News from the Philippines: Education Worse than Expected? Mandated Payrise for Workers? WHO and DOH Launch NICCP (National Integrated Cancer Control Program). Health Care Challenges & HMO Woes.

Education Woes Continue

The following commentary discusses that Filipino students academic performance is worse than many even suspect. The brain of each child is grown by their nutritional inputs. Thus, educational excellences starts with maternal nutrition prior to and during pregnancy, and continues (optimally) with breastfeeding by a well-nourished mother and sound early life nutrition with adequate protein and quality fats for brain and body. Then comes the learning environment, which starts during infancy and is only taken up by schools once the child is 5 or 6. Teaching materials, teaching facilities and teachers themselves become critical. Chanco’s article elaborates that money is not even adequate to assist if it cannot be spent appropriately. He refers to actual textbook procurement being a tiny fraction of the allocated budget.

There is no doubt that there are excellent Filipino teachers, though too few of them to meet national need. My children are being taught by brilliant teachers and I could not be happier with the quality of education they are getting. However, we live in Metro Manila and are privileged to have access to very good schools; though the cost of most of these are well beyond what most, except the top elite, can afford. If I was not being directly assisted by my employer, they are also beyond what I could afford.

Many children, even from well-off families, completely stopped education during the lockdowns from 2020 through to the end of 2022 when schools finally resumed. That is 3 years of lost education opportunity. For some the window to access education, particularly older student who now have to choose between finding some sort of work or going back to study, is closed, even assuming there are sufficient schools and qualified teachers available.

How can the Philippines train teachers, doctors, engineers, accountants, hospitality staff, etc. when students are not literate and thus cannot undertake higher education? These (failed) students may be barely competent to survive in today’s technological world! To get a job better than hard menial labor? To parent children in this technological world, to raise their families out of poverty! What an incredible loss of to Filipinos and their future!

I see a great need for adult education services. For people to improve maths, reading, science literacy. To qualify for further, adult education, and professional courses.

DepEd has introduced a revised and decluttered curriculum to try to improve student learning and competencies development. MATATAG stands for Make the curriculum relevant to produce job-ready, Active and responsible citizens; TAke steps to accelerate the delivery of basic education services and provision facilities; TAke good care of learners by promoting learner well-being, inclusiveness learning, and positive learning environment; and, Give support for teachers to teach better.” (PNA)

Legislation to Increase Minimum Salaries by PHP100

A bill to increase daily wages by PHP100 a day (effectively about a 16% increase on the current minimum legal wage of PHP610), has been hailed as disastrous by the Employers Confederation of the Philippines. They say this, if implemented, will massively increase costs and will result in either a rise in prices of commodities (that P100 raise will quickly be effectively negated), or companies will need to reduce staffing.

I absolutely agree with ECOP. It would not only be minimum wage earners getting a raise, it would need to be most wage-earners, because the entire workforce would need to be adjusted. If minimum wage earners are raised to PHP710, then all the workers who were previous receiving between 610 and 710 which is the new minimum have to be raised to retain company wage structures. This then overflows to workers higher up the pay scale, as senority and experience scales have to be maintained. Then there are Government Contributions, some of which are made by employer and which are based on salary rates. Overtime rates, where applicable, also rise and with them even more unanticipated and unbudgeted expenses. These will also rise with any pay rise, and the effective cost to employers will be more than P100/personnel/day! Of course this will be passed on. If it is not, the business will fail.

A massive wage rise will simply fuel out of control inflation.

The proper way to grow incomes is by improved productivity and profitability which is reasonably shared back to personnel in salaries and/or benefits by ethical employers. It is also addressed though reduced losses, such as better cold chain and farm-to-market (as an example), which effectively reduces prices. Many contractors work with fixed price contracts, and small margins. A large compulsory pay rise in the middle of contract may not be recoverable resulting in contractual financial failure. This is the reality on the ground!

