When a government agency flags a billion-peso problem, you listen. When that same agency simultaneously vows to deliver real relief to patients, you hold your breath. In December 2025, the Commission on Audit (COA) laid bare a troubling audit report on the Department of Health (DOH). The P405-M worth of medical equipment procured in 2024, for the department’s Health Facilities Enhancement Program (HFEP), sat idle, unutilized, undelivered, or uninstalled as of year-end. The Western Visayas Center for Health Development bore the largest share, with P207.844-M spread across 186 contracts. The COA was blunt that it is not because of lack of need, but because of lack of structure in plans. In short, the machinery existed in the books, but not in the health care facilities.
I cannot help but read the findings through lenses of accountability and patient welfare. The first is the easier lens to polish—the auditor’s lens. If you purchase gear you never install, you waste public funds. If you do not align end-user needs with procurement, you risk buying the wrong things, and the cycle ends with idle inventory and missed opportunities. The COA’s breakdown is like a map of avoidable inefficiencies that translate directly into more uneven access to care for Filipinos who can least afford delays.
The other lens, the one I wear with more weight, is the patient’s lens. This year, DOH has
tagged P1-B to launch zero balance billing (ZBB) in selected large LGU-run hospitals,
expanding a policy aimed at relieving patients of out-of-pocket charges for primary health
services. While this early ambition is commendable, there is a paradox that we cannot just ignore. You cannot run a successful ZBB pilot, if the hospitals are not ready to operate at scale. If procurement bottlenecks, site-readiness gaps, and fragmented coordination persist, ZBB is at risk of becoming a slogan rather than a service.
Thus, DOH shall fix the plumbing first before turning on the faucet. Didn’t the audit report show a misalignment already?
I challenge the DOH to answer three questions publicly and with specificity. First, how will they guarantee end-user involvement and needs assessment even if project ownership is dispersed among agencies and local units? Second, what compensation mechanisms will they implement to protect patients from continued service gaps when a facility’s construction overruns delay installation? Third, how will the ZBB rollout be shielded from the same governance gaps that left hundreds of millions of pesos unused? What guarantees that delayed funds won’t become squandered idle assets justified by a two-year budget cycle? If the answer is simply more funding, we should all fear the same old pattern—a larger budget, a larger problem, a bigger gap between intention and outcome.
The ZBB initiative can be a force multiplier if paired with governance reforms that DOH should have prioritized all along. Yes, the plan to extend ZBB beyond DOH-run facilities is a bold step toward health equity. BUT bold plans require robust, accountable execution. After all the political scandals in the country, there is no room for wishful thinking.
I have watched and reported on health policy for quite some time now, and here is what I have learned: funds alone do not heal. Systems that move money without moving people—without moving care—leave patients to endure needless costs while facilities grow weak.
If DOH can rectify their gaps, the ZBB initiative could maybe finally translate into real relief for Filipinos who have waited far too long for predictable, accessible, affordable health care. Until then, the idle equipment—northern and southern, provincial and city—stands as evidence that good intentions must be matched with diligent execution. Patients cannot wait for plans that arrive late or never arrive at all. They deserve care that is ready, reliable, and within reach.|
