REINVENTING THE CHARITY WARDS IN PRIVATE HOSPITALS

REINVENTING THE CHARITY WARDS IN PRIVATE HOSPITALS

President Ferdinand R. Marcos Jr. has announced the “zero balance billing” policy in all Department of Health (DOH)-owned and operated hospitals. In my book, that’s already close to having “universal health care”.

Finally, with the help of some friends at PHILHEALTH, I was able to clarify that the Zero Balance Billing (ZBB) program of the government applies not only to the public hospitals that are owned and operated by the DOH, but to all public hospitals, provided that the patients are confined in ward type accommodations, and not in private rooms.

Furthermore, the ZBB program includes all professional fees involved during the surgery or confinement, provided that no other doctors are involved in the surgery or confinement, aside from those who are already working in the hospital concerned. What that means is that if there is any other doctor or specialist who is called in from the outside, his or her professional fees will not be covered by the ZBB program.

But what if for any reason, the patient or the family of the patient has no choice but to bring him or her to a private hospital? It is not yet very clear, but I think that the government is working on that to be covered by ZBB too, if the patient is also billeted in a ward type of accommodation, and not in a private room.

One thing that is already in the law — and not open to interpretation — is that no hospital, public or private, may turn away a patient who enters their premises. The real question is: what happens if the patient is indigent and cannot afford to pay?

On paper, that’s not supposed to be a problem. PhilHealth can reimburse most of the bills — medicines, professional fees, and all — except for private room costs. For indigent patients, private rooms are usually out of the question anyway.

If PhilHealth can’t cover everything, there’s always the Philippine Charity Sweepstakes Office (PCSO), which can issue a Guarantee Letter to shoulder some expenses. Again, private rooms and professional fees may not be included — but in theory, an indigent patient can still walk out of a private hospital with zero to pay, provided they weren’t in a private room.

That’s in theory. Reality, however, tends to throw in a lot of ifs and buts. What if the hospital only has private rooms? What if ordinary rooms are full and the patient ends up in a private one? I’ve seen this happen and trust me — things can get messy very quickly.

So, here’s my proposed solution — one I wish hospital administrators would take seriously: bring back the charity wards.

Back in the day, every hospital had them. They weren’t just a token bed or two; they were actual wards — multiple beds set aside for indigent patients. This wasn’t just good practice; it was once official policy. In fact, DOH Administrative Order No. 2007-0041 still requires all private hospitals to allocate at least 10% of their authorized bed capacity as “charity beds.”

The problem? The requirement says “beds,” not “wards.” Beds can be scattered here and there, often not in the same room, and that defeats the whole point of a charity ward — a dedicated space for those who need it most. My suggestion is simple: interpret that 10% rule to mean charity wards, not just beds.

In principle, every public hospital should already be a charity hospital — free for everyone, not just the poor. The President’s recent pronouncement has moved us closer to that ideal in DOH hospitals. But I find it both amusing and a bit absurd that some public hospitals still have private rooms. Isn’t that an oxymoron — a “private” room in a public hospital?

I’m told they exist because hospitals need the extra revenue to survive under tight budgets. Maybe so. But if the President’s attention (and funding) is on this issue, perhaps that financial necessity will soon disappear. And maybe — just maybe — the day will come when private rooms vanish from public hospitals altogether, and every bed is, in effect, a charity bed.

Until that day, let’s make sure that private hospitals do their part. The 10% charity bed requirement shouldn’t just be a licensing checkbox; it should be visible, accessible, and serving those in need.

Right now, the DOH’s monitoring system is decentralized and largely manual. There’s no public dashboard to see which hospitals are compliant. Hospitals are supposed to declare their charity bed count in annual reports, but there’s little transparency. The DOH has hinted at requiring hospitals to post their charity bed numbers and standard fees publicly — both on-site and online — and I say, the sooner the better.

We could also sweeten the deal: offer tax incentives or PhilHealth processing priority for hospitals that actively and transparently maintain charity wards. Because while “charity” may sound like an act of goodwill, in this case, it’s also a legal obligation.

Yes, PhilHealth and PCSO are there to help cover costs, so technically these aren’t “free” beds in the sense of pure philanthropy. But at least they aren’t an oxymoron — unlike the private rooms in public hospitals.

If the government can truly enforce the zero-balance policy in DOH hospitals and require genuine charity wards in private ones, then maybe we can move closer to the day when the word “indigent” will no longer determine whether you get treated — or how well.

And if that day comes, we won’t just be reinventing the charity wards. We’ll be reinventing fairness itself.

Ramon Ike V. Seneres, www.facebook.com/ike.seneres
iseneres@yahoo.com, 09088877282, senseneres.blogspot.com

10-21-2025