, drenched and shivering. Fortunately,the roof managed to hold with even over three dozen people were on it.  They took on all who seek refuge, knowing quite well that the entire structure could come crumbling down.  For the next 5 hours they waited it out, hearing the initial cries and pleas for help from the surrounding houses in total darkness and the pall of death in the community permeating the night as the cries for help disappeared.  The rest is history, morning brought light and finally rescue boats, but they had to push their way through bodies of the dead.  They were the fortunate ones while a couple thousand others perished.

Is it possible to get some sort of a report on how scare resources were allocated and used to benefit the affected families and communities for both major catastrophes? 

Not sure if the failures in the rehabilitation efforts for Sendong still carries weight to many people other than those who were directly affected.  If anything, the lack of vision and the pwede na mentality in the administration validates that in a growing where the poor are left behind, the victory and claimed successes is shallow at best. 

Food Security

In 1973, just one year after Ferdinand Marcos declared martial law, as a young six (6) year old boy I remember lining up with my mother to buy government rice. The NFA we know now was then the National Grains Authority (NGA). The lines were long, the sun was intense, the air humid, my face and shirt soiled from sweat and dust, the wait seems to last forever, the people were grumbling and exhausted. It was miserable. To add to the unpleasant memory, when cooked you can taste the smell of old stale NGA rice; the stench lingers in your mouth and nostrils. We lived in Quezon City then, along Mayon St. very close to Welcome Rotunda. That was 1973, fast forward thirty-five years later, another familiar national rice crisis in 2008.

“Revisiting A 35-Year Old Problem”

MONDAY, MARCH 23, 2009

In 1973, just one year after Ferdinand Marcos declared martial law, as a young six (6) year old boy I remember lining up with my mother to buy government rice. The NFA we know now was then the National Grains Authority (NGA). The lines were long, the sun was intense, the air humid, my face and shirt soiled from sweat and dust, the wait seems to last forever, the people were grumbling and exhausted. It was miserable. To add to the unpleasant memory, when cooked you can taste the smell of old stale NGA rice; the stench lingers in your mouth and nostrils. We lived in Quezon City then, along Mayon St. very close to Welcome Rotunda. That was 1973, fast forward thirty-five years later, another familiar national rice crisis in 2008.

Rice shortages and spikes in prices is a recurring issue (except for some time starting from 1977 to 1978 as claimed under DA Sec. Arturo R Tanco Jr. with the Masagana 99 program). Severe droughts, natural calamities, inflation of commodity and energy prices, major currency depreciation and severe economic slowdown can trigger a rice crisis at any given time. The recent 2008 rice crisis is a sign of even worsening condition, habitual government failure even made more pronounced with a rapidly growing population. To stem the crisis, it cost the government billions paid to foreign suppliers for rice sold at subsidized prices.

Sadly, in the process of saving face for an administration unable to secure the most basic of food staples, there were widespread complaints that a significant chunk of the supply ended up in the hands of private profiteers. Many pro-poor sectors lamented that they were unable to buy or had very limited access to subsidized rice due to politically driven considerations and National Food Authority’s inefficient distribution schemes.

“Looking to Joseph of Egypt For Perspective”

To achieve long-term food security, we have to think out of the box.

Let us revisit the story of Joseph of Egypt, one to the twelve sons of Jacob. His jealous brothers sold him to slave traders on their way to Egypt. Falsely accused, Joseph was imprisoned where he demonstrated to his fellow inmates, in particular the Pharaoh’s cup bearer that he was able to interpret dreams with divine help.

We read that around that time, the Pharaoh of Egypt had a dream where seven (7) thin cows ate the other seven (7) fatted cows. In a second dream, seven (7) thin ears of corn ate the other seven (7) full ears of corn. The dreams distressed the ruler and he wanted to know what they meant.

After all the wise men and magicians in Pharaoh's court failed to interpret the disturbing dreams, the wine taster told Pharaoh that Joseph might be able to interpret the dreams. Again, with divine help Joseph interpreted the two dreams to be the same dream. The interpretation is that after seven years of plenty, seven years of famine will follow.

