In Unilab, power matters a whole lot
BY AMADO P. MACASAET
AFP ‘pabaon’ scandal and health
A.G ROMUALDEZ JR., M.D
‘George Rabusa may well have become the savior not only of the Armed Forces but possibly the entire Philippine bureaucracy.’
LT. Col. (ret.) George Rabusa may well have become the savior not only of the Armed Forces of the Philippines but possibly, if his supporters (handlers, classmates, friends, benefactors, admirers, etc.) pursue his testimony to its ultimate logical conclusion, the entire Philippine bureaucracy. His decision to detail the web of corruption in the nation’s military establishment will hopefully shock those of his comrades who have suffered in silence the atrocious effects of high-level corruption to speak out and finally lay bare a conspiracy that has robbed our brave fighting men of their main reason for courage - valuing service of country above self.
The practice of "pabaon" for a departing superior is a Filipino tradition not unique to the Armed Forces of the Philippines. Most sectors, including many government agencies show gratitude and respect for their retiring elders in similar fashion - with gifts and accolades. It is unfortunate that the "pabaon" for retiring chiefs of staff deteriorated into an orgy of corruption that actually cost the lives of lower ranked members of the organization.
This development probably reflects the pervasive acceptance of financial reward as a most valued token of appreciation (even higher than honor and respect) in a society that has been despoiled by the free-market fundamentalist adoration of profit as the highest good. In the corporate world of capitalism, "pabaon" is analogous to the "golden parachutes" given to financial leaders who eventually led the global economy into a still on-going current crisis - with ultimately adverse impacts on the world’s poorest.
In the health sector, this form of corruption takes the shape of government health institutions giving higher value to the generation of income than to the provision of health care services for all who need them. Just as the military in the case of the recent revelations, the health sector’s own value system has been subverted by the higher value assigned to monetary rewards.
Reproductive Health Matters is a peer-reviewed health journal that specializes in public and reproductive health issues. In its November 2010 issue, the journal carried an article on how a charitable health organization was diverted from its original purpose of providing services to the poor and has become yet another service provider for the wealthy.
Muhammadiyah is a charitable Islamic organization that was originally conceived to provide primary care services for the poor in the island of Sumatra, Indonesia. Under competitive pressure from both public and private institutions, the organization’s network of primary health centers - mainly maternal and child care units and maternity clinics - have been driven into the provision of more lucrative curative hospital services emphasizing expensive sometimes unnecessary interventions. As a result, there has been "a shift of its patient population away from the poor as market pressures transform this charitable enterprise into a commercial one".
In the Philippines, there have been equivalent transformations of a number of Christian (Catholic and otherwise) charitable institutions. What is more, most of these organizations have retained tax-exempt privileges even as they have evolved into profit-making enterprises.
Last Sunday, Novak Djukovic won the first tennis grand slam tournament of the year - the Australian Open Championship. In his post-victory statement, the young Serb said : "It has been a tough period for our people in Serbia. We are trying every single day to present our country in the best possible way, so this is for my country Serbia."
Most Filipino athletes who aspire to international competitions also yearn to be able someday to express the same feelings. Unfortunately very few of them (such as boxing’s Manny Pacquiao and maybe football’s Askals) have been able to do so at the same level as Mr. Djukovic in recent years. Responsibility for the sad state of Philippine sports clearly belongs to leaders who have perpetuated a fragmented sector dominated by elitist political and commercial rivalries with little regard for the participating athletes and their fans.
One of the more thoughtful Christmas gifts received by this writer last season is a book entitled "Innovator’s Prescription: A Disruptive Solution for Health Care". Its principal author is a well-known Harvard Professor of Business, Clayton Christensen while his co-authors are a Harvard Public Health Professor (the late Jerome Grossman) and a young internist with a Harvard business degree (Jason Hwang).
Although the main orientation of the book is along the free-market fundamentalist roots of its Harvard-based authors, its contents provide food for thought for health reformists across the whole spectrum of political conviction from radical progressives to ultra-conservatives. The main proposition is that, as in business transformations, true innovation in health requires adopting "out-of-the box" ideas. Such ideas need to be assessed using frameworks that are on a different analytical plane than current health care systems.
The most important message of books such as this is that modern technology offers opportunities for new ways of doing things which in turn require new ways of looking at things. Recommendations for changes in the Philippine health system would benefit from the analytical framework recommended by authors of his book published in 2009 by the prestigious American publisher McGraw-Hill.
Email: alberto.romualdez@ gmail.com