Without the White Coat
By Dr. Florentino P. Alerta II

 Increased VAT… its effects on Doctors

 Call it hard, but life is getting there for practicing physicians in our communities. Raising the VAT (value added tax) to 12 % will surely take a big dent on the doctor's practice; he/she might raise his/her consultation fees, and may have second thoughts of taking up a nursing course. The number of practicing doctors may have dwindled down due to the outflow of physicians to foreign countries as nurses or plainly migrating abroad for greener pastures. (The question is, who will then take care of the “sickly and ill” FILIPINO patients?) The practicing physician may pass the buck to his/her patients by increasing his/her professional or consultation fee, but in the long run it is the ill and sickly Filipino patient on the receiving end. Aside from the prime commodities like noodles and canned goods that will be taxed heavily, it is still the “common tao” who would carry the burden. (Leaving the government coffers full again, giving our officials in government more and an endless supply of monetary funds ready for the taking and picking for the graft and corruption in our government agencies). For some in medical practice they may raise their fees, but for some they may still stick to their old fee schedules. (These are the doctors with a clear and a Christian conscience, and mind you there are still the vultures in medical practice out there just waiting and preying on the poor patients in their emergency rooms, as one physician coined a name for it “MEDICAL CORRAL”, in where a patient is held at bay until all the vultures of medical practice will take a piece of the patient [in the future will try to do an article on it.])

It is like adding insult to injury, with a dwindling supply of physicians seen in the understaffed district hospital of the country due to either change of career or just simply searching for that greener pastures. (Medical practice don't pay that much anymore compared to the old days.) For the practicing physician it is either he/she will see only a few patients so that he will be taxed lesser, or go ahead with his thriving practice and pass the buck to his/her patient, either way we will be taxed, a game with no way out. Being taxed by the government properly is not a problem, what really hurts is the corruption that sips into the veins of our government agencies, the taxes that are collected then being used by our beloved government officials to purchase big, extravagant and humungous mansions, expensive, gas gusslers and top of the line vehicles, elaborate and luxurious trips abroad and lastly the money that is stolen from the government coffers goes into the purchase of expensive “flesh” from the entertainment industry. Tax money that is used properly in our case, in medical health care, in increased salaries for government doctors, availability of medications, and extended services for our community. A national medical insurance plan that any patient may he/she be rich or poor can avail of “all” the services of a private and government hospital, and the proper and correct reimbursements for the medical institutions and individuals rendering their services. It doesn't hurt if our tax money is used properly and returned back to us in form of services.

Adding the value added tax (VAT) on the income of doctors will surely change the trend of medical practice in this country, whose main purpose of getting more taxes is to cover up the deficits in our government's budget and hoping and praying it won't end up in someone's bank account. Those that are service-oriented physicians will just think of some ways to feed their starving family, or just look for an alternative way for a different kind of living and career. For some, a career shift just to augment the much-needed income. Lesser lines will form outside the doctor's office, since the consultation fees will go up. Patients and their families will either self medicate themselves or just wait and just keep on carrying the illness until it will get worse and sought emergency medical intervention and help in the medical institution's emergency (remember this is where all the vultures of medical practice hang out—I pity the patient any place he/she goes there are always these vultures), hoping they can still reach the medical institution and offered early medical intervention, but if realizing the severity of the illness the patient might go to failure or simply arrested in the emergency room and if she/he will be admitted then the cost of hospitalization will eat up all their family savings, thus not a good cost -effective move, so always consult your doctor.