I hope these legislators would realize the knee jerk response on making new laws (what do legislators do other than make laws?) do not necessarily solve problems; they just increase bureaucracy and make the business environment ever more challenging. Underlying fundamentals have to be addressed. No matter how many laws are made, they are just paper! Is there any sound underlying basis? Is the law actually practically and usefully implementable? Does it really help or us there (worse) colateral damage?

Health Care System News - Cancer Treatment

The WHO is getting in on assisting the Philippines with cancer treatment programs; cancer being the 3rd leading and increasing cause of death in the Philippines.

As an aside, this week’s FLCCC presentation featured world renowned oncologist Dr. Angus Dalgleish, in a simply brilliant interview. Very highly recommended to watch and share. He explained that worldwide we can expect cancer rates to explode in coming years. He also discussed approaches to management (and indirectly, prevention).

Where are the Health Care Workers, Facilities and Resources?

The NICCP, regardless of best intentions, is likely to fall very far short of need. Further, who is going to deliver the programs, using what facilities and resources? The Philippines currently has major challenges in their healthcare system, that cannot be readily solved, even if money were available. The following information is taken from a presentation by Congressman Golez, Jr. to a Makati Rotary Club Meeting last week:-

Philippines currently has 1,295 hospitals (mostly in major centers and built-up areas). Of these 443 are Government and 852 are Private Hospitals.

• In 2022 there were 1.2 hospital beds / 1,000 population, well below the 4 beds/1,000 target. 400,000 additional hospital beds are required.

• In 2022 the Philippines had only had 3.6 doctors / 1,000 population far lower than the WHO ideal Patient-Doctor Ratio of 14.3.

• The Philippines needs an additional 90,000 doctors and 300,000 nurses to meet optimal HCW to population ratios.

• The nation has 3,900 Primary Care Facilities, 2,593 of which are Rural Health Care Units (RHUs). RHUs provide essential services. Yet: -

  • Only 50% of Filipinos have access to a RHU within 30 minutes travel time.

  • 2,400 additional RHUs are needed by 2025.

  • 10% of rural health units (RHUs) do not have any doctor.

[Given these statistics, it is really quite amazing that the Philippines managed to inject some 78% of the population with Covid-19 vaccines from 2021 to 2023! Agree or disagree with the Covid-19 Injectables, the distribution did show the potential of what can be achieved when much of society is galvanized! Now what if similar were mobilized to bring education / better nutrition to everyone!!]

PHILHEALTH TO INCREASE MEMBER BENEFITS

The cost of any illness in the Philippines can spell the end of financial security for any family in the Philippines, even wealthy families. To assist, the Government health insurance company, PhilHealth to which both employers and employees are mandated to contribute¹, has just increased coverage for most of its packages. It has also raised mandatory member contribution from 4.5 to 5% of monthly salary this month.

Meanwhile, many local HMO’s suffered staggering losses in 2023, despite increased revenues, as member claims soared.

Summary of HMO woes, also from Golez’ presentation. 2024 is likely to be worse if the current trending continues and as the consequences of the C19 injectables continue to exert their impacts on recipient’s health.

Philhealth will need to manage affairs very carefully to keep up with demand from members. Treatment costs for serious illness can amount to 100's of 1000's, even millions of Pesos (PHP55:USD1).

Prevention Better than any Cure - Starts with Gut

There are no easy solutions to the health crisis gripping the Philippines. Prevention is surely much better and cheaper than cure. Prevention needs to come before primary health care, and has to start with gut health, with diet and lifestyle; particularly with nutrition at all life stages (everyone has to eat!). Teaser (11 minutes) into gut health!

A more detailed dive (1 hr) from Dr. Sabine Hazan, who discusses gut health and the importance of bifidobacteria in maintaining health.

1. Philhealth monthly mandated contribution has just increased this month from 4.5% to 5% of salary, with amount deducted 50% from employee salary and 50% contributed at the cost of the employers. Remittance is made monthly. Penalties apply for non-remittance.