<p>菲律宾的医疗专业人士对此感到 “愤怒”，他们呼吁国会限制或废除他们所称的 “医疗猪肉”——通过政治家个人签署的担保信渠道提供给患者援助的税款——因为立法者正在最终确定 2026 年国家预算。\n 至少 72 个医疗和健康专业组织签署了一份联合请愿书，谴责这一做法，认为这使得政治家能够影响谁获得国家医疗援助，从而可以被用于政治利益，扭曲医疗服务的获取，并削弱该国的全民医疗保健系统。\n 随着国会准备在周一将预算提交给费迪南德·马科斯（Ferdinand Marcos Jnr）总统签署，这一问题变得更加紧迫，批评者警告说，资金再次被转移出菲律宾健康保险公司（PhilHealth），该公司是负责提供全民覆盖的国家保险机构。\n 在当前系统下，当医院账单超过 PhilHealth 的覆盖范围时，患者可以通过多个项目申请额外的国家医疗援助，包括针对贫困和经济无能患者的医疗援助计划（MAIFIP）。\n\n\n 在实践中，批评者表示，MAIFIP 的支持往往依赖于患者从立法者那里获得担保信，通常通过政府运营的 “Malasakit 中心” 进行，迫使患者和家庭在医疗紧急情况下寻求政治调解。\n 与这些援助资金相关的政治权力在 5 月的参议院中期选举中得到了体现，参议员克里斯托弗·“邦”·戈（Christopher “Bong” Go）获得了最高票数。戈是创建 Malasakit 中心的法律的作者，该中心旨在通过作为多个政府机构（包括立法者的担保信）的援助清算中心来减少繁文缛节。\n 健康专业联盟的召集人、菲律宾大学医学院的名誉教授安东尼奥·丹斯（Antonio Dans）表示，数十个团体的成员对他所描述的根深蒂固的系统感到 “愤怒”。\n 请愿书谴责了所谓的 “劫持全民医疗保健”，指控有 “故意、协调的努力来转移和政治化” PhilHealth 的资金。\n 丹斯告诉《亚洲周刊》，PhilHealth 并没有得到充分资助，而是被 “削弱”，本应用于其的税款被转移到至少五个他所称的重复 PhilHealth 功能的不同项目中。\n 这些项目包括 MAIFIP，贫困者只能通过亲自从立法者那里获得担保信，然后通过 Malasakit 中心申请，以及通过社会福利和发展部请求的危机情况下个人援助（AICS），通常需要政治家的帮助。\n 此外，医疗援助还可以直接向菲律宾慈善彩票办公室和菲律宾娱乐和游戏公司申请。丹斯表示，这两个机构根据法律要求将其部分博彩利润上缴给 PhilHealth，但并未完全按照要求进行。\n\n 他说，健康专业组织正在密切关注立法者最终确定 2026 年预算的过程。如果他们不满意，他表示，他们准备将此事提交最高法院。\n 丹斯表示，作为一种保险机制，PhilHealth 需要维持 1470 亿比索（25 亿美元）的储备基金——他表示，这足以为 2450 万主要是缴费的成员提供保险，每人 6000 比索。\n“但截至昨天，明年的预算只有 690 亿比索，” 他说。“那么，800 亿比索去哪了？” 他补充道，批评了他所描述的缺乏透明度。\n 他还表示，政府在向 PhilHealth 释放其法定对口资金方面未能达到要求，声称在马科斯政府下，从 2023 年到今年，导致的资金缺口已达到 255 亿比索。\n 丹斯表示，明年 PhilHealth 的资金将进一步受到压力，因为马科斯总统承诺实施他的 “Yakap”（Yaman ng Kalusugan 或健康就是财富）计划，该计划要求 PhilHealth 资助包括为贫困者提供免费的癌症筛查和药物在内的多项内容。\n 丹斯表示，仅该计划就需要 198 亿比索。“那么你如何兑现这些承诺？” 他问道。\n 医疗援助作为 “竞选资金”？\n 医疗专业人士表示，他们对立法者决定将 PhilHealth 的 2026 年预算削减至 690 亿比索，同时将 600 亿比索从 PhilHealth 转移到 MAIFIP 感到特别愤怒。\n 菲律宾内科医师学会前会长托尼·利奇昂（Dr Tony Leachon）告诉《亚洲周刊》，作为一名健康改革倡导者，他无法掩饰对 MAIFIP 通过的深深背叛感。\n“我们的立法者、政治领导人，甚至负责保护公共健康的机构选择了一条削弱而非加强我们全民医疗保健法的道路，” 他说。\n“UHC 建立在一个简单而有力的承诺上：每个菲律宾人都应通过 PhilHealth 自动、基于规则地获得医疗服务——没有守门人，没有推荐，没有政治。”\n 最令人担忧的是，一些受益者根本不贫困——他们是富裕家庭，根本不需要政治调解来获得医疗服务。\n- 托尼·利奇昂博士\n“MAIFIP 使我们走向相反的方向。它不是强化 UHC，而是完全绕过它，创造了一个平行的、任意的系统，医疗服务的获取依赖于信件、办公室和影响力。”\n 利奇昂表示，在他的临床实践中，他曾看到立法者签发的担保信，金额差异很大。\n“最令人担忧的是，一些受益者根本不贫困——他们是富裕家庭，根本不需要政治调解来获得医疗服务，” 他说。\n 他说，这一过程对患者造成了伤害。“这些信件的延迟交付往往导致住院时间延长、家庭不必要的焦虑以及病房的拥挤，” 他说。\n“患者被迫等待文书工作、签名和推荐，而不是通过 PhilHealth 获得自动、基于规则的覆盖。”\n 在公众的强烈反对下，参议院院长文森特·索托（Vicente Sotto III）告诉《亚洲周刊》，立法者正在采取措施取消担保信的需求。\n“参议院的立场是通过卫生部和 PhilHealth 将其分配给私立医院。立法者可以请求，但不再是必要的，” 索托说。\n 丹斯表示，取消担保信仅解决了部分问题，认为多个援助项目的存在使医疗服务碎片化，复杂化了患者的获取途径。\n“想象一下，你已经处于危机中，” 他说。“如果 PhilHealth 的金额不够，你必须排队申请 MAIFIP。如果这还不够，你就去 PCSO 和 Pagcor 或 AICS。”\n“每一个都是不同的队伍，不同的排队，” 他说。“每一个都是不同的办公室，每一个都有不同的规定。”\n“你需要乞求，” 他说。\n 丹斯表示，医疗专业人士即将发布的一项研究发现，担保信系统下的分配对贫困者存在歧视。\n 立法者向贫困者发放的担保信平均约为 1 万比索，而发放给富裕收入群体的受益者的担保信平均超过 3 万比索。\n“如果这就是它的支出方式，我认为你不能称之为贫困基金，” 丹斯说。“因为贫困者从中获得的非常少。”\n“这实际上是竞选资金，” 他总结道。</p>