Unable to find anybody wiser than Joseph with the foresight to implement the storage program and prepare for the seven years of famine, the Pharaoh appointed Joseph to the to the second most powerful command in Egypt to undertake the food storage initiative. Joseph then proceeded to execute the storage program. He saved Egypt and his family from starvation when the seven years of famine came.

Let us fast forward to 2009. The administration has announced the government's planned increased spending to boost agricultural production. Assuming the funds for the FIELDS program is fully used as intended; it is the step in the right direction. However, as far as long-term food security is concerned, it is bound to fall short. There is no security in simply being able to have enough rice from one harvest to the next and a 120-day buffer.

In addition to FIELDS, what we need is a comprehensive food storage program. We need to empower the consumers to establish food security in their homes regardless of the continuing failure of the Dept. of Agriculture and the National Food Authority.

How do WE accomplish these? Yes, we are part of the solution. First, how do we get the people involved? Second, rice is perishable and susceptible to moisture, oxidation, rodents and storage issues. What is the solution? Is there a silver bullet? The answer is simple. Extend the shelf life of white rice.

“National Food Storage Build-Up: As If We Are Preparing For An Extended Three-Year War, Even If We Do Not Anticipate A War”

We need to approach solutions to long-term food security, with the same vision that Joseph of Egypt had. Not necessarily preparing for a seven-year famine, but we need to be ready for extended natural, man made economic and political disruptions.

In 2005, we had an American family friend that was taking back his family to the US after a two-year assignment here. He wanted to leave his food storage that his family has accumulated over the years. They it brought over when they first moved to the country.

His stockpile consisted of gallon size canned grains, cereal, peanut butter, wheat, powdered scramble eggs, beans, powdered milk, etc. The can of peanut butter was dry like powder, once opened that’s when you need to mix in the oil to make peanut butter.

One of the canned items caught my undivided attention. It was canned uncooked white rice. Even more surprising to me at that time was reading that they canned those in 1990, some 15 years prior. He gave the canned items to some friends. When cooked the recipient said the rice was good or even better than the rice that they buy from the store.

Imagine that, high quality 15-year old rice. Actually canned white rice can be stored for up to 30+ years.

With the experience, it occurred to me since then that any family, community, region, or country can achieve food security with a well-planned food storage program built-up over time. Families with significant food storage are better able to deal with family crises such as job loss, death of the main wage earner, food shortages, temporary price inflation, trade embargo, natural calamities and God forbid acts of war.

“Public, Private and Government Joint Effort”

Implementation has to be a joint effort but the bulk of the storage has to be at the family level, in the individual homes. The different stakeholders including the farmers, NFA, NGO, traders, community groups, religious organizations, and individual families will have to be involved in the canning and storage at different levels and scale, as they deem appropriate. The effort should be a sustained ongoing process in the years to come.

For example, if a family can set aside a gallon of canned rice each week, their home rice storage would look like this in 5 years:

Year 1 = 52 gallons - 156 kls. - 3 sacks @ 50 kls. each
Year 2 = 104 gallons - 312 kls. - 6 sacks
Year 3 = 156 gallons - 468 kls. - 9 sacks
Year 4 = 208 gallons - 624 kls. - 12 sacks
Year 5 = 260 gallons - 780 kls. - 15 sacks

Knowing that there is food for the family, a mother can feel some level of security during unforeseen temporary or prolonged times of difficulty.

“Use Local & Imported Rice To Accelerate Storage Build-Up”

The sourcing of rice for canning and storage would come from local production and importation while we are still able to buy rice from foreign sources. After all, the Philippines had been a net-rice importer for the past 20 years. Farmer cooperatives have been asking the government to buy rice at P19 per kilo. If farmers start canning a portion of their own produce, they can sell rice at a premium directly to the consumers for storage purposes as a value added product.

Having identified a path to long term food security for rice, this serves as a take off point to include other staples and basic daily food items.

Contractual (Endo) Workers: Individual Retirement Account

Since 1978, in the United States they have a defined contribution plan that allows employees to make pre-tax contribution to an Individual Retire Account or commonly called 401k.

Contractual workers would greatly benefit from a similar arrangement.  This would be in addition to the SSS benefits of the contractual employee. An IRA or an Individual Provident Fund can partially supplement the lack of benefits inherent to labor contracting.

