ANG GINAWA NG DUTERTE GOVERNMENT PARA SA BAYAN NG PILIPINAS SA 7 YEARS, GINAWA NG PILIPINO SA 7 DAYS. PATULOY ANG PANLOLOKO SA MATATANGI NA LEVEL KINA BONG BONG MARCOS AT SARA DUTERTE AT KANILANG OLIGARCH FINANCIERS.

 

THE DESIGNATION by incoming President Rodrigo Duterte of Rafael “Ka Paeng” Mariano as his secretary of agrarian reform is welcome news for the Filipino peasantry, farmworkers and the rural poor. Mariano, born into a poor peasant family in Nueva Ecija, is chair of Kilusang Magbubukid ng Pilipinas and former Anakpawis party-list representative.

He will be the first Cabinet member to come from the peasant class, who has a long history of activism on behalf of the marginalized rural masses. Mariano immediately called for a review of the “antifarmer decisions” of the Department of Agrarian Reform (DAR) and announced his priority in completing the long delayed redistribution of thousands of hectares of the Cojuangco-Aquino’s Hacienda Luisita, the Araneta estates in Bulacan and the Aguinaldo landholdings in Cavite.

Political will crucial

In implementing a contentious social justice program such as agrarian reform, the political will of the sitting President is crucial. The deficit here, however, has been appalling. Outgoing President Aquino’s public stance and the absence of an agrarian reform agenda in his major policy announcements reveal no sympathy, interest and understanding of agrarian reform’s role in the country’s overall socioeconomic, political and cultural development.

Ultimately, this self-indulgent and antireform mindset, common to all Philippine Presidents, have spelled the doom of agrarian reform.

The question is whether Duterte, by his self-ascribed Left persona and avowed socialist sympathies, would reverse the long-standing presidential pattern of ignoring agrarian reform’s social justice principles and stand firmly on the side of the long-suffering Filipino rural masses.

28th year of Carp

This June, the Philippine government’s agrarian reform law reached its 28th year of implementation with completion nowhere in sight. The Comprehensive Agrarian Reform Program (CARP) and its extension, the Comprehensive Agrarian Reform Program Extension with Reforms (Carper) had provisions that were generally favorable to their intended beneficiaries. But Carp and Carper were also essentially the result of a compromise between pro and antiagrarian reform blocs in Congress and thus also contained provisions, inserted by antireform and landowner lobbyists, that are considered legal loopholes.

CARP, enacted in 1988, was an improvement over previous legislation in that it covered all agricultural lands and the entire rural landless labor force. But it was hobbled by antipeasant and prolandlord provisions that allowed mere regulation of existing tenurial forms, including the nefarious stock distribution option and leaseback agreements, provided for an omnibus list of exemptions, established “fair market value” for landowner compensation, created a payment amortization scheme that was unfavorable for beneficiaries, set a high retention limit that could reach 14 hectares, mandated a long period of implementation, and generally ignored the role of beneficiaries and civil society groups in seeing the program through.

Carper’s record

Carper, on the other hand, also contained provisions that favored beneficiaries, such as the indefeasibility of awarded beneficiary lands, recognition of usufruct rights of beneficiaries, a grace period for amortization payments, speeding up the process of awarding lands, removal of the stock-distribution option, disallowing the conversion of irrigable and irrigated lands, automatic coverage of lands targeted for conversion pending for at least five years, reinstating compulsory acquisition and voluntary offers-of-sale as main redistribution modes, and recognition of women farmers as beneficiaries.

‘Killer amendment’

Despite all these gains, antireform legislators still managed to insert a “killer amendment” that allowed landowners to determine who would be beneficiaries and who would be excluded from the program. Other objectionable provisions are those expanding the list of exempted lands, allowing local governments to acquire agricultural lands beyond the 5-ha retention limit and the deprioritization of seasonal and other nonregular farmworkers as qualified beneficiaries.

