New pork barrel? Health workers flag MAIFIP budget hike in bicam

MANILA, Philippines – Organized health professionals have flagged the bicameral conference committee’s move to increase the budget for the Medical Assistance to Indigent and Financially Incapacitated Patients (MAIFIP) Program, with one calling it a “new pork barrel.”

The MAIFIP is a Department of Health-funded program that provides financial assistance for the medical expenses of patients who cannot afford out-of-pocket costs. It was established in 2014, and used to be called Medical Assistance to Indigent Patients.

To avail, patients need to reach out to the primary care facility’s MAIFIP Program coordinator. A hospital social worker then assesses the patient’s eligibility. If qualified, the social worker or the MAIFIP Program coordinator will seek the approval of the medical aid.

However, some patients cannot avail of the assistance without obtaining a guarantee letter from politicians, which critics said is a form of political patronage.

The bicameral conference committee, which reconciles disagreeing provisions of the budget bills of the Senate and House of Representatives, agreed to raise the MAIFIP Program budget from P49 billion to P51 billion.

The Philippine Medical Association (PMA) opposed the MAIFIP budget increase, noting that it would be better to put more funding for the Philippine Health Insurance Corporation (PhilHealth).

“We believe it is better to increase the budget given to PhilHealth, which offers direct payment benefits to the patients’ hospital bills rather [than] having to beg from politicians, which is a high form of patronage politics,” PMA president Hector Santos Jr. told Rappler on Tuesday, December 16.

For physician and health advocate Tony Leachon, the MAIFIP Program does not boost Universal Healthcare but instead “sidesteps” it.

“MAIFIP creates a parallel, discretionary system where access depends on letters, offices, and influence. That’s not universal care — that’s selective care,” Leachon posted on social media.

Describing it as a “new pork barrel,” Leachon wants the removal of the MAIFIP Program.

“The Supreme Court already struck down pork‑style programs that let politicians influence who gets public funds. MAIFIP looks and feels like a return to that old system,” he said. “When health care becomes political, patients lose dignity.”

Non-governmental organization International Center for Innovation, Transformation and Excellence in Governance (INCITEGov) echoed the sentiment on political patronage.

“As long as citizens must pass through politicians to secure assistance for hospital bills, the system will remain fragmented, inequitable, and vulnerable to patronage and abuse. This approach does not strengthen universal health care; it undermines it, delaying the realization of a health system that is rights-based, dignified, and accessible to all,” INCITEGov wrote on social media.

The DOH proposed a provision to direct much of the MAIFIP funding toward expanding the zero-balance billing program in local government-run hospitals.

Currently, the zero-balance billing is implemented in 87 DOH-run hospitals.

“This proposed special provision aims to provide not only catastrophic health funding but shall be used for expanded implementation of the ZBB initiative to LGU hospitals, ensuring that more Filipinos have access to health services and are protected from financial risk,” Health Secretary Ted Herbosa wrote in a letter addressed to Senate President Vicente Sotto III on October 17.

During the bicam meeting, the Senate contingent expressed concern that the program would perpetuate patronage of public officials, but the House counterpart said about 1.1 million patients would be affected if the MAIFIP budget would be slashed as the universal healthcare law is not yet fully implemented. – Rappler.com