00:00Dr. Stuart Bennett, TMCCO, Dr. Ruben Casada, TMCCMO, Dr. Gregorio Martinez, nursing heads
00:22of both RMC and TMC.
00:25Other leaders and managers of selected units of RMC and TMC.
00:30Our special guests, media friends, ladies and gentlemen, a pleasant good morning to
00:36all.
00:37Special mention to Bruni Cervosa, who is a good friend and you already heard is part
00:42of the original dream team, liver transplant team of this institution.
00:47This morning I will tell you a story.
00:51It was in January 7, 2011, 14 years and two days ago, when we did our first liver transplant
00:59here at the Medical City.
01:01It was in a three-year-old child with end-stage liver disease due to sclerosing cholangitis
01:06who received a left lateral sector graft from her uncle because her parents were not suitable.
01:13The operation was a success.
01:15She recovered, went home, went to school, lived a normal life for a child her age until
01:21she was treated with fulminant dengue in September that year and we lost her with a functioning
01:27graft.
01:28It was heartbreaking.
01:30But this case was the first successful pediatric and living donor liver transplant in the Philippines.
01:38A few attempts performed elsewhere previous to this resulted in early deaths.
01:45There were a few who survived but they were the deceased donors in adults.
01:49So our program grew since then and since then we have performed 26 liver transplants in
01:55both adult and pediatric recipients with acceptable outcomes.
02:00The math is easy.
02:02Since 26 cases in 14 years is only about two cases per year.
02:08Much as we have the expertise and established the program, it was difficult to grow because
02:13of several problems but mainly of two things.
02:17Lack of financial support and the lack of organ donors in this country.
02:22There is no commensurate bill of coverage for liver transplant in the country and patients
02:27pay out of pocket.
02:29This is why we have been losing our patients to other countries where it's cheaper, as
02:34you heard, like India.
02:35It used to be Taiwan, the go-to country, now it's India.
02:39And as we speak, about 230 cases of living donor liver transplant in Filipinos have been
02:45performed in India since 2016 while the total in the Philippines since the late 80s is only
02:52about 80 cases.
02:54Can you imagine?
02:56We definitely fail in comparison to our neighbors here in Asia who are doing it now in the thousands,
03:01thousands.
03:03The government doesn't have to do everything.
03:05In fact, the government is paying subsidy to India because they are able to offer the
03:11cost.
03:12That's my challenge to you.
03:14Because if you can offer me a cost that is competitive to India, I will give you all
03:19the liver transplantation that we find in our 87 hospitals in the Department of Health.
03:24And there will be a lot.
03:26Your hands will be full.
03:27So when Stuart says, don't worry about the profit cost, he's correct.
03:32Because if I give you volume, you will have suddenly profit.
03:36Kitang-in-check power natin mo.
03:41Pag dumami na, you can start having.
03:43And if there is one center that's going to do it, like when we built Heart Center, I
03:48can create the package for PhilHealth because I chaired the benefits package, benefits committee
03:53of PhilHealth.
03:54And you've been hearing all the benefits.
03:58So very important itong public-private partnership.
04:02And this is how I think we can implement universal health coverage in the country.
04:07The problem is supply.
04:09We have demand.
04:11The problem is how do you develop supply.
04:14Government to build a hospital takes about seven years.
04:17Imagine yung mga minoternized mga hospitals.
04:20Inaugurate nila namin.
04:23Duge, panahon pali Pinoy namin, Pinoy ngayon with syntaxation.
04:28It takes about five to seven years to build a center.
04:32And then training is even longer.
04:34To get top people to train a top liver anesthesiologist, a top liver surgeon, a top liver specialist,
04:41to get those people to make them even stay in government when they can earn so much more
04:45in the private sector is another struggle.
04:48How did it start po, yung partnership?
04:51Of course, we already had a liver transplant program here at the Medical City.
04:56Started in 2008, pero 2011 nagawa yung first.
05:00And then through the years, nakita ko na ang konti lang naman ang nagawa.
05:04Even if andyan na yung team, yung expertise.
05:07I thought there's really a need to expand the services na hindi naman namin kaya na private sector alone.
05:14Lalo na yung mga limitations, especially costs.
05:17Isa pang kakulangan dito yung organ donors.
05:20So I said, why don't we partner with government?
05:23And then, actually medyo inaral ko, tinigin ako,
05:27alin ba sa mga DOH hospitals ang pinaka may potential Rizal Medical Center?
05:33Dito sa Medical City for the transplant.
05:36Bano po yung magiging scope po niya?
05:38Ano po yung magiging parang pinaka may partnership po?
05:42Aside from the exchange of ideas and training.
06:13At magiging competitive siya dun sa mga ibang institution na nagbibigay nitong klaseng servisyo,
06:20maaari niya tayong tulungan.
06:22Kasi kasama rin siya sa benefits package ng PhilHealth.
06:26So magkakaroon na ng ganung klaseng benefisyo mula sa PhilHealth, yung liver transplantation.
06:32Tapos kung maaayos natin ang costing, which is yung isa sa mga assignment na ibinigay ni SECTED,
06:39siguro makakahanap kami ng paraan para maging affordable siya dun sa mga nangailangan.
06:47So on the part of Rizal Medical Center, dahil nga siya ay gobyerno at under the Universal Health Act,
06:55kinakailangan lahat ng servisyo maiprovide natin sa ating mga kababayan.
06:59So dun tayong magtatrabaho.
07:09Thank you for watching!
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