Joy Aceron, 24 July 2026
We come together today to talk about something most important to all of us: health.
We are here to recognize the problem, but not stop there. We are here to account for wins and persisting gaps to offer and work towards long-term systemic solutions. That’s what accountability means. It brings us closer to the truth that guides and anchors actions.
Not all health access is a right
Our key call: health is a human right.
What does it mean if it is a human right?
It is a right when it is guaranteed for all at all times.
Do we feel that our access to health care or medical care is guaranteed?
A recent article puts it succinctly: “we are one sickness away from being poor.”
For the poor, we are one sickness away from guaranteed death.
The Philippine Star released an editorial last Wednesday: “BROKEN: the state of public health care in this country.” It shares the story of Dayne in Catbalogan City, who complained of sore throat and was declared death on arrival after the nearby hospital couldn’t treat him for lack of facilities and because it took a lot for the family to transfer him to Tacloban given the expensive transportation, bumpy road and long ride.
This is not the society that we want. We don’t want a society where ten year olds die of sore throat. We need to do something about it.
If we look at our legal-institutional framework, including government programs and priorities, we can note where is the problem that needs to be fixed. If there is one silver lining: it is that we know how to fix the broken health system.
There are efforts being done. Local governments have mixed levels of performance. National governments indicate promises of solutions to perennial issues. More and more, local governments are taking on full responsibility of primary health care or reproductive, maternal, neonatal, childhood and adolescent health services. Local governments must have more funds that continue to be highly concentrated at the central government. The national needs better approaches to set strategies and direction for the entire country.
The glaring gap: private sector accountability
In sum, based on PRO-Health Monitoring that focused on RMNCAH services, which you will hear more later, when it comes to primary/ preventive health services, the gaps are mostly issues of implementation and resource misallocation, but the mandate is clear and there are considerable efforts. This is in account as well of international commitments, such as the Sustainable Development Goals, and international development community’s support.
But who guarantees medical care? When we are very sick, needing an urgent care, an operation, needing consistent treatment - who guarantees our right to health? This is a glaring gap.
The 2025 Current Health Expenditure report says that Out-of-Pocket and Voluntary Healthcare Payment, meaning private spending, still constitute more than half (total of 52.5% or 41.2% and 12.3%, respectively) of health spending with the rest, 46.5%, covered by Government Financing.
When it comes to Out-of-Pocket expenses, Philippines is almost 3 times the 18% global average. It is also way above the suggested range of 15% to 30% of total private health expenditure.
How does the government attend to this?
Yes, there are public hospitals, but they are severely underinvested. You go there in an emergency, the likelihood that you will die is high. That is a clear example that health is not a right in this country. It is a privilege.
Swerte ka kung maka-access ka. [You are lucky if you get access.]
Kung swerte lang ang health access, hindi sya karapatan. [If healthcare access is a matter of luck, it is not a right.]
You can go to private hospitals that constitutes most of the hospitals in the country. What happens if a private hospital takes advantage of the situation and abuses people who need urgent medical care? What can we do about it?
We post. We rant online.
We can file a case, but that also involves a lot of money that ordinary citizens do not have.
We can report to authorities, but they can only act on it through the licensing of the hospital or the medical practitioner.
So when you are abused by private healthcare, you Wait for Godot. Your own peculiar abuse will not be addressed because there is no part of our system mandated to ensure you redress.
If even in an incidence of an abuse, we are unable to do anything, how can that mean health is a right in this country?
In this light, health is a rare privilege. Swerte ka kung may medical care ka. [You are lucky if you are given medical care.]
Captured healthcare access perpetuates the status quo perpetually
Recognizing the reliance of the country on private sector, the government provides assistance. When you go to private hospitals, the government can assist you with your bill through PhilHealth and Medical Assistance to Indigent and Financially Incapacitated Patients (MAIFIP). How much of your bill will PhilHealth cover?