Major CARP constraints, such as landlord compensation based on market value and the beneficiary payment formula based on gross production, have been retained.

According to the peasant organization Katarungan, the DAR has accomplished only 18 percent of its 2015 target for land distribution, “the lowest performance in the history of CARP implementation.”

In five years under the Aquino administration, less than 20 percent of the goal for land distribution has been accomplished. As of December 2015, there remained a balance of about 477,000 ha of undistributed lands while 1 million ha of agricultural lands inexplicably vanished from the public records. To camouflage its lackluster performance, the DAR has resorted to merely reporting the issuances of notices of coverage as accomplishments while keeping from public view the more essential indicators of certificates of land ownership awards (CLOAs) and, even more crucial, emancipation patents (EPs).

Snail-paced implementation

Indeed, land distribution under the Aquino administration has been moving at a snail’s pace
—marked by a consistent and chronic failure to meet annual targets, the misrepresentation of performance indicators and lack of political commitment by the DAR leadership under Secretary Virgilio de los Reyes. In the distribution of privately owned and/or privately controlled landholdings, which constitute the heart and soul of agrarian reform, the implementation of Carp and Carper has been found to be most wanting and negligent.

Despite favorable judicial decisions, the redistribution of Hacienda Luisita lands has been slow and bureaucratic with harassments of worker-beneficiaries continuing. Worse, between 80 and 90 percent of the hacienda’s distributed lands have been taken over by nonfarming ariendadors (capitalist-financiers) due to the failure of government to provide the required support services.

Landowner resistance

Chronic landowner resistance continues to plague the program with numerous reports of farmers being evicted, harassed, intimidated and killed by landlords and hired goons. Land grabbing and land-use conversions are intensifying even in landholdings that have been covered for distribution.

These converted and grabbed lands are often misappropriated for nonagricultural purposes, such as real estate development, tourism, mining and special economic zones by foreign and domestic land speculators.

Property developers

Leading these antireform initiatives are influential politicians, local governments and giant property developers. In many instances, powerful families have taken control over public lands and have resisted (sometimes violently) their distribution to qualified beneficiaries.

Rent-seeking property developers pose a counterproductive and destructive role by their expansion into the Philippine countryside, which encourages the conversion by local government units of agricultural lands for commercial purposes. This is exemplified by the land conflict in Porac, Pampanga, where Ayala Land is developing a P75-billion 1,125-ha mixed-use commercial, recreational and high-end residential estate.

The “Alviera” project was facilitated by the exemption from agrarian reform coverage and conversion of 750 ha of Hacienda Dolores to commercial use. The conflict has resulted in “the unsolved killings of two Hacienda Dolores farmers, the jailing of a village chief, the eviction of 300 farmers and the destruction of their crops and huts, and the denial of access to a road traversing through Alviera property that leads to Aeta villages and farms.”

Protest marches

In April, several hundred farmers marched for 122 kilometers from Sariaya, Quezon to Manila. Organized by Katarungan and its NGO support group, RightsNet, the farmers were demanding the full implementation of a meaningful agrarian reform program, protection for the agricultural sector, food sovereignty and return to farmers of the coco levy fund. The Sariaya farmers lament the cancellation of CLOAs and EPs of 3,781 farmer-families covering 4,800 ha.

This was just one of the many long protest marches undertaken over the years by restive Filipino peasants and farmworkers frustrated and indignant over the poor track record of government in agrarian reform.

Special economic zones

Equally destructive of agriculture and family farms are the proliferation in almost all regions of the country of special economic zones, such as the controversial Aurora Pacific Zone and Freeport Authority, displacing farms and peasant households and establishing enclaves that have little or no backward and forward linkages with rural communities.

Mining activities, on the other hand, impact negatively on farming communities (including indigenous peoples) and on the agricultural environment. As lawyer Christian Monsod pointed out: “Mining activities are usually located in rural and mountainous areas and can affect farmlands, rivers and shorelines, where the poorest of the poor are located.”

