Can’t afford to die

October 31, 2019

by Casey Salamanca

My friend’s lola died last month. She was dear to me, as I grew up without grandparents and she was the lola I never had.

She once left the country to work as a domestic helper to ensure that all of her eight children would finish school. She liked gardening and ballroom dancing. She loved preparing for family picnics and enjoyed traveling despite her old age. Until she had a debilitating kidney disease and had to undergo dialysis thrice a week.

The treatment weakened her physically but her spirits never wavered. You could see in her eyes that she still wanted to spend more time with her grand- and great grandchildren. But she passed on one fine morning while preparing for her regular dialysis session. It was not unexpected, but all family and friends still grieved for Lola.

Her death has caused me sadness. But it has also made me think of the cost of dying as well as the cost of staying alive in our country.

Lola’s funeral service cost around Php100,000. She was practical enough to prepare for her death – she bought a memorial plan. The other funeral costs were mostly covered by the pooling of resources of her sons and daughters and the collection from the abuloy.

There were also other necessary expenses. Her wake lasted for five nights, and of course (especially in the province), this entailed feeding the guests for almost 24 hours. The family had four pigs butchered, bought three sacks of rice, boxes and boxes of juice, 3-in-1 coffee and chocolate drinks, packs of bread, and other kutkutin that is usual in Filipino wakes.

Not everyone has the financial capacity that Lola’s family has. Not everyone can afford to buy memorial plans or to extend one’s life by getting medical attention. And that’s the sadder part for most of us – healthcare service is available only to those who can afford it. It is not government priority, and privatization of provision is the main government policy.

For the year 2020, the health department’s budget has been slashed by Php9.2 billion. The Philippine General Hospital (PGH) also received a Php456 million cut in its budget. PGH is the go-to public hospital of our indigent kababayans, not just from Metro Manila but especially those coming from the rural areas,who cannot afford the exorbitant health service in private hospitals.

Filipino families are left to pay for a social service, a human right, which should be accessible and realized for all. According to the Philippine National Health Accounts, households spent the highest health expenditure in 2018, with out-of-pocket spending comprising 54% or Php413 billion of the current health expenditure.

Half of the out-of-pocket spending was spent on pharmacies. Hospitals received the second largest amount (Php148.8 billion), bulk of which went to private general hospitals.

Government neglect of health service in the country is an outright violation of the right to health. High statistics of Filipinos dying without seeing a doctor or receiving any medical attention are stark indicators of this violation.

Yet, while most of us are not given the fair chance to get cured or cared for, most of us also are not given decent burial. Graveyard plots cost around Php65,000 to Php100,000, almost the annual income of a minimum wage earner. In Manila North cemetery, a five-year lease for an “apartment style” niche and a tombstone costs Php600. The contracts are non-renewable, so the bones of the dead must be transferred to other cemeteries after the lease. Unclaimed bones, most probably belonging to poor families who cannot afford another grave, are buried in mass graves inside the cemetery.

As the saying goes, mahirap maging mahirap. It’s hard when a poor person gets sick, still the suffering doesn’t stop when he dies.

One thing’s for sure right now – I can’t afford to die. ###

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