A Headache Called Aspirin
COMMENTARY
Reprinted from Cebu Daily News, MALAYA Philippine National Daily, The Philippine News (California, national edition), and The Filipino Reporter of New York
Heart to Heart
With Philip S. Chua, M.D., FACS, FPCS
(A Serious Malady Disguised as a Cure)
What is House Bill 4955 about?
Otherwise known as the Medical Malpractice Act of 2002, this house bill was introduced by Rep. Oscar S. Rodriguez of Pampanga, who, very obviously, does not realize that the passage of his bill will make medical care more costly and cause patients all over the country to suffer, most especially the poor. If this bill passes, my "kabalen" will be doing a grave disservice and injustice to the Filipino people. The passage of HB 4955 will lead to poorer quality medical care, force physicians to retire early or abandon the practice of medicine, and cause some hospitals to close or downgrade their services. On the surface, the bill aims to protect the rights of the patients, but its actual implication, realistic meaning and resultant effects will be detrimental to every Filipino. One of the reasons why the cost of healthcare in the United States has escalated to its current ridiculous and untenable degree, holding the patients and their family hostage, is a similar move that resulted in skyrocketing malpractice insurance premium for physicians.
What does HB 4955 seek?
Philippine House Bill 4955 seeks to “criminalize” malpractice of licensed physicians. In other words, if the physician makes any mistake, (even an honest one and even if he/she is the best or a most competent one) in making a diagnosis or treatment, the error will be considered a criminal act, and the physician “shall be punished by prison mayor (imprisonment for 6 months plus one day and up to 12 years) and the cancellation of the license to practice the medical profession and a fine ranging from Five Hundred Thousand Pesos to One Million Pesos in the discretion of the court…” This is too harsh and excessive, not proportional to the error committed. This expectation of perfection and infallibility should be accorded only to God. Physicians are humans and not God, and therefore, imperfect. Also, medicine is not an exact science, and, therefore, there may be several ways to diagnose and manage any given disease or condition. I fully agree that criminal acts should be dealt with severely. Mistakes that should be severely penalized are those made with malicious intent, with greed, immorality, etc. So long as the physician practices within the peer-accepted standard of medical care in the community, he/she should be accorded just and fair treatment under our laws, and not singled out as a profession (like what HB 4955 in effect is doing), depriving licensed physicians equal protection under our constitution. This proposed bill clearly violates the equal protection clause in Article III, Section 1 of the 1987 Constitution.
How will HB 4955 harm the Filipinos?
Besides technology and fashion, etc., events and situations in the United States somehow find their way to the Philippines fast. The author and sponsors of House Bill 4955 have apparently “copied” the idea from the US, where insurance companies and other businesses with vested interest, had vigorously lobbied the Congress the past decades, which ultimately resulted in a prohibitive malpractice environment and the current managed healthcare that the Americans are now (finally, after all those years!) vehemently opposing. Why? Because the proposed bill that they originally thought would protect them and their rights, and improve healthcare at a more affordable price, has since then (after the bill was enacted into law) shown its true color and effects: a very expensive medical care even to the middle class Americans, a poorer quality healthcare, and a lesser accessibility to medical care. Today, the US congress is revisiting these issues because the Americans are angry and up in arms, demanding their congressmen and senators to protect the people and not cater only to the rich lobbyists and businesses, by rectifying the previous grave legislative mistakes.
Don’t we have laws currently in effect to address malpractice?
Yes, we do. We already have adequate laws in the Philippines under the Revised Penal Code to protect the patients against incompetent, erring and criminal physicians. All we have to do is to enforce the existing laws. As a matter of fact, there have been various significant awards in our courts to indemnify the victims and family members of patients on whom medical malpractice was committed. Our laws are effective, if enforced. The passage of House Bill 4955 enacting it into law will be like using a shotgun to remove a cancer from the patient's abdomen. The patient will get severely hurt unnecessarily. HB 4955, if approved and added to what we already have in the books, will realistically not add more protection or benefits for the patients. Instead, it will penalize the patients and their family with more expensive medical care, harder access to physicians and less quality care. Since I have lived in the United States since 1963, and have witnessed this same dilemma plaguing the Americans for years, I “could see” a bleak future for the Philippine healthcare delivery today in my crystal ball, if we repeated the same mistakes the American people and their legislators had made decades ago. We ought to learn from their mistakes to protect our future.
Are many US hospitals really closing?
Yes, many hospitals in the United States are closing, and numerous medical services (like the emergency room and obstetrical care), have been cut down, if not totally abandoned. Many physician specialists have relocated or retired, or have chosen to seek other jobs, because malpractice premiums have escalated to an unaffordable level. Malpractice premium for an obstetrician, for example, could be as high as $200,000 (10 Million Pesos). With a tax bracket of about 50%, that means the physician has to earn $400,000 (20 Million Pesos) to afford to pay for that insurance premium alone, without any money left for the office overhead, and for the physician and his/her family and other personal expenses. President Bush and the American Medical Association blame the cost of medical malpractice as the cause of the current healthcare crisis in the United States. And who would ultimately suffer? While the physician is the first one to directly feel the pain, the ultimate victims are the patients and their children. And once this HB 4955 passes into law, it will hold the Filipinos and the country hostage for a long foreseeable future. It has taken the United States decades to even start to correct its mistakes of the past. The Americans are presently seeking to amend the rules they foolishly passed.
What is the position of the PMA on this issue?
As could be expected, the Philippine Medical Association is gravely concerned and strongly opposes the passage of House Bill 4955 or any similar bill. The allied medical professionals, many business groups, lawyers, community leaders, who are well-informed of the issue and its ramifications, have also joined the band wagon in opposing HB 4955. It is obvious that only the uninformed and misinformed (besides some politicians and people with vested interest and financial gains from the passage of this bill) are the only ones who would like this bill to pass, even if it will cause suffering and pain for our people. This is the reason why our people from the various sectors of our country must unite now and forcefully fight to defeat the passage of House Bill 4955.
Why should Filipinos oppose HB 4955?
Besides making the cost of medical care for the Filipinos much more expensive and less accessible to patients and their family, and will negatively impact on our already deteriorating economy, the proposed HB 4955, in summary, must be defeated en toto (NOT amended) for the following major grounds:
Editor’s Note: This Bill and another similar one were eventually scrapped by the proponents in the Philippine Congress following the numerous organized public rallies held by the various sectors of the medical community and friends in Manila and other major cities.