DAVAO CITY (MindaNews / 31 October) — PhilHealth’s Z Benefits Package allots P100,000 for early stage breast cancer (Stage 0 to III-A). The amount is supposed to cover surgery and chemotherapy but breast cancer patients and survivors will tell you this amount is not enough.
Since the treatment cost goes beyond the P100,000 package, one has to look for other sources of funds. In places like Davao City, charitable organizations and politicians help fill in the gap, with guarantee letters addressed directly to the hospitals.
To get help, one cannot rely only on the government’s one-stop shop at the Malasakit Center within the compound of the Southern Philippines Medical Center (SPMC) .
The Malasakit Center, which houses various local and national government agencies that provide financial assistance, helps patients access aid. If the funding isn’t entirely available, the social workers direct you to the offices of senators and congressmen, party-list groups and the Office of the Vice President (OVP), which are located in different parts of the city.
To achieve a truly zero-based billing, patients or their watchers have to gather guarantee letters from these offices so that the hospitals can process free healthcare for the patients.
Breast cancer patients find new friends while waiting for their chemotherapy sessions at the Southern Philippines Medical Center’s Adult Cancer Institute radiology, and even beyond their “graduation.” MindaNews photo by YAS D OCAMPO
At what cost
The realistic cost estimates of chemotherapy medicines such as Trastusumab and Paclitaxel range from P10,000 to P80,000. These are available at the Murang Gamot facility at the ACI. The price depends on kind (drip type or injectable) and supplier (there are two private partners vouched for by the Philippine Charity Sweepstakes Office here aside from the Murang Gamot facility). The cost isn’t one time. At the San Pedro Hospital, my mother went through at least 18 cycles of Trastusumab every 21 days. Paclitaxel is another kind of chemo meds.
Total expenses for surgery, including hospital board and lodging, reached around P150,000. For a month of radiotherapy, patients have to find funding sources to pay P270,000 for the 30-day regimen.
The PhilHealth coverage and the persons with disabilities discount do not entirely cover the procedures; but at 20%, the benefits are helpful. Mother alternates between PWD and senior discounts.
In the case of my mother, who was diagnosed with Stage 3 breast cancer last year, the family had to shell out at least P400 every day for meals and fare.
To give more perspective to cost, the cheapest laboratory test is around P1,000. In some hospitals, 2D echo services cost P2,800. Mammograms and sonograms are around P5,000, each. CT scans, which determine your body’s capacity to tackle the necessary treatments during chemo, cost around P18,000. One needs to shell out P29,000 for a bone scan, to check if the patient can handle the eventual effects of therapy to her bones. Some of the interviewees said they had to shell out around P100,000 cash to pay for their surgery.
The first thing that scares you upon a confirmed breast cancer diagnosis is what doctors call financial toxicity, which affects patients’ mental health almost equally as the corporeal.
Almost immediately after the diagnosis, the oncologist tells us to actively avoid stress.
A lot of effort
In the Philippines’ health care system, zero-based billings require a lot of effort.
The loved one who is processing the documents (or sometimes, the patient herself) must set aside entire days to catch up on chemo medicines and other expenses.
For employed patients, this means setting aside work leaves. On good days, one can process these guarantee letters in two to three days. Sometimes it takes a week.
For the unemployed, this means a day or a few days of visiting various offices across the city, regardless of the weather. If one gets caught in the rain, one pushes through, as there are other offices to line up for. The Breast Friends GC has since become a map of where to go and what to expect at each queue.
To receive aid, the patient must secure documents such as copies of their medical abstract, prescriptions, barangay clearance, IDs, billings. One of the first things that my mother’s breast specialist told her to secure was a large folder that would hold all these documents. The patients lug these around to the different offices. A party-list’s office, for example, is located in Buhangin, which is relatively close to the SPMC. Another one is in Ma-a, seven kilometers away. In some instances, the patient and their watcher have to go back and forth to different ends of the city. Lucky beneficiaries who don’t have homes in Davao can avail of an NGO-funded dormitory service nearby. Those who are based here have to travel almost every day, from their homes to the hospital and vice versa.
Patients like Tessie, 58, have a support system through the help of her husband and her barangay, which gives a monthly allowance, an amount she uses for transport to get around from house to hospital, and to offices where help could be sought.
Tessie has been advised by barangay leaders not to line up with the documents herself, as the entire process can be tedious. Most of the offices to be approached allow a patient’s representative to process these documents and do follow ups.
In my mother’s case, help came from all over. Relatives, classmates, former officemates, my colleagues, even strangers, also chipped in. My mother cried happy tears one time at an ATM booth when we found out her bank account had a spare P10,000 from nowhere at a time we were feeling the perils of approaching paydays. In her own way, my mother’s thank you video post-op went “viral,” among my mother’s contacts. Everyone was praying with her.
In an ideal world, cancer patients would get bigger Z benefits to cover for hormonal therapy and other treatments, so they won’t have to source funds from other offices, according to the wishlist of Dr. Kenny Jun Demegillo, SPMC medical oncology section training officer.
But in all of the interviews with the patients, no one seemed to complain, and most were thankful for the financial help from these offices. “Hago lang” (it’s really just too tedious), Hanie said.
Based on patient anecdotes, it is the congressional offices that are the most generous. Patients only need to line up at these offices to receive aid ranging from P10,000 to P35,000, even more.
Party-list donations range from P3,000 to P10,000, depending on fund availability.
There are senators who have offices in Davao City (Dabawenyos Ronald dela Rosa and Christopher Lawrence Go, and Alan Peter Cayetano). They provide financial aid, too.
At the city government’s Lingap facility, located within the SPMC’s Malasakit Center, assistance ranges from P3,000 to around P5,000.
From the interviews, it appears that the Department of Social Welfare and Development is the sole agency providing cash for medical expenses. The rest issue guarantee letters. (Yas D. Ocampo / MindaNews)
The story is published with the support of the Philippine Press Institute, Philippine Cancer Society, ICanServe Foundation and Novartis in collaboration with the Swiss Chamber of Commerce of the Philippines and the Pharmaceutical & Healthcare Association of the Philippines.
