Tinio Demands DOH Budget Restoration, Warns Zero Balance Billing Hollow Without Funding

In the middle of budget deliberations for the Department of Health's 2027 spending plan, ACT Teachers Party-list Rep. Antonio Tinio stood up with a straightforward challenge: the government cannot claim to support Universal Health Care and Zero Balance Billing while simultaneously cutting the money that makes those programs possible.

The cuts are real and specific. Rizal Medical Center faces an 8 percent reduction in personnel services—roughly P112 million gone. Rizal Memorial Medical Center would lose P500 million in operational funding. The National Center for Mental Health would see P311 million cut. Across DOH hospitals in Metro Manila, the maintenance and operating budget would shrink from P30 billion in 2026 to P26.9 billion in 2027, a 10.2 percent decrease, even though the DOH itself had requested P31.7 billion.

What makes this particularly sharp is the timing and the logic. These hospitals are already understaffed. Doctors, nurses, and support personnel are in short supply. The DOH has acknowledged that many plantilla positions—permanent staff slots—remain unfilled, particularly in specialized areas like physical therapy and speech therapy where government salaries cannot compete with private sector pay. Now, according to Tinio, the budget cuts would remove those unfilled positions entirely from next year's authorization, meaning hospitals would have no chance to fill them during the fiscal year. The government's explanation that total plantilla "remains the same" rings hollow when positions are being eliminated, he argued.

The deputy minority leader pressed the DOH for written justification: why are these positions unfilled, and why remove them rather than fund them? The answer matters because hospitals currently rely heavily on job order and contract-of-service workers—temporary staff with low pay and no job security—to fill the gaps. Restoring and filling those permanent positions would reduce that dependence and provide stability.

But the personnel cuts are only part of the problem. The operational budget reductions create a different kind of squeeze. The government's plan is to offset the cuts through PhilHealth reimbursements and MAIFIP allocations—essentially, the hospitals would operate on less direct funding and rely on money flowing back from insurance and other programs. Tinio's objection is practical: reimbursement is not instantaneous. While hospitals wait for that money to arrive, they operate with insufficient funds. Patients suffer. During surges in dengue or leptospirosis cases, when wards and emergency rooms overflow, there is no cushion.

The larger context is capacity. The DOH currently has about 30,000 authorized beds across its hospitals. An expansion to 45,000 beds is promised by 2028. But if the Health Facilities Enhancement Program is cut, that expansion target becomes uncertain. And without expansion, the Zero Balance Billing program—which eliminates out-of-pocket costs for patients in public hospitals—cannot reach as many people as intended. Overcrowded public hospitals with limited beds will turn people away or force them toward private facilities, which are far more expensive. The policy looks good on paper, Tinio said, but limited capacity means limited benefit. Filipinos facing rising living costs and increasingly expensive private care will be left with nowhere to go.

Tinio has committed to raising these issues again when the DOH budget reaches the full House floor for debate. The question he is pressing is whether the government's stated commitment to universal health care is matched by the resources to deliver it.