Senate President Pro Tempore Ralph G. Recto

13 May 2020

A medical diploma carries a hefty price tag in this country.

Tuition is so high, and other fees so prohibitive, that the joke is that medical schools should put a recovery room beside the school cashier.

Or deploy crash carts all over the campus during registration time.

This leads to the parents remaining in financial ICU while their child is in school.

This is probably the reason why some parents retain custody of the medical diploma of their child, because while it is indeed a katunayan ng pagtatapos for the graduate, it is more of a resibo ng gastos for them.

As a friend once proudly told me, the medical diploma which hangs on his sala wall is worth as much as the Manansala beside it.

But medical education goes beyond receiving that parchment, or passing the Board.

What follows are years of training and specialization, including long periods of unpaid OJT stints. Medicine is a profession which has more fellowships than the Lord of the Rings.

With such a high investment—financial, intellectual, not to mention the vats of coffee to fight off sleep during marathon duties—the unavoidable natural recourse is how to recoup it.

This leads to the congregation of medical practitioners in urban centers where the patient catchment-size is bigger.

The pressure for a personal ROI also affects graduates of state medical colleges for the simple reason that while tuition is free and the fees might be affordable, such are not the only costs incurred in the long march to medical practice.

The bottomline is that medical education in this country remains largely a privilege only the sons and daughters on the top of the economic pyramid can afford.

It is against this inconvenient truth that this bill comes to light.

In a nutshell, this bill allows the best and the brightest from the lower social rungs to become doctors.

It is founded on the egalitarian proposition that becoming a physician should be a function of intellect, not tax returns nor postal zip codes.

Today, there are reportedly 130,000 licensed doctors in the country but only about 70,000 of them are in active practice.

This translates into one doctor for every 33,000 Filipinos, a ratio inflated by the concentration of doctors in cities.

In rural areas, the doctor-to-the-people ratio is very low. If towns were patients, their medical charts would show the underlying cause: the higher the poverty incidence, the fewer doctors there are.

Often, the only doctor in this town is deployed by the Doctor to the Barrios program of the Department of Health.

These are often unmarried new graduates who are willing to weave the vow of poverty and the pledge of single blissfulness with the Hippocratic Oath.

But we should not be relying on missionary doctors to attend to the last, the least, and the lost. That important public service should not be dependent on the altruism of selfless individuals.

This is the reason why I have filed, for several Congresses now, two bills which will provide medical scholarships to the young people who have the head and the heart to serve their countrymen.

The first is the One Town, One Doctor bill.

This proposed law requires government to choose one medical student scholar per town.

To qualify, an applicant must belong to the upper 30 percent of a graduating class of any pre-Med course and has been accepted to medical school. Thus, it is not an unconditional entitlement. The quota is linked to merit. To remain in the program, academic standards have to be met.

The scholarship will cover tuition, laboratory, miscellaneous fees, and all school fees; textbooks, supplies and equipment; clothing and uniform allowances; traveling, subsistence and living expenses.

If no one from a town qualifies for the program, the allotted slot may be assumed by a scholar coming from another town in the same province.

The scholarship is linked to the condition that when the scholar becomes a doctor, he will go back to his town to serve for four years.

In short, this is a “galing sa bayan, tungo sa bayan” scheme of producing doctors.

We pick from among the town’s best and brightest, finance his medical studies, and when he becomes a doctor, he repays it by serving his own people.

The second one is the Medical Scholarship Bill.

This bill creates another window to finance the training of doctors.

You know, our spending for tertiary education will breach P100 billion this year— P112.6 billion to be exact—P38.9 billion for the free college program, and P73.7 billion for the operation of SUCs.

And if we are spending this much, which, by the way, does not include DOST scholarships, then we might as well identify priority courses, of which medicine is undoubtedly one. We have a surfeit of political science students but a shortage in STEM enrollees.

For this year, the DOH’s medical scholarship program has a measly budget of P167 million, for less than 2,000 students in eight SUCs.

These are the Bicol University in Albay, Cagayan State University in Cagayan, Mariano Marcos State University in Ilocos Norte, Mindanao State University in Marawi City, University of Northern Philippines in Vigan City, UP Manila College of Medicine in Manila, UP Manila School of Health Sciences in Leyte and the West Visayas State University in Iloilo.

I do not know, Mr. President, how much the bill we are discussing today will cost annually.

But this I am sure of: My two bills and the one we are finalizing today will have, cost-wise, a far smaller cost footprint than the hundreds of frivolous and unessential items that annually inhabit the national budget.

It is certainly lower than this year’s P9.6 billion Intelligence and Confidential Fund, a fraction of the P20.1 billion Travel Fund, and a drop in the bucket of the P1.2 trillion Personal Services budget for 2020.

If the budgets of many inconsequential agencies are seen as an expense vital to democracy, then why should medical scholarships be disparaged as a nonessential luxury?

For those who think the cost is too big, here’s a point to ponder: The most recent figures show that the Philippine Military Academy spends P4.2 million to produce one graduate.

In contrast, we will be spending half that amount to produce one graduate of what would virtually become the “Philippine Medical Academy.”

Mr. President, my dear colleagues:

If there is one unassailable truth that this pandemic has revealed for all of us to come to grips with, it is that doctors are vital for humanity’s continued existence.

This bill, in essence, seeks to produce more frontliners that we love to lionize and valorize today.

The best way to honor them is to create a scholarship on their collective behalf.

Pandemic or not, this bill is the required companion measure to the Universal Health Care Law.

We may give every Filipino a PhilHealth card, but it will be useless if the facility he can present that card to for treatment has no doctor to attend to him.

We may erect hospitals, but if there are no physicians who will staff them, then what we have built are white elephants.

We may allot billions of pesos in health care, but if it cannot hire the right number of doctors required, then it will be money down the drain.

We may be able to bring down the prices of drugs, and stock our pharmacies full of them, but they will remain out of reach for the sick if there will be no physician to write the prescription.

My dear colleagues:

Coronavirus taught us one lesson: We have to future proof our country. Not only are emerging diseases wreaking havoc, but our greying population requires greater medical care.

And this bill will ensure that there are enough doctors for our people, and that the next time a bat flies from a forest and unleashes a lethal pathogen that will bring civilization to a standstill, we have an army of white coats ready to confront it.

I urge the immediate passage of this bill.