环球保健

<p>菲律宾医生呼吁国会消除 “医疗猪肉”，即用于患者援助的税款通过政治家进行分配，从而扭曲了医疗服务的获取。72 个医疗组织已对此做出请愿，他们认为这一做法使医疗资金政治化，削弱了全民医疗保障。批评者指出，资金从国家保险机构 PhilHealth 转移到其他需要政治调解的项目。随着 2026 年预算的最终确定，这一问题显得尤为紧迫，如果不满意，可能会采取最高法院行动</p>

<p>“Outraged” medical professionals across the Philippines are urging Congress to curb or scrap what they call “medical pork” – tax money for patient assistance that is channelled through politicians via personally signed guarantee letters – as lawmakers finalise the 2026 national budget.\nAt least 72 medical and health professional organisations have signed a joint petition denouncing the practice, arguing it allows politicians to influence who receives state medical aid in ways that can be used for political advantage, distorting access to care and weakening the country’s Universal Health Care system.\nThe issue has taken on fresh urgency as Congress prepares to send the budget to President Ferdinand Marcos Jnr for signature by Monday, with critics warning that funds are again being diverted away from the Philippine Health Insurance Corporation (PhilHealth), the state insurer mandated to deliver universal coverage.\nUnder the current system, when hospital bills exceed PhilHealth coverage, patients can apply for additional state medical assistance through several programmes, including the Medical Assistance to Indigent and Financially Incapacitated Patients (MAIFIP).\n\n\nIn practice, critics say, MAIFIP support often depends on patients securing guarantee letters from lawmakers, typically routed through government-run “Malasakit Centres”, forcing patients and families to seek political mediation during medical emergencies.\nThe political power associated with these assistance funds was on display in May when Senator Christopher “Bong” Go topped the Senate midterm elections. Go authored the law creating Malasakit Centres, which were designed to cut red tape by serving as clearinghouses for assistance from multiple government agencies, including lawmakers’ guarantee letters.\nAntonio Dans, convenor of the Health Professional Alliance and an emeritus professor at the University of the Philippines College of Medicine, said members of dozens of groups were “outraged” by what he described as an entrenched system.\nThe petition denounced what it called the “hijacking of Universal Health Care”, alleging a “deliberate, coordinated effort to divert and politicise” PhilHealth funds.\nDans told This Week in Asia that instead of being fully funded, PhilHealth was being “gutted”, with tax money meant for it diverted to at least five separate programmes that he said duplicated PhilHealth’s function.