Worse, land grabs by large mining companies are taking place, such as the 508-ha farmlands in Calatagan, Batangas, tilled by 323 farmers and covered by 818 EPs.

The Aquino administration, like all previous administrations, via its inaction on abuses and its neoliberal economic policies of indiscriminately welcoming any and all forms of investment regardless of the social consequences, is party to and similarly accountable for this uncontrolled pattern of dispossession and human rights violations triggered by land speculations gone berserk.

Inadequate support services

The neglect by government agencies led by the DAR and the Department of Agriculture to provide timely and adequate support services to agrarian reform beneficiaries (ARBs) have prevented the latter from becoming economically viable producers and jeopardizing whatever land distribution may have accomplished. Only 44 percent of agrarian reform beneficiaries have had access to support services packages with 27 percent of them in so-called agrarian reform communities (ARCs).

As with other farmers, a majority of ARBs source their credit from loan sharks,who charge usurious interest rates. ARBs in commercial farms and plantations are forced to rely on former landowners and corporations for support services. In Mindanao, reformed areas and ARB ownership of lands have been rendered meaningless due to onerous contracts, leaseback and lopsided growership and production arrangements, leading eventually to farmer bankruptcies.

Property rights

The reasons for Carp and Carper’s failures cannot be traced, as a University of the Philippines Economics professor argues, to the absence of a fully functioning property rights regime “due to strictures on the sale (and rental) of reformed lands and the land ownership ceiling.” Under conditions of a protocapitalist system where political and other noneconomic factors play dominant roles, where rural elites are predatory in character and where rent-seeking financial speculation through aggressive property developers rules the day, it would be the height of naiveté to dream of a fully functioning property-rights regime.

Even today, the absence of such a regime has not prevented “investors” from invoking the “laws” of the market by encroaching on land reform areas and harassing and dislocating legitimate ARBs and other farming communities. All in the name of productivity, efficiency and optimum land utilization.

Ayala Land, through its president for international sales, Thomas Mirasol, candidly admitted that the lack of a “land use blueprint by a regulatory body … has enabled it to acquire large plots of land and develop them according to its own plan and design” (Business Times. May 6, 2014). Mirasol added that the absence of a land regulatory framework “has been great for Ayala Land,” which uses its resources to develop “big tracts of land” and thus “become the government; (that) control and manage everything (and become de facto) mayors and the governors of the communities that (Ayala) develops.”

On the other hand, an “efficiently managed” property rights regime will simply open wide the floodgates of the rural areas to modern versions of the unlamented landlord class and reintroduce the oppressive and exploitative social relations that necessitated a land reform program in the first place. It is precisely this elite-biased property rights regime in the rural sector that a truly just and meaningful agrarian reform seeks to prevent and where it exists, to overturn.

Recommendations

After 28 years of implementation of a program meant to emancipate the Filipino peasantry from serf-like servitude to elite landowning interests, the agrarian reform goal remains elusive with final resolution nowhere on the horizon. To start the process of fixing this dismal state, the incoming administration must immediately take the following steps:

First, extend the land distribution component of agrarian reform since it is obvious that the DAR will be unable to complete this by June 30.

Second, provide that all unpaid amortizations of farmers be condoned and all future land distribution be made free of cost to the beneficiaries.

Third, constitute a high level independent commission of upright and credible citizens with legal powers to evaluate and audit the performance of the DAR, Department of Environment and Natural Resources, and LandBank, and investigate all circumventions of coverage and human rights violations against farmers and farmworkers, their leaders and supporters.

Lastly, the goal of equitable land redistribution must be made a permanent feature of the state’s policy agenda. Land redistribution is a continuing process that will necessarily have to be resorted to time and again in order to assure that there is no backtracking on the agrarian reform agenda.

Social justice has no beginning and no end.

