Can we also mourn the living?

The cries of children echo through a pediatric ward. In another part of the hospital, an elderly patient lies on a bed in the hallway, waiting for a room to become available. Nurses move between patients, attending to one need before another arises. Families wait, worry, and try to make sense of a system they depend on but cannot always afford.

For many Filipinos who rely on public hospitals, these scenes reflect a difficult reality: seeking medical care does not always mean receiving it under conditions that preserve a patient’s comfort, privacy and dignity.

Recently, posts shared in a local public Facebook community sparked discussions about conditions in two public hospitals in Iloilo City. The posts featured images that appeared to show patients waiting for medical attention, a shortage of available hospital beds, patients receiving intravenous fluids while seated on steel waiting benches, and overcrowded wards accommodating patients of different ages.

As Congress deliberates the proposed 2027 national budget, the allocation for healthcare raises a pressing question: Are public resources sufficient to meet the needs of the people who depend on the public health system?

Indeed, some horrors unfold beneath the fluorescent lights of public hospital wards — found in the cries of a child whose pain blends into the chorus of other children crying for relief. In the elderly patient lying on a makeshift bed in a hospital corridor, surrounded by strangers and deprived of the privacy that should accompany their most vulnerable moments. In the exhausted healthcare worker who moves from one patient to another, fighting to keep people alive while struggling to make a living themselves.

Here, there are no ghosts to blame. Only people who need help, people who provide it, and a system that too often leaves both to suffer.

And perhaps the most frightening question of all is this: Can we also mourn the living?

The horror behind the hospital doors

A public hospital should be a place where the right to healthcare becomes tangible. It should be where a person’s income, occupation or social standing matters less than the urgency of their need. It should be where a sick person can expect treatment without having to calculate whether getting better will leave their family financially devastated.

Yet the realities of an overburdened healthcare system can make receiving care an ordeal in itself.

Overcrowding reduces patients to bodies competing for beds. Long waits turn suffering into a queue. Limited facilities and resources force healthcare workers to make difficult decisions about how to distribute their attention. Patients who should be resting and recovering may instead find themselves exposed in corridors, waiting areas and other spaces never intended to substitute for proper hospital rooms.

In these circumstances, dehumanization does not always arrive as outright cruelty. Sometimes, it comes through necessity masquerading as normalcy.

It is important to recognize that healthcare workers themselves are not the villains in this horror story. Many labor under immense pressure, doing what they can with the resources available to them. They, too, are caught in a system that demands extraordinary sacrifice while often failing to provide the staffing, equipment, facilities and compensation necessary to sustain their work.

The tragedy is that suffering becomes routine. The sight of a patient in a hallway no longer shocks us as it should. The image of an exhausted nurse no longer surprises us. We begin to accept conditions that should never have become acceptable in the first place.

And when indignity becomes ordinary, the system no longer has to explain itself.

The people simply learn to endure.

The price of being sick

Healthcare is not charity. It is not a favor bestowed upon the poor by a benevolent institution, nor a reward reserved for those fortunate enough to afford private treatment.

It is a public responsibility — and a right that demands public investment.

That responsibility becomes especially urgent when we examine the government’s proposed spending priorities.

Under the proposed 2027 National Expenditure Program (NEP), the Department of Health (DOH), its attached agencies and corporations, specialty hospitals, and PhilHealth were allocated approximately PHP 353.8 billion. The Department of Budget and Management (DBM), meanwhile, placed the broader consolidated health sector budget at PHP 1.06 trillion, equivalent to approximately 3.19 percent of the country’s gross domestic product (GDP). The two figures reflect different scopes of health spending.

The DBM has presented these allocations as part of the administration’s broader effort to improve access to healthcare. Yet the adequacy of that funding, and how effectively it will translate into services, remain questions that deserve serious scrutiny.

