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Medical Files

Increase tobacco taxes to fund universal healthcare

/ 05:03 AM February 05, 2019

Everyone in the medical community is wondering about the fate of the universal healthcare (UHC) law which promises to give every Juan dela Cruz adequate access to healthcare.

Without a clear source of funding to sustain it, it’s likely to run out of steam after a few years.


The fate of the UHC now hinges on the Senate, specifically on the ways and means committee (WMC) headed by Sen. Sonny Angara.

Angara is one of our regular columnists in H&L (Health & Lifestyle) magazine, and in some of his commentaries, he sounded committed to finding a reasonable common ground that can fund and sustain UHC.


In last week’s hearing of the WMC, he reiterated this position.

Of course, finding such common ground is easier said than done. Health champion Dr. Tony Leachon informed me that Health Secretary Francisco Duque was present at the WMC hearing last week, with Finance Undersecretary Karl Chua. They appealed to Angara to pass a tobacco tax rate that would balance the health and revenue objectives of the reform.

Cheapest cigarettes

The Philippines still has one of the lowest costs for tobacco products in the world. Even compared to most Asian countries, the price of cigarettes here is still much cheaper, making it relatively affordable even for students.

Based on the preliminary model of the Department of Finance, any price below P73.30 will not produce significant impact on the demand for tobacco products, and thus will not achieve the health objective of curbing cigarette smoking in the country.

For health advocates, the P70 tax rate proposed by Sen. Sherwin Gatchalian can be considered the “sweet spot,” and anything below Sen. Manny Pacquiao’s proposed P60 rate will not be acceptable.

The health advocates headed by Dr. Tony Dans and Dr. Leachon expressed their alarm at the 17,000 new cases of lung cancer in 2018, which translates to 1,400 cases a month, or 50 cases per day. Smoking is still the major risk factor for lung cancer.


With this alarming prevalence of smoking-related diseases, the government and health insurance companies are actually spending a lot, probably more than what it’s getting from the current sin taxes.

A study in 2017 by Fajutrao and Dans estimated the economic burden from four tobacco-related diseases at P210 billion—much higher than the P124 billion collection from sin taxes annually.

Pacquiao rightfully stressed that taxing tobacco will protect the youth and help raise revenues for health. Although tobacco farmers may be affected financially, this is the lower price to pay for reducing smoking-related diseases like cancer and heart and lung diseases.

Another hearing of the WMC was set for Feb. 4. At this writing, we don’t know yet what were discussed. We hope that for the agreed sin tax adjustments, our legislators will decide on the side of what must be done, and not what political expediency dictates.

Workplace health

We spend almost half of our waking hours in the workplace. For some workaholics, the workplace is their virtual home.

This highlights the need to keep the workplace healthy, safe and devoid of any serious risk factors that promote disease and accidents.

The field of occupational medicine is now recognized as an important specialty in medicine. It has evolved rapidly over the last three decades.

Although called a workplace, it paradoxically may promote sedentariness, an established risk factor. Just imagine sitting at one’s desk for a regular eight-hour work shift, and one can appreciate the cardiovascular risk.

Sitting is now considered the new smoking, and occupational medicine is addressing that problem by encouraging everyone to stand up and do some quick exercises preferably every hour. There are also desks that are designed so they could be elevated and make one work in a standing position. Anything that can prevent one from remaining seated while at work can go a long way in preventing cardiovascular diseases.

The Philippine College of Occupational Medicine (PCOM) has its plate full with health and safety issues at work, and this includes making sure there is optimal control of substances and practices hazardous to health.

Call centers

Call centers are of particular concern because of the nature of their work. To keep themselves fully awake in the night shift, workers have to load up on caffeine and other stimulants. Unfortunately, some resort to prohibited substances to stay alert.

The disruption of their sleep cycle, likely caused by the decreased secretion of melatonin, which is usually stimulated by darkness, can also wreak havoc on their health. These unhealthy environmental risks, if not properly addressed, may also impair their judgment, and that may well be one reason there is a prevalence of unsafe sex practices among call center workers, linked with an increased incidence of HIV infection.

The members of PCOM are trained to conduct regular appraisal and careful examination of the potential health hazards in the workplace that may promote diseases and accidents.

The paradigm shift in the practice of occupational medicine is truly laudable and game-changing (in fact, life-changing) for many workers. From a previously reactive and curative orientation as company physicians, these specialists in workplace-related diseases are now proactive and prevention-oriented, nipping in the bud all potential health hazards.

It’s not rocket science to conclude that a healthier workforce is more motivated, more engaged, more empowered, more fulfilled and definitely more productive. That can have a tremendous impact on building a more prosperous nation.

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