my own activism
as some of you may know, i have had the dubious privilege of being elected USC councilor in UPManila. i've promised myself not to allow myself to be indoctrinated into the leftist system (which would, of course, require either a total lobotomy, or at the very least decerebration) of knee-jerk reactionary-ism. if anything, i would want to inject at least some veneer of intellectual analysis into the UPM-USC stands...
so for purposes of transparency, i am uploading my proposed USC resolution regarding the recently-passed Med TFA. i was the one who sponsored the first resolution of the USC, also opposing the med TFA.
the problem i have with this is that it sounds/reads like a transcribed 7 minute speech...wuh. speaking and writing are definitely two different art forms.
hopefully this gets passed. i don't want the med TFA to be dragged down a trail of endless mobilizations and mudslinging.
The decision of the Board of Regents comes as a saddening development in the UP students’ continued struggle for greater state subsidy. With a 7-2 vote, the BOR essentially passed the increasing cost of education on to the students, the sector least capable of carrying the burden.
The UP Manila-USC believes the government’s inability to provide sufficient financial support to the premiere state university is in effect, a de facto reneging on its responsibility to maintain affordable, accessible, and quality education for the underprivileged. We recognize that the proposed Tuition Fee Adjustment coming from both the Chancellor’s Office and the UP College of Medicine faculty arose from their genuine concern in sustaining the quality of education given to the future students of the institution, even in light of inflating costs and dwindling budget.
Inasmuch as the issue may have previously polarized the students and the faculty, the UPM-USC takes the stand that the current situation calls for unity in mitigating the blow that this burden will deal to the incoming students. Even if the TFA has been passed by the BOR, we continue in our calls for greater educational subsidy from the state.
The UPM-USC offers the following suggestions:
1) Restructuring of the STFAP brackets
The primary justification of the TFA is the failure of the current matriculation to take into account the inflation rates since the last adjustment. Thus, the students are paying an abnormally low tuition (PhP 11 529.75) relative to other medical institutions, whose tuition usually ranges from PhP 60-70 thousand.
Firstly, we believe that disparity in tuition fees should come as no surprise, given that the UPCM is a state-sponsored institution, not comparable to the private ventures of UST or DLSU. The purpose of the institution then is to produce doctors who are paragons of “leadership and excellence in community-oriented medical education directed towards the underserved”; i.e., doctors trained to serve the less fortunate sector of the country. As such, the government then has an inherent responsibility to subsidize the education of its scholars because the ultimate goal of the institution is to train doctors who are not doctors for their own selfish interests, but doctors for the country.
Secondly, we believe that the unusually low tuition rates offered by the UPCM should not be viewed as a financial loss for the institution. Rather, this has made education more accessible a wider sector, instead of its traditional sector of the upper and upper middle classes. This democratization of education distinguishes the UPCM from other profit-oriented medical schools. More than servicing the upper classes, the low tuition has made the UPCM an avenue wherein the underprivileged can avail of medical education that they would otherwise been unable to afford. Any form of across-the-board increase will necessarily preclude the most financially underprivileged from even beginning medical education. In any form of TFA, the viability of this marginalized sector must always be taken into account.
Given that we have to maximize both the provision of education and income generation, the UPM-USC then suggests the review of the STFAP brackets. The rationale behind the progressive rates is to provide the maximization of education, by charging from each according to his ability to pay. Ideally, this system would protect those in the lower economic bracket by offering tuition at more subsidized rates than those given to the more privileged sectors. We suggest that if the BOR would apply the inflation rate to the tuition fee, it must similarly apply such adjustment to the STFAP brackets, which remain unrepresentative of the actual social strata of the country. The adjustment must not be limited to solely the amount of tuition charged, but also extended to the manner through which it is demanded of the students.
The current STFAP has remained idle and unadjusted since 19--, and as such, fails to provide a viable stratification that is reflective of the current economic state. Its failure to adapt to inflation rates thus places students into STFAP brackets higher than their actual economic standing. The TFA then becomes insensitive to the capacity of the students to adapt to the sudden increase in tuition because there is an inherent assumption of the capacity of each and every student to pay for the increase.
The framework that would best protect the disadvantaged sectors from the brunt of the TFA must then be reviewed and restructured to continue to provide socially progressive rates. Inasmuch as the UPM-USC acknowledges the fact that majority may be able to comply with the TFA, we put primacy on the interests of the sector that is least able to protect itself. The restructuring of the STFAP would be the best balance, so much so that the underprivileged are still able to afford more subsidized rates even in the event of a tuition hike.
2) Establishment of the UPCM as a state college through:
The consistent criticism of the UPCM is the migration of majority of its graduates to other shores. As such, the government considers the UPCM as a failure on investment, because of the millions spent in the training of each class, only a minority will continue to stay in the country to continue service. This serves as a major disincentive for the government to continue financial support of the institution.
The UPM-USC concedes that being products of a state-run institution, graduates of the UPCM have a responsibility to render service to the Filipino people. The education being granted at the UPCM is not a right freely given to all, but a responsibility that must be fulfilled by all those deemed worthy to study in its halls. However, we believe that it is unfair for certain senators to claim that the UPCM is a waste of money simply because majority of its graduates go abroad.
Firstly, we believe that majority of our graduates do not go abroad for purely selfish reasons, but because of the hostility of the environment in the country. The doctors and other medical professionals in the Philippine health care system are often overworked and underpaid, and it is entirely unreasonable to demand their continued stay for purely altruistic reasons. We believe that in order to mitigate the brain drain, the government must increase its support of the health sector, by prioritizing further the health system in terms of budgetary allocation and ceasing its efforts to further marginalize the health professionals through the Medical Malpractice Bill.