Of the proposed PHP 353.8 billion allocation, approximately PHP 135.48 billion was earmarked for the operating expenses of DOH hospitals and public health facilities. PhilHealth was allocated roughly PHP 74.4 billion, including approximately PHP 55.4 billion for premium subsidies for eligible sectors such as indigent families, senior citizens, persons with disabilities and solo parents, alongside PHP 19 billion intended to improve benefit packages and support priority health interventions under the Universal Health Care Act.

Another PHP 25.39 billion was designated for deploying doctors, nurses and allied health professionals. The original proposal included approximately PHP 24.23 billion for the Medical Assistance to Indigent and Financially Incapacitated Patients (MAIFIP) program and PHP 4.5 billion for the Health Facilities Enhancement Program (HFEP). Subsequent House budget deliberations also provided for an additional PHP 23.97 billion in medical assistance. These figures describe proposed appropriations and legislative adjustments, not necessarily the amounts ultimately released or spent.

On paper, these allocations represent billions of pesos directed toward hospitals, health workers, financial assistance and public facilities. But the question is not merely how large the numbers appear on a budget document. It is what those numbers will mean to the people who depend on them.

Will there be enough beds for patients who need them? Will hospitals have sufficient medicines and functioning equipment? Will indigent families receive timely assistance? Will doctors and nurses be adequately supported? Will public facilities be able to treat people without forcing them to endure conditions that compromise their dignity?

A budget can announce its intentions in billions. A patient experiences those intentions one medicine, one consultation, one hospital bed and one difficult night at a time.

The distance between these two realities is where accountability must begin.

The government has defended its proposed health allocation as part of a people-centered spending plan. However, during House budget deliberations in September 2026, Health Secretary Edwin Mercado disclosed that the DOH and its attached agencies had originally proposed PHP 837 billion — substantially more than the PHP 353.8 billion provided under the NEP. He warned that some programs could be compromised by the difference. PhilHealth officials also sought additional funding to support the insurance contributions of indirect contributors.

The figures invite an uncomfortable question: When the resources available to public healthcare fall short of the needs identified by the very institutions responsible for delivering it, who bears the consequences?

The consequences are borne by patients who wait, families who borrow, and workers who are asked to do more with less.

And the cost of an inadequate healthcare system is not measured in pesos alone. It is measured in prolonged pain, compromised dignity and opportunities for recovery placed further out of reach.

When even the country’s hospitals must beg

The strain becomes particularly visible in hospitals connected to state universities and colleges (SUCs), whose budgets are tied to higher education appropriations rather than being funded directly through the DOH.

Among them is the Philippine General Hospital (PGH), a major public teaching and referral hospital under the University of the Philippines System. For patients who cannot afford private healthcare, institutions like PGH are not merely hospitals. They are often among the few remaining places where treatment may still be within reach.

Yet the proposed 2027 NEP places PGH’s Hospital Services Program at approximately PHP 7.291 billion, a reduction of PHP 805.46 million from its 2026 funding level.

The DBM and Malacañang have defended the reduction as an adjustment for nonrecurring capital expenditures. According to economic managers, certain infrastructure projects and one-time building construction expenses funded in 2026 had been completed, so those specific allocations would no longer recur in the following budget cycle.

That explanation matters. A reduction in a hospital’s budget does not automatically mean that the same amount has been taken away from its day-to-day patient care; the composition of the previous allocation must also be considered.

Nevertheless, the reduction deserves close scrutiny. Even if some capital expenses were one-time costs, lawmakers and the public must still determine whether the remaining appropriation will adequately support the hospital’s continuing operational needs.

The broader SUC budget raises similar concerns. The proposed allocation stands at PHP 141.090 billion. While this represents a nominal increase over the previous year’s proposed budget, it is PHP 2.979 billion, or about 2.1 percent, below what SUCs received under the finalized 2026 General Appropriations Act.

For universities with hospitals, laboratories and clinical training programs, fiscal constraints can affect more than classrooms and research. They can also affect the institutions that provide medical care to lower-income communities.

When public hospitals are embedded in educational institutions, the consequences of budget decisions can extend across both systems. A shortage of resources may affect patient services, medical training and the capacity to sustain a healthcare workforce.

