Poor tobacco farmers  prop up PhilHealth fund

March 28, 2016 at 9:03 am Leave a comment

By Yolanda Sotelo
DAGUPAN CITY – Twice last year,  Dahlia Parajas, 41, was hospitalized for five days each time.
The first was in May 2015 when she had a miscarriage and had to undergo some medical procedures that needed confinement for five days at the Region I Medical Center (RIMC). In October, she was afflicted with measles and pneumonia for which she was treated at the Pangasinan Provincial Hospital for five days.
His husband, Roland, 47, was confined for five days at the RIMC in July after he complained of pain in the chest and nape. He was suffering from hypertension.
If the two paid for their hospital expenses, they would have shelled out around P40,000, a hefty sum for Dahlia, a kasambahay (househelper) who earns P4,000 a month; and Roland, a tricycle driver who earns an average of P150 a day. The couple from Calasiao has five children aged from three to 20.
But since they are beneficiaries of the 4Ps (Pantawid Pamilyang Pilipino Program) of the national government and are automatic members of the Philippine Health Insurance Corporation (PhilHealth) which paid for their hospital bills.
Somewhere in Villasis, Federico Feria looked much older than his age of 66 years. His skin is burnt and wrinkled from staying out in the sun from sunrise to sunset tending an 8,000 square meter tobacco farm.
Feria, whose parents were also tobacco farmers, started to lease the farm when he was 25 years old. He has nine children, two of whom are his helpers in the field.
But he started smoking “cigarette” at much younger age – “maybe at 14 or 15,” he says.
He and his cousin Manio, 64, recalled how they would spray the tobacco leaves with vinegar (“to give flavor to the leaves”), dry them under the sun, and roll them. Those were the first cigarettes of the young residents of the tobacco producing village, they recalled.
Later, they would buy shredded tobacco leaves (“sometimes we shredded our own leaves”) in  town store. They rolled these using cigarette papers locally called ar-ros. Soon, Frias was smoking “branded” cigarettes named Serena and Bataan Matamis.
Feria now smokes a popular brand which costs P40 a pack (with 20 sticks). Daily he consumes one pack.
“I tried to stop smoking, but I felt dizzy and weak,” Feria says.
They do not know it  but the lives of these persons are interlinked. Whenever the Fabros buys a pack of cigarette, they pay a sin tax, part of which is used to fund PhilHealth, the country’s health insurance system.
During a recent six tax workshop for journalists held in Bolinao town,  May-I Fabros of the WomanHealth Philippines –Alternative Budget Initiative Center presented how much money was allocated to the PhilHealth in the past three years from the sin tax.
In 2015, sin tax (or excise tax levied on alcohol and tobacco) contributed P37.19 billion to the PhilHealth funds. The allocation from sin tax for PhilHealth in the years 2013  was P12.63 billion  and in 2014, it was  were P35.34 billion.
For three years, smokers and drinkers contributed P120 billion to the PhilHealth, aside from the allocation to the Department of Health which is P138.7 billion.
One may find it ironic that the tobacco farmers who “feeds” the cigarette manufacturing companies are still at the lowest rung in the tobacco sector.  And that it is the smokers who buy cigarettes by stick; who “produce” bilions of money to pay the bill of many poor patients who cannot afford high cost of hospitalization.
Fabros for instance who has been planting tobacco almost all his life and has been smoking cigarettes since he reached his teen-aged years, still has to buy a single piece of land that he can call his own. His parents never owned the land they tilled, and his sons may never buy a piece of farmland.
Instead, Fabros has to rent the farm lot he plants to tobacco at P20,000 each cropping season. He considered the last harvest as “good” as the buying price of dried tobacco leaves was from P60 to P65 per kilo.
His gross sale was around P140,000, he says, but the net income is half of the amount, as half goes to land rental, fertilizer, pesticide, tractor rental, irrigation and labor.
One cropping season for tobacco is five months, with the planting in November and harvesting in March, or sometimes late February, he says.

The net income of P70,000 may seem hefty at first glance, but if divided by five months and shared with his two sons, it may not be as big. Fabros gets P40,000 which means he earns P7,000 a month; while his sons get P30,000 which they divide between them.
The year 2015 may be considered special for the farmers as far as tobacco price was concerned. In 2013 and 2014, the prices were pegged at P20 to P30 per kilo, discouraging most farmers from planting tobacco. “Since there were only few of us who planted, there was low production so the prices went up,” he says.
But most tobacco farmers and smokers do not know they contribute to PhilHealth, including Fernando Lozano, 70, who started smoking when he was 15 and never stopped until now.  In his 20s and 30s, he was a chain smoker, consuming up to three packs a day.
When, as a teenager he ran out of money, he smoked rolled tobacco leaves, just like what other young residents in Villasis did.
There was a time that when Lozano, who also farmed tobacco,  smoked a “high-end” brand which cost P30 before the Sin Tax Law was implemented. That brand cost P60 per pack now (“P80 at the sari-sari store”) so he shifted to a cheaper brand which cost P30 a pack in the market at P50 at the sari-sari store in his village. He is also down to two packs daily.
But he did not know that the price increase was because of sin tax, saying he had no idea what that law was. Neither did he know that by smoking, he was directly contributing to the PhilHealth funds.
It could be the hospitals that are the big winners in the PhilHealth program. Dr. Policarpio Manuel, chief of the Pangasinan Provincial Hospital in San Carlos City, says.
“There are times when you spend only P5,000 for a pneumonia patient, but you collect P28,000 from PhilHealth. But there was one instance, too, that we had to spend P850,000 for a stroke patient but PhilHealth pays only P38,000.  But overall, the hospital wins,” Manuel says.
And it wins real big.
In 2015, the PPH spent P19 million to enroll indigent patient to the PhilHealth through the Point of Care system (when patients are enrolled only when they are hospitalized).
But the enrollment fee was a pittance compared to the total collection of the PPH from PhilHealth – a whooping P320 million
Since smoking contributes to PhilHealth, should it be encouraged?
“Not at all,” says Maria Encarnita Limpin of the Framework Convention on Tobacco Control Alliance Philippines that worked for the passage of Sin Tax Law.
“Increasing taxes would reduce smoking among the people, as well as raise fund for tobacco control policies and pay for other public health and social programs,” she says.
But while the Sin Tax Law has been passed,  the battle is not over yet, Jo-Ann Latuja of the Action for Economic Reforms, says.
“The tobacco industry people and those with vested interests are very aggresive and are using their influence to reverse the law. We should always be vigilant to defend the gains of the law,” she says.

Entry filed under: News.

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