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“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.
At 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.
The 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.
Under 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).
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In 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.
The 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.
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