Like Mary and Joseph looking for a place to give birth, Eleanor and Edgar approached several government hospitals for Eleanor’s premature delivery. And like Mary and Joseph who were several times turned away, Eleanor and Edgar “were refused admission for some reason or other. Some facilities claimed they did not have incubators for premature babies.”[1]
We still cannot understand how hospitals, especially government hospitals, continue to turn away people in need of medical help. We do not think that’s mere ignorance of the almost 15-year old law that is Republic Act No. 8344 (“An Act Penalizing The Refusal Of Hospitals And Medical Clinics To Administer Appropriate Initial Medical Treatment And Support In Emergency Or Serious Cases …), we think its just the blatant disregard of it.
But that is not why we are making this post since we’ve already discussed RA 8344 previously - it’s because Eleanor and Edgar’s plight did not end upon the birth of their boy. While Mary and Joseph were given gifts by wise men, Edgar and Eleanor were given a ransom demand by not so wise men. The hospital told them that they had to pay “more than P700,000 for the delivery and care of [their] premature baby.”[2]
Eleanor is a golf caddie while Edgar is an unemployed former grass cutter. So, from the time of their son’s birth on July 19, 2011 until November 25, 2011 – over 4 months - Baby John stayed inside the University of Perpetual Help - Dr. Jose Tamayo Medical Center in Biñan (UPH), Laguna not because he was sick but because his parents couldn’t pay the (unbelievable) P700,000.00-plus hospital bill.
Baby John was released only on November 25, 2011after media exposure of their story and after the couple’s appeal to the Department of Health (DOH). Pursuant to R.A. 9439 (An Act Prohibiting The Detention Of Patients In Hospitals And Medical Clinics On Grounds Of Nonpayment Of Hospital Bills Or Medical Expenses)[3], Eleanor and Edgar “signed a promissory note undertaking to pay the hospital bill in monthly installments.”[4]
Illegal Hospital Detention
We don’t have to tell you that what UPH did was wrong, at least morally. But how wrong were they, legally?
Let’s start with Section 1 of RA 9439 which states:
It shall be unlawful for any hospital or medical clinic in the country to detain or to otherwise cause, directly or indirectly, the detention of patients who have fully or partially recovered or have been adequately attended to or who may have died, for reasons of nonpayment in part or in full of hospital bills or medical expenses.
The news reports do not contain any allegation that Baby John was being held by UPH because he was still sick. Although, it was reported that for “four months [Eleanor] was not allowed to touch or hug her baby as hospital staff said he needed intensive care because, having weighed only 1.14 kilograms at birth, he had pneumonia and pulmonary problems.”[5] That excuse seems to be a defense against Eleanor’s claim of lack of contact with her baby than a defense in favor of the baby’s detention.
Section 2 further states:
Patients who have fully or partially recovered and who already wish to leave the hospital or medical clinic but are financially incapable to settle, in part or in full, their hospitalization expenses, including professional fees and medicines, shall be allowed to leave the hospital or medical clinic, with a right to demand the issuance of the corresponding medical certificate and other pertinent papers required for the release of the patient from the hospital or medical clinic upon the execution of a promissory note covering the unpaid obligation…
Promissory Note
Unfortunately, under the circumstances, hospitals/clinics are at best left with –
1) A promissory note required as follows -
The promissory note shall be secured by either a mortgage or by a guarantee of a co-maker, who will be jointly and severally liable with the patient for the unpaid obligation. In the case of a deceased patient, the corresponding death certificate and other documents required for interment and other purposes shall be released to any of his surviving relatives requesting for the same. (Section 2)
In the case of a deceased patient, DOH Administrative Order No. 2008-0001 (Implementing Rules And Regulations of Republic Act No. 9439) [6] clarifies that any of the surviving relatives who refuse to execute a promissory note shall be allowed to claim the cadaver and can demand the issuance of death certificate and other pertinent documents for interment purposes, but documents for other purposes shall be released only after the execution of a promissory note. (Part V. A. Paragraph 3)
2) An assignment of proceeds, as follows:
DOH AO No. 2008-0001 adds that in the case of a deceased patient and in the event that the above-mentioned documents “will be needed for the purposes of getting the benefits from the SSS, GSIS, Philhealth, insurance policies or pre-need plans, the hospital may require the execution of an assignment of proceeds up to the extent of the hospital bills or medical expenses/hospitalization.” (Part V. A. Paragraph 2)
The only other protection for hospitals/clinics is that RA 9439 does not apply to “patients who stayed in private rooms” (Section 2). So does that mean private room patients can be held by hospitals/clinics for ransom if they can’t pay? Food for thought.
