Policy conversations H

ealth policy. The vaccination issue has prompted a rethink of the devolution of health services. Since immunization is one of the main fundamentals of the download, the undeniable local resurgence of infectious diseases has reignited second guessing on whether we were right to entrust it to local governments. Of all the services devolved by the Local Government Code in 1992, health services has seen the most traction in public debate.

The intent was to improve the effectivity and efficiency of delivery, heightened public accessibility and the opportunity to decide for themselves. LGUs know best their priorities. Shorthand is giving them “space for self determination”. The Department of Health was to standby if LGU capacity proved inadequate or their priorities distorted.

The experience has been varied. With no benchmark, and with contexts and outcomes differing, there is uncertainty as to whether the program was a success.

But the DOH itself sees it as the experiment that failed. Health Secretary Francisco Duque III is batting for renationalization to address the “patchy” implementation of devolved programs.

Just this month, House Speaker Alan Peter Cayetano called for a review of the Code. The premise is to address rapid urbanization, specially the worsening traffic situation in major urban centers. Local Governments Undersecretary Marivel Sancendoncillo this week echoed the call for a review. The Code itself provides for a mandatory review at least once every five years. The DILG pointed out, for example, how local governments might fare poorly in meeting Sustainable Development Goals as a number of basic government services are still performed directly by national agencies and have not been given to local governments.

Stalwarts of the 1991 Local Government Code, notably main author Senate President and Local Government Secretary Nene Pimentel; Senate President Ernie Maceda, himself a former PACD (Local Governments) Secretary who ran on the program of Barangay ang Una and was behind the landmark provisions of the Code favoring barangay autonomy; and Senator Joey Lina, who was later appointed Local Government Secretary, should welcome this long overdue revisitation.

Fiscal policy. We are way past our conception of tax as a purely revenue measure. Of fiscal policy’s non revenue objectives, it is health promotion that has been occupying Congressional attention.

At first, the targets were alcohol and tobacco. Finance Undersecretary Karl Kendrick Chua, wunderkind fellow Xavier School graduate, explained that increasing taxes on alcohol products is the “most cost-effective way to discourage excessive consumption”. Shades of Justice James Ostrand in the landmark Cu Unjieng vs Patstone who wrote of the “desirability of imposing restraint upon the number of persons who might otherwise engage in non-useful enterprises”. These explanations have had a direct bearing on the wider berth conceded to raised revenue values for these products.

Today’s targets are sweet and salty foods/drinks. Expectedly, as the tax would disproportionately affect lower income households – imagine the daing and tuyo being taxed up into the luxury foods bracket, Senators have been gifted with another platform to attack the government’s taxing rampage. House ways and means chair Joey Salceda adds that it will be inflationary. His committee will not entertain the DOH proposal.

Justifications take note of collateral damage to productivity. The official line is to offset the “economic costs” of obesity. Usec. Chua again on the attempt to kill alcohol consumption by taxation acknowledged the rationale that “beyond the personal health costs, the socioeconomic costs of alcohol need to be mitigated. The massive economic costs of alcohol abuse justify significantly higher rates. For behavior to change meaningfully, the tax rates have to be high enough”. This is the same pigovian impetus to tax sweet and salty food: save billions in health care.

Nanny state much. Also known as the fat tax, this genre comprehends possible taxes on being too obese. Taken to its extreme, the approach may even make you liable to pay for not exercising. In Japan, already they measure waistlines! No, you wont be shot nor taxed for exceeding the ideal waist to height ratio. But they make it more expensive for your employer who will have to cough up higher insurance premiums. For Japanese men, the ceiling measurement is – wait for it – 33.5 inches. Goodbye Ramen.

Nuclear policy. Senate energy stalwart Sherwin Gatchalian has been asking: does the President know? Ambassador to Russia Carlos Gorreta says there is no policy.

At the Department of Energy budget hearing, Senator Gatchalian noted that we spend P48 million this year and P97 million in next year’s budget for a nuclear energy program. But Secretary Alfonso Cusi admits that the President hasn’t signed off on a draft Executive Order pending since 2017. The Department was just exploring alternative sources of energy to meet the burgeoning demand. We should be appreciative of this solicitous initiative given the inevitable power shortages due to our failure to act.

Our bitter Bataan Nuclear Power Plant (BNPP) history and its transmogrification into the face of the Marcos era foreign debt (the BNPP was finally paid off in 2007) assures that this issue remains divisive and controversial. There will always be resistance to nuclear alternatives for as long as there are incidents like Fukushima. Three Mile Island happened just as BNPP started construction. Chernobyl came a month after the 1986 EDSA revolution.

PRRD is still on the fence even after the signing of the Nuclear Energy agreement with Russian Firm Rusatom Overseas, actually a memorandum of intent to jointly explore the prospects of cooperation in the construction of nuclear power plants. He suggested it might be unconstitutional but what the Constitution pointedly states is a policy of freedom from nuclear weapons only.

Its not true that we don’t have a nuclear energy policy. The Philippine Nuclear Research Institute formerly Philippine Atomic Energy Commission was established in 1969, under R.A. 5207. For 50 years, we have possessed a clear, congressionally established mandate on the use of nuclear energy. Hence, unless there is scientific evidence or contrary legislative guidance not to proceed, our path is clear.