Every day on the frontlines of our medical practice, healthcare professionals witness a quiet tragedy that has become normalized.
Families are driven into poverty by catastrophic health spending, patients forgo urgent care because their family has run out of money, and thousands are forced into an indignity that no Filipino should ever endure. They are forced into a humiliating search for assistance: forced to line up and beg for endorsements from politicians for the funds they need to stay alive.
This is the grim reality behind our national health budget.
Two weeks ago, the House of Representatives passed their version of the budget, the General Appropriations Bill (GAB) for fiscal year 2027 on its second reading. On Oct. 13, they voted on the GAB on its third and final reading, 281-13, with one abstention.
Healthcare professionals are calling out the GAB’s doubling in budget of the discretionary, politicized Medical Assistance for Indigent and Financially Incapacitated Patients (MAIFIP) program from P24 billion to almost P50 billion, while the Philippine Health Insurance Corp. (PhilHealth) remains grossly underfunded.
Seventy-two healthcare professional organizations across the Philippines have come together to call for fundamental problems to the health budget to be resolved and to put an end to the destruction of Universal Healthcare.
The proposed P74-billion PhilHealth allocation for 2027 in the GAB is grossly inadequate and will rapidly be exhausted.
Projections show that this amount is projected to sustain PhilHealth only until approximately March 2027. After that, the burden of healthcare costs will increasingly fall on patients themselves, including direct contributors who already pay into the system but are not receiving benefits commensurate with their contributions.
This is not an isolated budgetary shortfall. The chronic underfunding of PhilHealth represents a continuing failure to fulfill the government’s obligations under the Universal Healthcare Act (Republic Act No. 11223). Since 2022, approximately P311 billion in earmarked revenues from sin taxes, the Philippine Charity Sweepstakes Office (PCSO), and the Philippine Amusement and Gaming Corp. (PAGCOR) have been withheld or left unappropriated. These resources were intended to help finance Universal Health Care (UHC) and should not be diverted, withheld, or left idle when Filipinos continue to face catastrophic out-of-pocket healthcare costs.
The government is increasing funding for politicized medical assistance programs while leaving true universal healthcare behind.
Although financial assistance to patients in need is essential, the current system is fundamentally inequitable. Tens of thousands of Filipinos are arbitrarily denied MAIFIP. They come to us healthcare professionals asking for help, yet we are often powerless because access to these funds depends on the discretion of local executives and legislators.
Healthcare should not depend on who a patient knows, who they can approach, or who they can persuade to help them. The amount of assistance a patient receives should be determined by the nature and severity of their illness and the healthcare they require — not by personal or political connections. MAIFIP has consequently become vulnerable to use as a political instrument and a mechanism of patronage.
We are advocating for the abolition of discretionary medical assistance funds such as MAIFIP and are pushing for the transfer of these resources to PhilHealth, where they can be administered through transparent, equitable, and rules-based mechanisms that ensure assistance is determined by healthcare needs and ability to pay — not political connections.
The 72 healthcare professional organizations are calling for four concrete reforms:
First, Congress must decisively close the approximately P170-billion funding shortfall and provide PhilHealth with at least the full P244-billion minimum subsidy requirement for FY 2027.
Second, the government should immediately release and appropriate the P311 billion in withheld, unappropriated, and unreleased sin tax, PAGCOR, and PCSO funds (2022-2027) earmarked for PhilHealth, particularly to strengthen PhilHealth benefit packages and reduce the burden of out-of-pocket spending.
Third, discretionary medical assistance funds, including MAIFIP, should be transferred directly to PhilHealth and converted into transparent, rules-based health benefits, including effective zero-balance billing for indigent and financially incapacitated patients.
Lastly, the government needs to ensure transparency and accountability in all budgetary actions affecting universal healthcare. We need full public disclosure and accountability for all executive releases and congressional budget actions affecting Universal Healthcare, including the allocation, withholding, release, and utilization of funds intended for PhilHealth and other UHC programs.
Healthcare is not a currency to be traded for political loyalty, nor is it a personal favor dispensed by those in power. As united organizations of doctors, nurses, and medical professionals remind us, it is a fundamental human right.
As the Senate receives the General Appropriations Bill and is about to start its plenary debates in November, make a firm appeal to our lawmakers: that even at this juncture, they will pause to listen to the cries of patients and frontliners. May they find the courage to look past political expediency, fund our universal healthcare system properly, dismantle the culture of health patronage, and put patients — not politics — at the absolute center of our national budget.
Dr. Antonio L. Dans is a clinical epidemiologist, Professor Emeritus of the UP College of Medicine, and academician at the National Academy of Science and Technology. He convenes the Healthcare Professional Alliance After COVID-19 (HPAAC) and the Sin Tax Coalition.