(Eduardo Climaco Tadem, Ph.D., was one of the founders of the Congress for a People’s Agrarian Reform in 1988 and coconvenor of the People’s Agrarian Reform Congress in 2014. He is currently president of Freedom from Debt Coalition and professorial lecturer in Asian Studies, University of the Philippines Diliman.)

 

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ANG PILIPINAS GOVERNMENT AT ECONOMIC ELITES AY MGA SERFS NG GLOBALIST FEUDAL CORPORATE MULTINATIONAL LORDS NA GUMAGAWA NG POPULATION REDUCTION PLAN SA PILIPINAS. IBININTAHAN KA NILA SA MAGTATAY, PARA SA PANGAKO NA MANATILI SA PAREHONG UNEARNED AND UNWARRANTED SOCIAL AND ECONOMIC POSITIONS KUNG KUNG ANO SILA NGAYON. ISANG ILUSYON: PAGKATAPOS NG KANILANG PAGGAMIT BILANG MGA KAIBANGANG TANGA, MATAWALA RIN SILA.

 

MMDA: Metro Manila to restrict movements, activities of unvaccinated

Philstar.com
MMDA: Metro Manila to restrict movements, activities of unvaccinated
Makati residents receive the first dose of the Sinovac vaccine at the Makati Coliseum.
Krizjohn Rosales, file

MANILA, Philippines — Metro Manila's mayors have agreed to pass local ordinances that will restrict the movements and activities of unvaccinated people in the National Capital Region while the region is under Alert Level 3 or higher, the Metropolitan Manila Development Authority said Monday morning.

The local legislation will restrict unvaccinated people to their homes and will bar them malls, restaurants and other public areas, MMDA Chairman Benhur Abalos said in a briefing. He said that the mayors of Metro Manila have already agreed in principle to the sweeping restrictions although there may be differences among the ordinances that local governments will pass.

The government managed to vaccinate 50 million people in 2021, short of its target of 54 million.

Unvaccinated people are supposed to stay at home except for essential trips like buying food, water and medicine. They will be allowed to engage in individual outdoor exercise "within the general area of residence" but will not be allowed to do much else.

Although going to work is among the valid exceptions, Abalos said that unvaccinated people will have to take RT-PCR tests every two weeks at their own expense and must present a negative COVID-19 test result before being admitted to on-site work.

This requirement will cover people who don't live in the National Capital Region but work there.

RELATED: For people in provinces near Manila, inclusion in 'NCR Plus' more a minus

Unvaccinated people will also be barred from eating at food establishments and will not be allowed to go on leisure and social trips to malls, hotels, event venues and sports and country clubs. They will also not be allowed domestic travel on public transportation.

"This is like [Enhanced Community Quarantine] but only for the unvaccinated, and for their own protection," Abalos said, referring to the strictest form of lockdown under a previous system that the government used from 2020 to part of 2021.

"It will be hard for us to go into lockdown again," he said earlier in the briefing. "We must learn how to live with the [Omicron] variant."

The Palace announced on December 31, 2021 that Metro Manila will be under Alert Level 3 from January 3 to 15 because of an increase in COVID-19 cases and the threat posed by the Omicron variant of the coronavirus. — Jonathan de Santos


NANGAKO NILA SA MAMAYANG PILIPINAS ANG PAG-UNLAD NG BANSA tungo sa HIGH INCOME ECONOMY? ITO ANG TINUTUKOY MO SA REALIDAD - ANG TRANSITION MULA SA PIYUDALISMO tungo sa IBANG FEUDALISM, KUNG SAAN NILA PWEDENG PATULOY NA MAGLARO ANG FEUDAL LORDS.

 

The Social Conditions That Shaped Lola’s Story

Editor’s Note: This article previously appeared in a different format as part of The Atlantic’s Notes section, retired in 2021.

Anakbayan USA, a national organization of Filipino youth and students dedicated to advancing democratic rights, sends this response:

In the viral Atlantic article, “My Family’s Slave,” author Alex Tizon tells his account of Eudocia Tomas Pulido, who was to Tizon’s family both “Lola” and slave. Behind the heart-wrenching storytelling is a reality we must face: the oppressive class structures and culture that brought forth Eudocia’s enslavement and trafficking, and the need to change them in order to address the root of modern day slavery within the Filipino community.