See also: http://newsinfo.inquirer.net/598582/worker-hired-fired-every-5-months

Savings for the Poor: Eradicate 5-6 Lending

Similar to the program of PM Modi of India called MUDRA short for Micro Units Development and Refinance Agency, the Philippines can also do the same to address the needs of the poor families and entrepreneurs.

Banking Reform: Micro Saving and Loans

Most individuals have been excluded from the benefits of formal banking system. Therefore, they never had access to insurance, credit, loans and other financial instruments to help them establish and grow their micro businesses. So, most individuals depend on 5-6 from local money lenders for credit. The loan comes at high interest and often with unbearable conditions, which make these poor unsuspecting people fall in a debt-trap for generations. When businesses fail, the borrowers become vulnerable to the lender’s strong-arm tactics and other forms of humiliation.

Clearly, the potential to harness and nurture these micro businesses is vast and the government recognises this. Today, this segment is unregulated and without financial support or cover from the organised financial banking system.

The principal objectives of the Bank are:

1.   Regulate the lender and the borrower of microfinance and bring stability to the microfinance system through regulation and inclusive participation.

2.  Extend finance and credit support to Microfinance Institutions (MFI) and agencies that lend money to small businesses, retailers, self-help groups and individuals.

3.  Register all MFIs and introduce a system of performance rating and accreditation for the first time. This will help last-mile borrowers of finance to evaluate and approach the MFI that meets their requirement best and whose past record is most satisfactory. This will also introduce an element of competitiveness among the MFIs. The ultimate beneficiary will be the borrower.

4.  Provide structured guidelines for the borrowers to follow to avoid failure of business or take corrective steps in time. The Bank will help in laying down guidelines or acceptable procedures to be followed by the lenders to recover money in cases of default.

5.  Develop the standardized covenants that will form the backbone of the last-mile business in future.

6.  Offer a Credit Guarantee scheme for providing guarantees to loans being offered to micro businesses.

7.  Introduce appropriate technologies to assist in the process of efficient lending, borrowing and monitoring of distributed capital.

8.  Build a suitable framework  for developing an efficient last-mile credit delivery system to small and micro businesses.

Major Product Offerings

Borrowers will be classified into three segments: the starters, the mid-stage finance seekers and the next level growth seekers.

Three loan instruments:

1.    Starter: covers loans upto PhP 50,000/-

2.    Sustaining: covers loans above PhP 50,000/- and upto Rs 500,000

3.    Growing: covers loans above PhP 500,001 and up to PhP 1,000,000

Initially, sector-specific schemes will be confined to “Land Transport, Community, Social & Personal Services and Food Product sectors”. Over a period of time, new schemes will be launched to encompass more sectors.

The Offerings will also include:

1.    ATM Card

2.    Portfolio Credit Guarantee

3.    Credit Enhancement

Women & Children at Risk

Strong Families - Matatag na Pamilya

Secrets to Filipino Greatness: 

1) Secure & Strong Family 

2) Waste-Free Government 

3) Break through solutions 

4) Do more, do better, with less!

Political Dynasties: Darkness' threatening PH democracy, ex-CJ Puno Warns

By: FPJ

A foreigner friend recently commenting on the state of Presidential politics in the country, stated "For anybody to be seriously considered by main stream media (newspapers, radio, and television stations) you have at three qualifications:  1) You have to be a convicted plunderer, an alleged plunderer, or come from a family of plunderers. 2) You need to have the support of senators, congressmen, governors, mayors, etc, paid reporters, journalists & judges.  3) You need to have your own political party, business backers, sports celebrities, actors, actresses and most importantly money to spend.

Agriculture Left Behind: Investing in People and Innovation

Agriculture is the back bone of our economy, the strength of the nation.

11 million people or a third of the manpower involved in agriculture are among the poorest in the Philippines.  

Investing in people and innovation is key to stronger families and food security.

The Philippines imports 99% of it's milk requirements.  Establishing the milk industry similar to the approach that was a huge success in India will make a significant difference in the lives of the ordinary farmers.

Establishing a nationwide semen banking and a comprehensive full access artificial insemination program can upgrade the quality of livestock and the quality of life of the ordinary farmers.