\nThese include MAIFIP, which the poor can access only by personally obtaining guarantee letters from lawmakers which are then routed through Malasakit Centres, and the Assistance to Individuals in Crisis Situation (AICS), requested through the Department of Social Welfare and Development, often with the help of politicians.\nOn top of these, medical aid can also be requested directly from the Philippine Charity Sweepstakes Office and the Philippine Amusement and Gaming Corporation. Dans said both agencies were required by law to remit a portion of their gaming profits to PhilHealth, but had not done so to the full extent required.\n\nHe said health professional organisations were watching closely as lawmakers finalised the 2026 budget. If they were not satisfied, he said, they were prepared to raise the matter before the Supreme Court.\nDans said PhilHealth, as an insurance mechanism, was required to maintain a reserve fund of 147 billion pesos (US$2.5 billion) – enough, he said, to finance insurance for 24.5 million largely paying members at 6,000 pesos each.\n“But the budget [for next year] is only 69 billion pesos as of yesterday,” he said. “So, where did the 80 billion pesos go?” he added, criticising what he described as a lack of transparency.\nHe also said the government had fallen short in releasing its legally mandated counterpart funding to PhilHealth, claiming that from 2023 to this year, under the Marcos administration, the resulting funding gap had reached 255 billion pesos.\nDans said PhilHealth funds would be further strained next year by President Marcos’ pledge to implement his “Yakap” (Yaman ng Kalusugan or Health is Wealth) programme, which directs PhilHealth to fund, among other things, free cancer screening tests and medicines for indigents.\nDans said the programme alone would require 198 billion pesos. “So how do you fulfil those promises?” he asked.\nMedical aid as “campaign funds”?\nMedical professionals said they were particularly incensed by lawmakers’ decision to cut PhilHealth’s 2026 budget to 69 billion pesos while diverting 60 billion pesos from PhilHealth to fund MAIFIP.\nDr Tony Leachon, former president of the Philippine College of Physicians, told This Week in Asia that “as a health reform advocate, I cannot hide the deep sense of betrayal I feel over the passage of MAIFIP”.\n“Our lawmakers, political leaders, and even the institutions tasked to protect public health have chosen a path that weakens – not strengthens – our Universal Health Care Law,” he said.\n“UHC was built on a simple, powerful promise: every Filipino should have automatic, rules-based access to care through PhilHealth – no gatekeepers, no endorsements, no politics.”