The use of underpaid and overworked katulong, utusan, and kasambahay—the kind of servitude Eudocia was forced to perform—is common practice among many Filipino families. It is an unjust practice that stems from a violent history of colonization and exploitation of the Filipino people. In the Philippines, thousands of Filipinos are brought to the cities, suburbs, and wealthy households in the countryside as domestic help. These domestic helpers are very often young women who must face exploitative conditions. No matter their destination, they are undoubtedly a product of the massive landlessness and joblessness brought about by feudalism in the Philippines.

Feudalism is primarily an agriculture-based economic system where most farmers or peasants don’t own land and are forced to work for a landlord who profits off excessive land rent rates, exorbitant loan interest rates, and very low crop prices, among others. Over decades, this setup has become dominant across the Philippines. In effect, it has left 9 out of 10 farmers landless today and has forced peasants and families to sell their labor to landlords, in urban areas, and abroad.

Equally important to this economic system is the backward haciendero, or feudal, culture needed to maintain it. Oppressive religious practices combined with the lack of access to quality education produces a culture in which people internalize unquestioning obedience and utang na loob (debt of gratitude). It produces a society where exploitation is downplayed as a temporary state worth bearing to prevent any collective resistance and thoroughgoing change. In a feudal society, bahala na (come what may) becomes a guiding principle, just as Eudocia was forced to internalize.

Domestic feudalism also plays a role in the forced migration of millions of Filipinos every year. Along with imperialist interests from countries like the U.S., feudalism helps to maintain an economic structure in the Philippines that is export-oriented and import-dependent. On one hand, agricultural products like sugar and coconuts produced on feudal haciendas (with one of the largest haciendas in the Philippines located in the same province Eudocia hails from), as well as other natural resources like minerals, are exported to other countries. On the other hand, finished consumer goods—like electronics, clothes, and cars—are largely imported and sold to the Philippines at high rates rather than made domestically. This is due to unequal trade agreements with imperialist countries that seek to dump excess products on foreign markets to earn profit. In essence, Filipino peasant farmers who work long days to produce goods that feed and supply the rest of the world face the harsh contradiction of being unable to provide for their own families.

The result? Lack of domestic industry and widespread landlessness—conditions that have pushed Filipinos into poverty, and subsequently out of the country to find work. Facilitated by Philippine laws and institutions, and dictated by foreign demands, Philippine migration has supplied the world with at least 12 million Filipinos, four million of whom are in the U.S., with one of those families being the Tizons. Beyond the reality that Filipinos are forced to migrate abroad due to lack of economic opportunity at home, many are actually trafficked and forced to work in different countries. Indeed, Eudocia is one of hundreds of Filipinos who are trafficked into the U.S. every year as teachers, bakery workers, shipyard workers, and more.

Tizon’s confession opened the eyes of many to an unjust social practice occurring in the Philippines and abroad. It is a practice stemming from feudalism, imperialism, and a government in place that facilitates this exploitation and oppression of its people. This does not exonerate the Tizon family’s abuse and exploitation of Eudocia. But in seeking justice for Eudocia, we should seek justice as well for the millions of Filipinos pushed into poverty and out of the country by feudal landlessness, joblessness, and the lack of opportunities. We invite those seeking to channel their justified rage, sadness, and desire to act to meet with or join a local chapter of Anakbayan-USA or other BAYAN USA organizations near you. Only through collective action and organizing can we ensure that no other person must live their life as someone else’s servant.

PANAHON NA PARA ILAGAY SILA SA KANAN NG MGA KULATAN.

