Suansing Defends the Indefensible: ₱51 Billion for Patronage, Zero for PhilHealth—Because Dignity is Overrated

The Real Game: Graft, Votes, and Keeping PhilHealth on Life Support

By Louis ‘Barok‘ C. Biraogo — December 19, 2025

BRAVO, Congress! In a stroke of pure genius, you’ve turned healthcare into a medieval begging ritual: a desperate mother drags her burning-hot child to queue outside your district office at dawn, clutching dog-eared medical records, all for the honor of receiving your personal “guarantee letter”—that enchanted scrap of paper that might, just might, save a life. This isn’t satire; it’s the actual, state-sponsored reality of MAIFIP. And your latest act of compassion? Inflating its budget to a breathtaking ₱51 billion for 2026. Because nothing says “universal healthcare” like making the poor audition their suffering for political favor.

As Cardinal Pablo Virgilio David so rightly put it, this system is a “violation of human dignity.” The sick are forced to trade their pride for survival, transforming illness into a political debt—utang na loob—that binds them to their benefactor come election day. It’s not compassion; it’s a subtle, insidious form of vote-buying, where the price of medicine is gratitude, and the currency is loyalty. How grotesque that in a nation that prides itself on resilience, the poor must audition their suffering before a politician’s staff just to afford a hospital bed.

***“Who needs PhilHealth when you’ve got Phil-Hurt-them-for-votes?”***

Eviscerating the Defense: Mikaela Suansing’s Hollow Arithmetic

Oh, bless Representative Mikaela Suansing, chairperson of the House appropriations panel, who warns with grave solemnity that trimming this ₱51 billion bonanza would “deprive aid to over a million beneficiaries.” She trots out the numbers like a magician pulling rabbits: in 2025, ₱41.2 billion supposedly helped 3.3 million people; cut the funds, and 1.1 million poor souls will suffer (Panti,16 Dec. 2025). How heartbreaking. How convenient.

But let’s pause the violins and consult the Commission on Audit, that lonely voice of fiscal sanity. Billions in existing MAIFIP funds sit idle—₱3 billion unspent in 2024 alone—gathering dust while hospitals refuse guarantee letters and patients die waiting. Is the real crisis a shortage of money, or a system so drenched in patronage and incompetence that it cannot even spend what it already has? Suansing’s arithmetic is touching, but it crumbles under the weight of reality.

And here’s the ultimate perversion: while MAIFIP swells like a politician’s ego, the government’s direct subsidy to PhilHealth—the very cornerstone of the Universal Health Care law—has been slashed to zero. This isn’t strengthening healthcare; it’s deliberately starving the institutional, rules-based system to feed a discretionary slush fund controlled by lawmakers. Bravo, Congress—you’ve turned universal coverage into a punchline.

Patronage Politics: The “Health Pork Barrel” Unmasked

Let’s call it what it is: a health pork barrel. Cardinal David again nails it—this mechanism “reproduces precisely what the Supreme Court prohibited” when it outlawed the Priority Development Assistance Fund (PDAF) in 2013. Yet here we are, a decade later, with the same playbook: politicians deciding who gets help, how much, and when. The guarantee letter places them at the center of the drama, the benevolent patrons dispensing favors from their offices.

This isn’t a safety net; it’s a political web. Access depends not on need, but on connections—on letters, on lining up, on knowing which congressional door to knock. It makes a mockery of the Universal Health Care law’s promise: automatic, equitable coverage for all Filipinos. Instead, the poor are reduced to supplicants in a feudal ritual, while the powerful harvest votes from their desperation.

The Real Motivations: Graft, Power, and Political Survival

Why do lawmakers cling to this broken system with such fervor? Spare us the noble rhetoric about “filling gaps” in PhilHealth coverage. Deputy Speaker Kristine Singson-Meehan insists MAIFIP “strengthens” universal healthcare. How noble. How absurd.

The guarantee letter is the perfect campaign coupon—tangible proof of a politician’s “concern,” delivered personally to create manufactured gratitude. In an election year, with midterms looming in 2026, ₱51 billion is less a health program than a war chest.

Then there’s the scent of graft. A massive pool of cash, distributed through opaque, discretionary letters, with lax vetting and delayed reimbursements? It’s an engraved invitation to corruption—kickbacks from favored hospitals, inflated bills, funds parked for campaigns. And let’s not ignore the deeper sabotage: some prefer a crippled PhilHealth because a dysfunctional public system leaves room for private profiteering and, of course, more political intermediation. The poor stay dependent, the powerful stay in power. Everyone wins—except the sick.

A Path Forward: Prescriptions for a Dignified System

Enough. This isn’t inevitable; it’s a choice—and a shameful one.

President Marcos should wield the line-item veto and strike this ₱51 billion insertion from the budget. No more half-measures.
Abolish the politician-issued guarantee letter immediately. Non-negotiable. Redirect every peso to PhilHealth—bolster its coverage, expand zero-balance billing, make healthcare a right, not a favor.
Build a system worthy of a modern nation: replace bond-paper begging with a transparent, digital voucher tied to national IDs, managed by hospital social workers and the Department of Health, not congressional staff. Publish a real-time public dashboard tracking every cent disbursed. Let Filipinos see where their taxes go, instead of watching politicians play Santa Claus with their suffering.

As Cardinal David reminds us, “The sick should receive care because they are sick, not because they know someone.” Anything less is a betrayal—of dignity, of law, of the very promise of a compassionate society. The poor deserve better than to be pawns in this grotesque theater. It’s time to close the curtain on patronage politics and open the door to real healthcare for all.

Deep in the Cave of Truth

Nothing says “universal healthcare” like making the sick beg on cue. Bravo on the ₱51 billion encore, lawmakers—don’t forget to take a bow on election day.