\nWhat is most concerning is that some of the recipients are not poor at all – they are well-to-do families who should not need political mediation to access care.\n- Dr Tony Leachon\n“MAIFIP moves us in the opposite direction. Instead of reinforcing UHC, it sidesteps it entirely, creating a parallel, discretionary system where access to care depends on letters, offices and influence.”\nLeachon said that in his clinical practice, he had been shown guarantee letters issued by lawmakers, with amounts varying widely.\n“What is most concerning is that some of the recipients are not poor at all – they are well-to-do families who should not need political mediation to access care,” he said.\nHe said the process harmed patients. “Delayed delivery of these letters often leads to prolonged hospital stays, unnecessary anxiety for families and avoidable congestion in our wards,” he said.\n“Instead of automatic, rules-based coverage through PhilHealth, patients are forced to wait for paperwork, signatures and endorsements.”\nFollowing public outcry, Senate President Vicente Sotto III told This Week in Asia that lawmakers were moving to remove the need for guarantee letters.\n“The Senate’s stand is to distribute it to the private hospitals through the Department of Health and PhilHealth. A legislator may request but it is no longer necessary,” Sotto said.\nDans said removing guarantee letters addressed only part of the problem, arguing that the existence of multiple assistance programmes fragmented care and complicated access for patients.\n“Imagine, you are already in a crisis,” he said. “If the PhilHealth amount isn’t enough, you have to line up for MAIFIP. If that isn’t enough, you go to PCSO and Pagcor or to AICS.”\n“Each one is a different line, a different queue,” he said. “Each one is a different office and each one has different regulations.”\n“You need to beg,” he said.\nDans said a soon-to-be-released study by medical professionals found that allocations under the guarantee-letter system discriminated against the poor.\nGuarantee letters issued by lawmakers to indigents averaged about 10,000 pesos each, he said, while those issued to beneficiaries in richer income groups averaged more than 30,000 pesos.\n“I don’t think you could call it an indigent fund if that’s what it’s being spent for,” Dans said. “Because the poor are getting very little from this.”\n“It’s really campaign funds,” he concluded.\n</p>