Illegal Detention of Cadaver
Yet, despite the clear mandate of the RA 9439 and DOH AO No. 2008-0001, hospitals continue to find excuses to try and circumvent the law -
“To add insult to injury, the hospital put us through a terrible and humiliating ordeal before we were able to take my mother’s body for a proper funeral and burial. We were asked to provide collateral, postdated checks, OR/CR of vehicles or find a guarantor who will vouch for us.
Funeraria Paz arrived to take mama’s body but the hospital insisted that we needed to keep the body at Holy Trinity for “preservation” while we are negotiating the terms of the promissory note. They insisted that they weren’t holding my mom’s body, but repeatedly refused to release it. They advised us to keep the body at Holy Trinity for preservation in a fridge for a “minimal fee” of P4,000-5,000 per day.” – Account of Alva Marano-Alfonso detailing “what the Marano family went through when their beloved mother, Josephine, passed away last November 16 at age 56. The body was held for ten hours, pending down-payment of P200k. The title of their home is being demanded by the Paranaque Doctors’ Hospital as collateral — until their bills are fully settled.”[7]
DOH assistance
To help both the patients and the hospitals/clinics, the DOH is mandated to, “as far as practicable, assist patients in looking for financial assistance from government and non-government sources to settle the unpaid hospital bills or medical expenses / hospitalization expenses. Toward this end, the DOH shall work closely with fincancial institutions like, but not limited to, [Philhealth], [PCSO], [PAGCOR], [LGUs], as well as Congress, to provide funds for this purpose. (Part V. B. Paragraph 1 c))
Although, in the case of Eleanor and Edgar, the DOH guaranteed P10,000.00 financial assistance and the PCSO guaranteed a P50,000.00 donation, the government should be made to guaranty more substantial financial assistance to indigent patients.
Liability of hospital/clinic
Any officer or employee of the hospital or medical clinic responsible for releasing patients, who violates the provisions of R.A. 9439 and its implementing rules and regulations shall be punished by a fine of not less than P20,000.00, but not more than P50,000.00, or imprisonment of not less than 1 month, but not more than 6 months, or both such fine and imprisonment, at the discretion of the proper court. (Section 3, RA 9439; Part V. B. Paragraph 3, DOH AO No. 2008-0001)
Business is business, true; but lives are lives – priceless and invaluable. Lives are mothers, fathers, daughters, sons, relatives, friends, loved ones. Business is just business. For a profession that deals with lives regularly and intimately, it is appalling that it should be health personnel who should treat people the worst if only to continue making money.
[1] Alcantara, S. R. (2011, November 20). Baby john’s plight touches netizens. Retrieved from http://technology.inquirer.net/6299/baby-john’s-plight-touches-netizens/
[2] Supra.
[4] Alcantara, S. R. (2011, December 4). ‘Hostage’ baby is finally home. Retrieved from http://newsinfo.inquirer.net/104923/hostage-baby-is-finally-home
[5] Supra.
[6] January 7, 2008
[7] Villanueva-Ong, Y. (2011, December 6). The high cost of dying. Retrieved from http://www.philstar.com/Article.aspx?articleId=755429&publicationSubCategoryId=64