 Puro papogi! De Lima rips Duterte: Jail visit just a 'publicity stunt' |  Politiko Metro Manila

MASASAMAHAN

 Duterte to attend the inauguration of daughter Sara as VP – Manila Bulletin

BONG BONG MARCOS AT SARA DUTERTE AY PATULOY ANG DUTERTE FATHER DECEPTION OF THE PILIPPINES PEOPLE UPPHOLDING THE FAKE PCR TEST: KAHIT SINO NA PATULOY NA TINIGYAN ITO AY KINAKAILALA ANG SARILI AT KRIMINAL NA PANLOLOKO.

 

‘It Felt Like Deception’: An Elite N.Y.C. Hospital Charges Huge Virus Test Fees

Insurers are stuck with the big bills from Lenox Hill, but the public ultimately pays through higher premiums.



ImageThe Lenox Hill Greenwich Village emergency department, where patients have been charged extraordinarily high prices for coronavirus tests. This photo was taken in mid-March; the blue parts of the signs advertising coronavirus testing have since been removed.
Credit...Steven Molina Contreras for The New York Times
The Lenox Hill Greenwich Village emergency department, where patients have been charged extraordinarily high prices for coronavirus tests. This photo was taken in mid-March; the blue parts of the signs advertising coronavirus testing have since been removed.

Lenox Hill Hospital in Manhattan advertised its “Covid-19 Testing” on a large blue and white banner outside its Greenwich Village division’s emergency room. The banner said nothing about cost.

But cost turned out to be the testing’s most noteworthy feature. Lenox Hill, one of the city’s oldest and best-known hospitals, repeatedly billed patients more than $3,000 for the routine nasal swab test, about 30 times the test’s typical cost.

“It was shocking to see a number like that, when I’ve gotten tested before for about $135,” said Ana Roa, who was billed $3,358 for a test at Lenox Hill last month.

Ms. Roa’s coronavirus test bill is among 16 that The New York Times reviewed from the site. They show that Lenox Hill arrives at its unusually high prices by charging a large fee for the test itself — about six times the typical charge — and by billing the encounter as a “moderately complex” emergency room visit.

In one case, a family accrued $39,314 in charges for 12 tests this winter, all taken to fulfill requirements for returning to work or school. In another, an asymptomatic patient walked in because she saw the banner outside and wanted a test after traveling. Her insurance was charged $2,963.

Federal legislation last year mandated that coronavirus testing be free for patients, so individuals are typically protected. None of the patients tested at the Lenox Hill emergency room were billed directly for the service. But eventually, American patients bear the costs of these expensive tests in the form of higher insurance premiums.

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Patient bills show that at least one additional hospital owned by Lenox Hill’s parent group, Northwell Health, has charged emergency room fees to patients at a mass testing site.

“It felt like deception, and an effort to try and get money that they are not entitled to,” said Ute Tabi. She was reviewing her family’s insurance claims and saw a $2,793 charge for a drive-through coronavirus test her husband got at a Northwell hospital in the New York suburbs, Huntington Hospital on Long Island. The hospital pursued the family for a share of the bill, which Ms. Tabi has so far refused to pay.

The Times has been asking readers to submit bills so that we can understand the costs of coronavirus testing and treatment. So far, more than 600 patients have participated. Their bills have revealed high charges and illegal fees, as well as patients who face substantial medical debt for coronavirus treatment. If you have a bill for coronavirus testing or treatment, you can share it here.

Northwell Health, a nonprofit, operates 23 hospitals in the region, and received about $1.2 billion in emergency health provider funding in the federal CARES Act last year.

The chain recently came under scrutiny after The Times revealed it had sued more than 2,500 patients for medical debt during the pandemic. It has since dropped those cases.

Northwell, which defended its coronavirus testing charges as appropriate, has since removed the blue signs at the Greenwich Village division advertising the service.

Officials said patients tested at the emergency room received more advanced care than they would elsewhere. They declined to comment on specific patient cases but said their protocols involve notifying patients that their test will come with emergency room fees. A sign with the information is taped to a plexiglass shield at the registration desk.

