WHY ARE MALAYSIANS AND INDONESIANS SPENDING LESS FOR HOSPITALIZATION?

WHY ARE MALAYSIANS AND INDONESIANS SPENDING LESS FOR HOSPITALIZATION?

In his latest SONA, the President proudly announced that the zero-balance billing rule now applies in all Department of Health (DOH) hospitals. That means, if you are confined in any DOH-run hospital, you don’t have to pay a single centavo—whether for medicines, procedures, or room charges.

However, I have also heard from other sources that this rule applies to all government-owned hospitals, not just those directly operated by the DOH. If that is indeed true, it would be like a dream come true: universal access to hospitalization for every Filipino citizen in public hospitals.

If confirmed, that would mean we Filipinos would be better off than our Malaysian and Indonesian neighbors, who are already enjoying extremely low hospitalization costs. In Malaysia, citizens reportedly pay as little as 1 ringgit—around 13 pesos—for hospital treatment, no matter the procedure, even surgery. In Indonesia, the cost is also minimal, thanks to their national health insurance program.

Now imagine: if our zero-balance policy covers all public hospitals nationwide, then at least in terms of cost, our public healthcare would be at par with that of Canada—where citizens pay nothing at the point of service in public hospitals. Of course, the quality of service and availability of facilities are separate issues, but in principle, universal access would be achievable.

Here’s how it works elsewhere:

In Malaysia, hospitalization is not entirely free, but it is heavily subsidized for citizens. Government hospitals charge minimal fees—anywhere from RM 3 to RM 80 for hospitalization, depending on the ward class. Outpatient visits can be as cheap as RM 1 to RM 5. Their Social Security Organization (SOCSO) also provides free treatment for work-related injuries and illnesses. Foreigners, however, must pay full rates unless they have private insurance.

In Indonesia, the system is even closer to being fully universal. Through BPJS Kesehatan (their national health insurance), over 100 million Indonesians are covered for inpatient care, surgeries, and chronic disease treatment. Premiums are based on service class, with the cheapest being the equivalent of only about 3 US dollars per month. Citizens need to go through community health centers for referrals, but emergencies are covered. The downside? Long queues, shared rooms, and some hospitals reluctant to accept BPJS without the right paperwork.

Looking at these two examples, we see two important lessons. First, it is possible to make hospitalization almost free for citizens, without bankrupting the government, if there is a well-managed subsidy or insurance system. Second, the system must be monitored to ensure that the promise of affordability reaches the poorest citizens, and is not diluted by bureaucratic hurdles or underfunding.

In our case, even if the zero-balance billing policy is now in place, we need to ask: will it be implemented consistently across all public hospitals? Will patients really be discharged without having to beg relatives for money or pawn their belongings? And will medicines, diagnostic tests, and surgical supplies be fully included, or will patients still be asked to buy these outside?

There’s another question: how will this policy be funded in the long run? If the goal is to make it permanent, we need to ensure that PhilHealth, DOH, and local governments are aligned, properly funded, and transparent. Otherwise, what starts as a promising reform could turn into another failed program.

If this policy holds and works as promised, we could surpass Malaysia and Indonesia in this one critical measure of social welfare. But the real test will be in the details of implementation. Because while it’s nice to say, “We are now like Canada,” it will mean nothing if patients still have to bring their own bedding, buy their own oxygen, or pay “informal fees” just to get admitted.

For now, I will take the President at his word—but I will also keep my eyes and ears open. Universal healthcare in public hospitals is not just a political talking point; it’s a basic right that could finally lift millions of Filipinos from the fear of financial ruin every time they get sick.

And if we succeed, maybe one day, it will be Malaysians and Indonesians asking: “Why are Filipinos spending nothing for hospitalization?”

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

10-06-2025