These are not merely accounting concerns. They are questions about whether public institutions can continue fulfilling the responsibilities entrusted to them.

If a hospital’s funding is reduced because certain construction projects have ended, the next question should be whether the facilities that remain can be properly staffed, equipped, maintained and operated.

The government must therefore demonstrate that its budget decisions account not only for the construction of facilities but also for the continuing human needs within them.

Where do the people’s resources go?

There is something especially unsettling about the contrast between the public’s need for healthcare and the persistent questions surrounding the use of public money.

Filipinos contribute to the national coffers through taxes and other public revenues. They do so while paying for food, transportation, education, utilities and the many other expenses required to survive. When illness comes, they should not have to confront a system in which the ability to receive timely, dignified care depends so heavily on what they can afford.

Yet public spending does not become meaningful simply because it has been appropriated. It must be translated into services that people can actually access.

This is where transparency and accountability become indispensable. When public resources are misused, diverted, wasted or spent without delivering their intended benefits, the consequences extend far beyond financial losses. They can mean fewer medicines, poorly maintained facilities, inadequate staffing, delayed compensation for healthcare workers and greater hardship for those who have nowhere else to turn.

These problems are not new. From reports of ghost healthcare facilities to delayed hazard pay for healthcare workers, questions about the management and distribution of public health funds have persisted for decades. A 2005 investigation by the Philippine Center for Investigative Journalism (PCIJ), for instance, documented estimates from doctors, suppliers and local officials that kickbacks on some local government medicine purchases ranged from 10 to 70 percent of contract prices. More than two decades later, these longstanding concerns remind us that the problem is not simply how much money the government allocates to healthcare, but also how much of it actually reaches the people and institutions it is meant to serve.

The horror is not simply that the country has limited resources. Every government faces competing demands and fiscal constraints. The horror is that public suffering persists without sufficient urgency to address it, while decisions about public money remain beyond meaningful public scrutiny.

A government cannot ask its people to trust a healthcare system merely because it promises to improve it. If healthcare is a right, then access to it cannot remain a privilege in practice.

The living deserve to be mourned, too

But mourning must not become another way of accepting defeat.

Grief, after all, does not end with tears. It moves through stages, and though those stages are neither universal nor orderly, they offer a language for what comes after loss.

There is denial: the insistence that the system is functioning well enough, that crowded wards are simply inevitable, that patients must learn to be patient.

There is anger: the realization that suffering should not be normalized, that public services must be held accountable, and that the people who depend on these services deserve more than assurances.

There is bargaining: the negotiations over budgets, the appeals for additional funding, the demands to restore allocations, and the promises that the next spending cycle will be better.

And then there is something that grief alone cannot accomplish.

There is resistance.

Not resistance to change, but the refusal to accept preventable suffering as the natural order of things. The insistence that public funds be spent transparently, that healthcare workers be supported, that hospitals receive the resources they need, and that universal healthcare become more than a policy written into law.

Resistance means asking difficult questions during budget deliberations and continuing to ask them after the hearings end. It means demanding that appropriations be evaluated not only by their stated objectives but also by their actual effects on patients. It means listening to healthcare workers, amplifying the experiences of patients, and recognizing that the right to healthcare requires sustained public investment and accountability.

It means refusing to let the living disappear into the background of a system that has grown accustomed to their suffering.

So, can we mourn the living?

Maybe we can. Maybe we must.

But we must also understand that mourning, by itself, is not enough.

If we are to mourn the living, let our grief become a demand for change. Let our anger become scrutiny. Let our questions become accountability. Let our compassion extend beyond individual acts of kindness toward the larger structures that determine whether people receive the care they need.

Because the real horror is not only that people die.

It is that people suffer in ways we have learned to tolerate, in places where they should have found relief, under institutions that exist to protect them.

And the greatest tragedy would be to witness this suffering, mourn it for a moment, and then allow it to continue unchanged.