The medical system in the Philippines is ridiculously simple: if you don't pay, you don't receive treatment. Nor do you go home. End of story.
Hospitals are organized as primary, seen at the local level, secondary, seen at the regional level and tertiary, the big city hospitals that are at the equivalent of what we are used to.
If a patient is admitted to the hospital, families are given a list of necessary supplies and medications that need to be purchased. Families also are responsible for bringing in food for the patients. No family? No supplies or food. Simple.
If the patient cannot afford the supplies or to pay the room fee, they sign a promissory note but here is the kicker: patients are not discharged until the promissory note has been paid! The patient remains in the hospital until the bill has been paid with a guard posted to prevent the patient from leaving and the daily fees continue to compile! In these instances the hospital becomes a debtors jail of sorts and patients do occasionally escape.
Costs are ridiculously inexpensive but a simple blood test costing $1.50 can easily eat up an entire day's salary, not to mention the loss of income when a day is taken to go to the hospital. An earlier blog mentioned that the local hospital in Culasi can perform CBCs on a daily basis and lipid panels and uric acids on Wednesdays. For anything else, potassium, sodium, bun, creatinine, etc., the patient gets the blood drawn at the hospital then transports it two hours away for processing and brings the results back to the ordering doctor. A blood draw, two hours on a bus, waiting for processing and a return to trip of two hours. All for lab work that can be done on a hand-carried machine here in the United States.
There are no specialists; cardiologists, ENTs, gastroenterologists and even dentists are nonexistent in this region that serves 50,000 people. Access to care, as you can see is ridiculously difficult and when you do find a practitioner that can help you, they too are caught up in the same bureaucratic maze that severely limits their capabilities and visions as the patients they are trying to help.
The system in our Americanized eyes is seriously flawed but this is their system, not ours and we must learn to work with the reality of what is available.