The fiercest clash on the Senate floor Wednesday afternoon, June 17, came over a measure meant to shield patients from being held captive over unpaid hospital bills — with Sen. Pia Cayetano warning it could devastate small private hospitals in its current form.
Senate Bill 1511 seeks to amend Republic Act No. 9439, the 2007 law barring hospitals from detaining patients who cannot pay. Cayetano wrote that original statute while heading the Senate health committee; Sen. Risa Hontiveros sponsored the revisions.
Cayetano said she backed the bill but zeroed in on a clause sparing indigent patients endorsed to the Department of Social Welfare and Development from signing a promissory note. Who, she pressed, would pay the country’s 864 private hospitals. “Magkano ang impact nito sa ating private hospitals na wala nang promissory note?” she asked.
Hontiveros laid out five ways the note could be secured — a mortgage, a co-maker’s guarantee, a deed of assignment from the SSS or GSIS, or a guarantee letter from the Philippine Charity Sweepstakes Office or the DSWD or Department of Health — with government bodies backstopping indigent patients.
That answer drew Cayetano’s ire. Those mechanisms, she argued, appeared nowhere in the text, and removing the promissory note for indigents left the guarantees with nothing to secure. “Should we suspend? Because what her honor is saying is not written in the bill,” she said. “Kindly read it. Kindly read it. Kindly read it into the record then.”
Hontiveros conceded the language might need tightening and offered to replace “promissory note” with “guarantee note” throughout.
Pressed on committee scrutiny, Hontiveros admitted the provision had not been specifically examined — only an earlier version covering senior indigent patients had come up. “Hindi niyo nga na-take up iyan, pero ang impact nito napakalaki sa private hospitals. Wala silang chance na marinig ang side nila kasi hindi iyan na-take up during the hearing,” Cayetano said.
She then reached for the word that defined the exchange. “Otherwise, this is a disaster because ang mangyayari, pipila lang sila sa Malacañang, magmamakaawa sila na huwag ipasa ‘to,” she said.
Hontiveros rejected it: “Definitely this is not going to turn out to be a disaster. The whole point of the bill … is to amend and update the original law.”
Citing small hospitals shuttered during the pandemic by lagging PhilHealth reimbursements, Cayetano held firm. “The only reason I use the word disaster … is because time and again, the small private hospitals have practically bent — kneel down in front of us, begging us for support,” she said.
The clash came hours after the chamber installed Sen. Sherwin Gatchalian as Senate president that morning, unseating Cayetano’s brother, Sen. Alan Peter Cayetano, in a vote the minority skipped. Sen. Joel Villanueva, once a Cayetano ally, cast the decisive 13th vote for the new majority.
Cayetano returned at the 3 p.m. resumption with Sens. Loren Legarda, Imee Marcos and Camille Villar, framing the turnover as plain arithmetic. “There are thirteen, right? Common sense, right? What’s in the rules? What’s in the Constitution? When you have 13, that’s it,” she told reporters.
Gatchalian later floated a compromise: government would cover indigents through the DSWD, while non-indigent patients would still sign a promissory note backed by the five guarantees. Hontiveros welcomed the idea but noted even middle-class patients can sometimes be unable to pay.