The system in itself is flawed, and until the government can correct a situation where it is entirely unfeasible to practice in the country, the brain drain will continue to eviscerate the ranks of our graduates even in spite of any the measures to stop it. In their criticism of the health care professionals, the legislators are obfuscating the root of the problem: the sorry state of health care in the country. The long term solution therefore is not be found within the UPCM, but with the increase of health spending to meet WHO standards.
Secondly, the students already render service to the country even while undergoing their medical education. PGH interns and clerks already become de facto hospital care givers, assimilating duties and rotations gratis. UPCM medical students already are returning service by treating the charity patients in the wards and in the OPD. The UPM-USC believes that during their rotations in PGH, where they are already integrated into the health care system without pay or benefits, students have already accomplished some measure of their responsibility to the government and the people.
Moreover, there are also doctors who do return from abroad after specialization, and these doctors also practice pro bono and as consultants in PGH. In terms of creating a medical environment that is at par with those abroad, these foreign-trained consultants are absolutely essential in the diffusion of knowledge and best practices from the more advanced facilities abroad to the residents and fellows who receive their training here.
However, the UPM-USC also believes that there has also been a lack on the part of the UPCM graduates to manifest their commitment to the service of the underempowered communities of the country. The appalling statistics of migration cannot be denied, and we believe that there must be efforts to minimize the effect of these on the already declining health care situation of the country.
The UPM-USC believes in the principle of two-way commitment: inasmuch as the government is obligated to subsidize the education of the UPCM students, the UPCM students have a greater duty to serve the less fortunate citizens of the country. In order to be more credible in the fight for greater state subsidy, we believe that the UPCM student body must come up with more tangible incentives to offer in exchange for financial support.
As such, the UPM-USC suggests two things, which would further concretize the UPCM as a state-run institution with valid reason to demand government support:
a. Strengthening of the RSO program
There is an undeniable tendency for doctors to aggregate in urban centers, close to the high-paying tertiary hospitals that prioritize specialized tertiary health care. In this situation, the specialists are disproportionately concentrated in but few areas, making quality health care inaccessible in the more far-flung and backwater areas.
The RSO program seeks to resolve this problem by incorporating prospective students from the various provinces of the country and mandating them to return service in their particular locales. There is particular emphasis on primary health care and encouragement for these students to become the catalysts for change in the health care system of their regions.
However, the problem is that the number of slots given to this program is frightfully small. The UPM-USC suggests greater a greater proportion of the students be placed under the RSO program. We believe this is more consistent with the principles of a state university and its thrust towards community-oriented primary health care. In line with being an institution that looks after the country’s needs, special attention should be given to the rural areas which lack specialists and development; the strengthening of the RSO program would best address this need.
b. Exploration of a ROS clause
Other countries which afford state subsidy for its university students demand return of service (ROS) in exchange for government subsidy of their tuition. ROS is done for a set period of time in government run health centers, and in effect, guarantees that graduates pay back the taxpayers’ investment through the time spent working in the country.
However, the UPM-USC believes that even the ROS is not a perfect solution. Even though it may alleviate the dwindling number of doctors servicing our country, it does not guarantee the resuscitation of the health system. These will be fresh graduates manning the health centers, and not consultants nor specialists; as such, the relative quality of service provided would be in question. More than that, increasing the number of doctors would be moot without the infrastructure through which the can serve the people. More doctors would be better, but they would be useless without a proportionate increase in the medicines and equipment with which they provide health care. We reiterate that ROS would only be a seeming-palliative; the comprehensive panacea for the ills of the health care system can only be found in greater government support and prioritization.
Instead of a blanket imposition of ROS, the UPM-USC suggests that we make this a viable option: those who submit to ROS enjoy greater state subsidy than those who would wish to practice and specialize abroad. We believe that there must always be a balance between the choice of the students and their responsibility towards the people.
In the adoption of these two suggestions, the UPCM concretizes its role as an institution that is able to produce doctors who would look beyond their selfish interests and serve that of the people. More than that, it creates tangible results for government investment, thereby invalidating excuses made by lawmakers for not providing increased government funding.
3) Increasing student awareness of financial support systems
The UPM-USC acknowledges the fact that the previous suggestions would take some time to be reviewed and implemented by both the UPCM faculty and the UPM administration. More than looking at the long term compromise, we believe that there must be united efforts from both the faculty and the student councils in providing palliative measures for those lateral entries who will first be affected by the TFA.
There exist numerous scholarship programs, grants and loans that can be tapped to mitigate the burden of medical education. The importance of such cannot be demeaned, especially in light of the continuous increase in the cost of education which extends significantly beyond that of tuition. The student already has to carry the inflation rate in shouldering the expenses of books, equipment and living allowance. The USC believes that the TFA will pose a double burden on the students, and all means must be exhausted to defer such costs to sectors other than the students.
However, the sad fact remains that very few students are made aware of the presence of these scholarships, and more so, the means by which to avail of these. There is a lack of efforts to increase awareness of these financial support systems, and unfortunately, the students end up picking up the onus themselves.
In light of these facts, the UPM-USC calls for a proactive campaign to instill awareness of these alternatives in the students. The existence of these programs and the means to avail of them must be emphasized at the onset, preferably during the various freshman orientation programs conducted at the beginning of LU III’s academic year. More often than not, the student is left to fend for himself, and this may sometimes dishearten the students’ pursuit of financial support. The UPM-USC believes there must also be active support from the administration in the application for and handling of these scholarships: we suggest the partnership of the MSC and the UPCM administration in the creation of a partnership office be solely devoted to the handling and maintenance of student’s scholarships. The delineation of its powers and responsibilities may be discussed later, but the important thing is the creation of a scholarship body that is accessible, student-friendly and student-centered.