What does the Marcos-Duterte government mean for access to health in the Philippines?

The election of Bongbong Marcos and Sara Duterte is cause for concern for health justice activists in the Philippines as they expect increased persecution and insufficient budget for health

May 13, 2022 by Peoples Health Dispatch
Protests calling on Dr. Naty Castro to be released. Photo: Photo from Free Dr. Naty Castro Now Campaign/Facebook

Following the landslide victory of Ferdinand “Bongbong” Marcos, son of the Philippine dictator Ferdinand Marcos, in the country’s presidential election, human rights activists have expressed concern about what his victory will mean for social justice in the Philippines. The country’s health system has been unable to meet the people’s needs for years, and things are unlikely to take a turn for the better as Bongbong Marcos and running mate Sara Duterte, the incumbent president’s daughter, remain faithful to the outgoing administration’s values.

Marcos will inherit a chronically ailing public health system, who has given higher spending priority on his flagship infrastructure program, the police and military, rather than to healthcare – even during the COVID-19 pandemic. Rodrigo Duterte has not taken any measures to strengthen the public health system and make health services accessible to ordinary people, relying instead on the neoliberal scheme of privatizing health care through social health insurance.

A sizable portion of the 2022 national health budget goes to Philhealth (Philippine Health Insurance Corporation), instead of direct health services such as government hospitals, primary health care, and promotive and preventive health programs undertaken by the local government units. During the COVID-19 pandemic, private hospitals benefited most from the payment of insurance packages – since the packages were rolled out for Philhealth accredited hospitals, which are mostly private. The health insurance program also does little to address the country’s problem of shortage of medical workers, who are leaving the country in high numbers due to low wages and poor working conditions.

It is possible that Marcos will push the public health system further into collapse as, once Duterte leaves office, the country’s debt will climb to a record high of Php 13.42 trillion (243.5 billion euros). A substantial portion of this debt was spent on Duterte’s infrastructure projects and debt servicing rather than on strengthening the health system amid the COVID-19 pandemic.

Despite surges in COVID-19 cases, the Duterte administration did not prioritize mass testing, contract tracing, and isolation, or effective treatment of positive cases. They did not even address the limited investment in public health care and the shortage of healthcare workers. Continuing along similar lines, during the campaign period, Marcos did not put forward any concrete plans for improving the health system and instead delivered general statements making sweeping claims about securing a higher budget for healthcare and improving the conditions of medical workers. There is no indication of how he will make this possible, or whether he means to make it possible at all.

In this context, campaigning for the right to health will be more critical than ever. A broad mass movement emerged during the election campaign period supporting the candidacy of Leni Robredo, the current vice-president, and rejecting Marcos’ attempt to return to power as well as threats to democracy. People from different sectors of society, particularly the youth, have taken it upon themselves to fight against the historical distortions presented during the election campaign, expose the crimes and wealth of the Marcos, and demand justice and accountability.

Rewriting the history of the Marcos dictatorship

Ferdinand Marcos Sr. plundered the country, committed blatant human rights violations, and stayed in power for more than twenty years. Thousands of people were jailed, tortured, involuntarily disappeared, and killed during his dictatorship. In 1986, a popular revolt ousted Marcos, but only after he had robbed the country of more than $10 billion and left its economy in shambles.

After the dictator died in exile in 1989, the Marcos family was able to return to the Philippines and began making their way back to political life – never apologizing for the blatant abuses of human rights they were responsible for. The succeeding administrations also failed to hold the Marcos family accountable for their crimes against the Filipino people. With time and with the aid of social media platforms and an army of trolls, the Marcos have managed to whitewash the obnoxious legacy of the dictatorship, even refashioning it as the “golden era” of the Philippines.

According to some political analysts, many Filipinos have supported Marcos because of their growing disillusionment with liberal democracy, which failed to bring real change to the country. Poverty is still widespread, corruption in the government has worsened, and the rich-poor divide has widened since 1989, with the country having one of the worst rates of income inequality in the world.

Continuing the struggle for social justice as space for action shrinks

During the campaign, progressive social movements supported Robredo’s candidacy in a bid to thwart the return of the Marcos to power. Robredo’s socioeconomic plans in many aspects resonated with their demands in various fields, such as promoting people’s right to health, defending human rights and the environment, genuine agrarian reform, ending labor informalization, and promoting a rights-based pandemic response, among others.

The return to power of the Marcos presents both challenges and opportunities for the social movements. During the campaign period, Bongbong Marcos promised to carry on with President Duterte’s plans and programs. He vowed to shield Duterte from accountability and international court proceedings for his human rights abuses, from the bloody drug war to the crackdown on dissenters, to jailing and killing of human rights and environmental defenders.

Critics fear that Marcos will intensify the culture of impunity instigated by President Duterte, shrinking further the democratic space for social movements where they can operate and hold the government accountable for all its actions. However, the people’s readiness to stand up for demands focused on justice and accountability during the election campaign show that there is still no place for defeatism.

There remains a vast opportunity for social movements to organize and mobilize people for the right to health beyond the election process, asserting that people’s health is the government’s responsibility and thus demanding that the new government ensures that the public health system is able to effectively provide health services to the people, especially during a health crisis like the COVID-19 pandemic.

Social movements are poised to wage a determined struggle against the incoming administration to defend what is left of the civic space under Duterte, so that they can continue to fight for the people’s right to health and empower them to bring about social change.

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