<div class="lb-trans"><p>菲律宾的医疗专业人士对此感到 “愤怒”，他们呼吁国会限制或废除他们所称的 “医疗猪肉”——通过政治家个人签署的担保信渠道提供给患者援助的税款——因为立法者正在最终确定 2026 年国家预算。\n 至少 72 个医疗和健康专业组织签署了一份联合请愿书，谴责这一做法，认为这使得政治家能够影响谁获得国家医疗援助，从而可以被用于政治利益，扭曲医疗服务的获取，并削弱该国的全民医疗保健系统。\n 随着国会准备在周一将预算提交给费迪南德·马科斯（Ferdinand Marcos Jnr）总统签署，这一问题变得更加紧迫，批评者警告说，资金再次被转移出菲律宾健康保险公司（PhilHealth），该公司是负责提供全民覆盖的国家保险机构。\n 在当前系统下，当医院账单超过 PhilHealth 的覆盖范围时，患者可以通过多个项目申请额外的国家医疗援助，包括针对贫困和经济无能患者的医疗援助计划（MAIFIP）。\n\n\n 在实践中，批评者表示，MAIFIP 的支持往往依赖于患者从立法者那里获得担保信，通常通过政府运营的 “Malasakit 中心” 进行，迫使患者和家庭在医疗紧急情况下寻求政治调解。\n 与这些援助资金相关的政治权力在 5 月的参议院中期选举中得到了体现，参议员克里斯托弗·“邦”·戈（Christopher “Bong” Go）获得了最高票数。戈是创建 Malasakit 中心的法律的作者，该中心旨在通过作为多个政府机构（包括立法者的担保信）的援助清算中心来减少繁文缛节。\n 健康专业联盟的召集人、菲律宾大学医学院的名誉教授安东尼奥·丹斯（Antonio Dans）表示，数十个团体的成员对他所描述的根深蒂固的系统感到 “愤怒”。\n 请愿书谴责了所谓的 “劫持全民医疗保健”，指控有 “故意、协调的努力来转移和政治化” PhilHealth 的资金。\n 丹斯告诉《亚洲周刊》，PhilHealth 并没有得到充分资助，而是被 “削弱”，本应用于其的税款被转移到至少五个他所称的重复 PhilHealth 功能的不同项目中。\n 这些项目包括 MAIFIP，贫困者只能通过亲自从立法者那里获得担保信，然后通过 Malasakit 中心申请，以及通过社会福利和发展部请求的危机情况下个人援助（AICS），通常需要政治家的帮助。\n 此外，医疗援助还可以直接向菲律宾慈善彩票办公室和菲律宾娱乐和游戏公司申请。丹斯表示，这两个机构根据法律要求将其部分博彩利润上缴给 PhilHealth，但并未完全按照要求进行。\n\n 他说，健康专业组织正在密切关注立法者最终确定 2026 年预算的过程。如果他们不满意，他表示，他们准备将此事提交最高法院。\n 丹斯表示，作为一种保险机制，PhilHealth 需要维持 1470 亿比索（25 亿美元）的储备基金——他表示，这足以为 2450 万主要是缴费的成员提供保险，每人 6000 比索。\n“但截至昨天，明年的预算只有 690 亿比索，” 他说。“那么，800 亿比索去哪了？” 他补充道，批评了他所描述的缺乏透明度。\n 他还表示，政府在向 PhilHealth 释放其法定对口资金方面未能达到要求，声称在马科斯政府下，从 2023 年到今年，导致的资金缺口已达到 255 亿比索。\n 丹斯表示，明年 PhilHealth 的资金将进一步受到压力，因为马科斯总统承诺实施他的 “Yakap”（Yaman ng Kalusugan 或健康就是财富）计划，该计划要求 PhilHealth 资助包括为贫困者提供免费的癌症筛查和药物在内的多项内容。\n 丹斯表示，仅该计划就需要 198 亿比索。“那么你如何兑现这些承诺？” 他问道。\n 医疗援助作为 “竞选资金”？\n 医疗专业人士表示，他们对立法者决定将 PhilHealth 的 2026 年预算削减至 690 亿比索，同时将 600 亿比索从 PhilHealth 转移到 MAIFIP 感到特别愤怒。\n 菲律宾内科医师学会前会长托尼·利奇昂（Dr Tony Leachon）告诉《亚洲周刊》，作为一名健康改革倡导者，他无法掩饰对 MAIFIP 通过的深深背叛感。\n“我们的立法者、政治领导人，甚至负责保护公共健康的机构选择了一条削弱而非加强我们全民医疗保健法的道路，” 他说。\n“UHC 建立在一个简单而有力的承诺上：每个菲律宾人都应通过 PhilHealth 自动、基于规则地获得医疗服务——没有守门人，没有推荐，没有政治。”\n 最令人担忧的是，一些受益者根本不贫困——他们是富裕家庭，根本不需要政治调解来获得医疗服务。\n- 托尼·利奇昂博士\n“MAIFIP 使我们走向相反的方向。它不是强化 UHC，而是完全绕过它，创造了一个平行的、任意的系统，医疗服务的获取依赖于信件、办公室和影响力。”\n 利奇昂表示，在他的临床实践中，他曾看到立法者签发的担保信，金额差异很大。\n“最令人担忧的是，一些受益者根本不贫困——他们是富裕家庭，根本不需要政治调解来获得医疗服务，” 他说。\n 他说，这一过程对患者造成了伤害。“这些信件的延迟交付往往导致住院时间延长、家庭不必要的焦虑以及病房的拥挤，” 他说。\n“患者被迫等待文书工作、签名和推荐，而不是通过 PhilHealth 获得自动、基于规则的覆盖。”\n 在公众的强烈反对下，参议院院长文森特·索托（Vicente Sotto III）告诉《亚洲周刊》，立法者正在采取措施取消担保信的需求。\n“参议院的立场是通过卫生部和 PhilHealth 将其分配给私立医院。立法者可以请求，但不再是必要的，” 索托说。\n 丹斯表示，取消担保信仅解决了部分问题，认为多个援助项目的存在使医疗服务碎片化，复杂化了患者的获取途径。\n“想象一下，你已经处于危机中，” 他说。“如果 PhilHealth 的金额不够，你必须排队申请 MAIFIP。如果这还不够，你就去 PCSO 和 Pagcor 或 AICS。”\n“每一个都是不同的队伍，不同的排队，” 他说。“每一个都是不同的办公室，每一个都有不同的规定。”\n“你需要乞求，” 他说。\n 丹斯表示，医疗专业人士即将发布的一项研究发现，担保信系统下的分配对贫困者存在歧视。\n 立法者向贫困者发放的担保信平均约为 1 万比索，而发放给富裕收入群体的受益者的担保信平均超过 3 万比索。\n“如果这就是它的支出方式，我认为你不能称之为贫困基金，” 丹斯说。“因为贫困者从中获得的非常少。”\n“这实际上是竞选资金，” 他总结道。</p>
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愤怒的菲律宾医生呼吁国会限制立法者的 ‘医疗利益’