“I don’t think of the emergency room as a testing site,” said Barbara Osborn, Northwell’s vice president for communications.

But the Lenox Hill in Greenwich Village has tested 15,000 patients for coronavirus over the course of the pandemic. Patients interviewed by The Times said they went there because of the banner outside, not to seek emergency care. They were asymptomatic and seeking tests as a precaution before traveling or socializing.

Ms. Roa spotted the emergency room fee through an unusual circumstance. Her wallet had been stolen, and she was checking her bills. She feared her identity had been stolen because she had no memory of visiting an emergency room.

“I called my insurance and was freaking out, asking who has my identity, what will this bring,” she said. “After maybe 45 minutes, I got transferred to someone who was able to tell me that this was all about a Covid test.”

Americans have taken about 370 million tests during the pandemic. The price of each — as with most services in the American health system — can vary widely from one hospital or doctor’s office to another.

State-run testing sites in New York do not charge patients or collect health insurance information for the coronavirus nasal swab tests. A study published last year found that a swab test at a hospital can run from $20 to $850. Some independent laboratories have charged more, billing $2,315.

The Lenox Hill Greenwich Village center bills $671 for its coronavirus test, six times what major labs such as LabCorp and Quest charge. The rest of the price discrepancy comes from the emergency room fees.

Doctors and hospitals that bill higher prices for testing can rely on new federal protections to ensure they are paid. Congress passed a law last year that requires insurers to fully cover coronavirus testing costs and not apply any patient co-payments or other fees to the service.

Insurers must also pay for services that are necessary to obtain the coronavirus test, such as a doctor’s visit or, in the case of Lenox Hill, an emergency room facility fee.

“This is such a gold mine for hospitals because now they can charge emergency fees for completely healthy people that just want to be tested,” said Renee Hsia, a professor of emergency medicine at the University of California, San Francisco, who researches medical billing. “This is what you’d expect from a market-oriented approach to health care. It’s the behavior our laws have incentivized.”

Emergency rooms in the United States typically charge patients something called a facility fee, the price of walking through the door and seeking care. The fees have risen sharply in recent years, and can cost about $200 for a simple visit or $1,800 for the most complex cases.

Hospitals like Lenox Hill often defend these costs as necessary to fulfill federal laws that require them care for all patients regardless of their ability to pay.

“If someone does not have insurance, we still provide the same level of care as we would to someone who has insurance,” said Rich Miller, Northwell’s chief business officer.

Emergency room fees are common in the American system but rare in the world of coronavirus testing. At The Times’s request, the data firm Castlight Health analyzed insurance claims for 1.5 million coronavirus tests.

It found that less than 4 percent of coronavirus tests are billed through emergency departments. The vast majority of those tests are associated with large claims that have many charges, suggesting the nasal swab was incidental to a more complex visit.

Only about 5,000 bills out of the sample of 1.5 million — about 0.3 percent — were billed in a way that looked similar to Lenox Hill’s fees, the Castlight data shows.

At the Lenox Hill site, Mr. Miller explained, there are actually two separate coronavirus testing processes. Patients who arrive with a doctor’s order for a coronavirus test are routed to a service center that does not charge emergency room fees.

Patients who come in without that prescription are sent to the emergency room for an evaluation, where they will incur the facility fee charges. About 75 percent of coronavirus tests at Lenox Hill Greenwich Village are routed through the emergency room, a practice Mr. Miller defended.

“Anyone who would have been billed for an emergency room visit would have been assessed accordingly to see if other things were wrong with them,” Mr. Miller said. “We believe we’re adequately disclosing that this is an emergency department visit, and will be billed as E.R.”

Founded in 1857, Lenox Hill has long served a wealthy clientele at its main division on the Upper East Side of Manhattan. It is where Beyoncé gave birth in 2012, and is the subject of an eponymous Netflix documentary series that shows the hospital’s inner workings.