Again, swerte ka kung malaki macover ng PhilHealth sa sakit mo. [Again, you are lucky if PhilHealth will cover most of your bills.]
How do you access MAIFIP? You ask a politician. Here, we see that in our legal-institutional framework for health, not only that our health is not guaranteed, it has been turned into a way for patronage politics to be perpetuated.
If you get sick, to avoid becoming poor and dying, you need to be indebted. As you do, you become part of the vicious cycle in the country of poverty, patronage and corruption.
Is health a right in this country then? No. It makes people part of the patronage system that fuels and is fueled by the corruption machinery.
A society where health is a rare privilege that pulls people to being part of the vicious cycle of poverty, patronage and corruption is a society that is sick. It is a republic that is failing.
Any other changes and reforms will go back to perpetuating the status quo if access to health and basic services is captured by such a vicious cycle. People will not be a power for change; they will be tools for the unjust status quo.
How do we break the vicious cycle
We come here to do something about this.
The rich who mostly occupy positions of power in our government and society will not prioritize this. They are among those who can have that rare privilege of guaranteed healthcare and medical care - the best there is. We need to make them prioritize our health too.
Authorities will not automatically prioritize this. Our laws and institutions are not designed to guarantee our health as a right as a whole. We need to make the Philippine state prioritize health.
I am aware of the vested interests in the private sector that profit from the status quo. But I want to think the private sector can be convinced to make health to be truly a right for all if they are convinced there is a different way of doing business.
And if the private sector will not observe health as a right, the government must have the power to side with the people and discipline the private sector.
Greed and patronage should not have a place in providing healthcare. Our health is the most basic need.
There is no exercise of agency without health. And without an individual’s exercise of agency, we are not free. People who are not free will always be defeated by power that abuses. That’s a recipe for impunity. It is a recipe for the death of democracy.
When it comes to health as a right, the ordinary citizens will surely prioritize it and fight for it. Only through our collective actions that we can make health truly a right.
Through our initiative, we have collectively come up with a citizen-led, citizen access-centered, bottom-up health reform agenda based on data gathered on the ground by citizens themselves substantiated with evidence from mainstream sources. This will be our anchor in the days to come.
We will need allies. We will need leaders from government, civil and political societies and private sector who can usher the changes needed to indeed make health a right for all at all stages of life.
We need allies from all levels from barangays to international and we need to connect all our shared experiences, analyses and efforts to build an alternative source of power that will assert what the status is depriving us to claim: our right to health.
Accountability as our armor
We need all the spaces, tools and mechanisms that we can use.
Accountability is our readily available way to check abusive power. There is a reason accountability is an indispensable part of democracy. Without it, state and private power will be abused.
But accountability needs to be enabled. It needs access to information, broader and meaningful engagement of citizens in governance, it needs to be working as an ecosystem - connected and integrated. We can’t be monitoring public performance only to elect the same corrupt politicians or their enablers.
One emerging lesson about accountability ecosystem is that it is not natural or automatic. Just because there are mechanisms, it doesn’t mean that it will work, especially amid concentration of power. Just because there are rules in the procurement and a Commission on Audit, it doesn’t mean it can avoid corruption in health facilities and medicines badly needed in barangays all over the country, especially the remotest and poorest.
There has to be painstaking efforts and relentless prioritization to fire up the accountability ecosystem - to prevent it from being captured or rendered inutile (like how it was so in the flood control plunder), to make it work for the people and the common good. This is an agenda only the pro-reform and pro-accountability forces in communities, government, civil society and private sector at all levels from barangay to international will advance at all times. Like an environment’s ecosystem that needs water and the sun, accountability ecosystem needs people’s vigilance and alliances to work at all times.
We continue our struggle for healthcare as a right today through this gathering and for the commitment, solidarity and hope that we will build alongside our well thought-out strategies based on lessons from the past.
Let this be the start for a new state of health - where there will be no more 10 year-olds like Dayne dying because of poverty and lack of basic health infrastructure.
Let’s get to work.
Maraming salamat!
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