In 2010, New York State awarded Lenox Hill the rights to take over the Greenwich Village building left empty by the closing of St. Vincent’s Hospital. It replaced it with a free-standing emergency room.

It would stay open 24 hours and provide care to patients regardless of their ability to pay. But unlike traditional emergency rooms, it is not physically attached to a larger hospital.

Free-standing emergency rooms have proliferated in recent years, across the country and across New York City. Montefiore, Northwell and N.Y.U.-Langone have all opened them within the last decade.

Supporters have praised them for expanding critical care access without building an entire hospital, a potential boon to underserved urban and rural areas.

But they have also faced criticism for how they price care, especially for simple visits. One analysis conducted by the health insurer UnitedHealthcare found that the average cost for a visit related to a common condition like a fever or cough was 19 times higher in free-standing emergency rooms than in urgent care centers.

“Free-standing emergency departments simultaneously represent the best, innovative side of American health care and the pure profit motive,” said Dr. Jeremiah Schuur, chair of the emergency medicine department at Brown University’s Alpert Medical School.

The prices at Lenox Hill’s free-standing emergency room caught the eye of local government officials shortly after it opened. New York City’s Community Board 2, which has jurisdiction over Greenwich Village, held a meeting in 2016 to discuss several cases. One patient was charged $1,000 to have a bee sting looked at, and another faced fees of $3,000 related to a sprained ankle.

Sarah Nathan was not looking for emergency-level care when she was tested at Lenox Hill Greenwich Village. She just needed a test to return to her job as a nursery school teacher.

The bill for her visit came to $3,194, which her insurance negotiated down to $2,084. She recalls asking a front desk representative whether she would be billed for an emergency room visit. She said she was told she would not be.




  • BONG BONG MARCOS AT SARA DUTERTE AY PATULOY ANG DUTERTE FATHER DECEPTION OF THE PILIPPINES PEOPLE UPPHOLDING THE FAKE PCR TEST: KAHIT SINO NA PATULOY NA TINIGYAN ITO AY KINAKAILALA ANG SARILI AT KRIMINAL NA PANLOLOKO.

     

    Shin Jie Yong

    Feb 15, 2021

    10 min read

    Is the Coronavirus PCR Test a Fraud? An Objective Look Into Why People Insist So

    Reasons for the doubt are actually not entirely wrong, but they need proper interpretations.

    A person wearing a mask, gloves, and protective clothing inserting a nasal swab into test tube.
    Medical photo created by freepik — www.freepik.com

    It’s ‘scientifically meaningless’ and all false positives, some have claimed about the current polymerase chain reaction (PCR) test for SARS-CoV-2 infection or its disease, Covid-19. False-positive means that the positive result of a test is false, so it’s picking up a signal when there’s none.

    There are at least 5 reasons why some doubt its scientific validity:

    1. The inventor of PCR said it could not detect infectious viruses.
    2. It has not been compared to a gold-standard, definitive test.
    3. It’s a qualitative test, not quantitative.
    4. The cycle threshold (Ct) value used is too high, so it’s detecting coronavirus genes when there are no real viruses.
    5. There’s no proof that the detected genes belong to SARS-CoV-2 since this coronavirus has never been purified.

    This article will look at each of these points — evaluating if they are correct or not. Actually, however, most of the above points are in the grey area that is not outright wrong, which is why they can be misleading if not interpreted properly.

    In brief, PCR works by using specific primers to attach to both ends of a gene segment. An enzyme then amplifies that primers-marked gene until its detectable by genetic dye or marker. The type of PCR used to detect SARS-CoV-2 is real-time reverse transcription PCR (RT-PCR). Specifically, the RT-CR test detects the E and RdRp genes coding for the viral envelope and RNA polymerase enzyme, respectively, unique to SARS-CoV-2.

    1. It can’t detect infectious viruses?

    PCR tests “cannot detect free infectious viruses at all.” a quote attributed to Kary B. Mulis, Ph.D., a biochemist who invented the PCR test worthy of the Chemistry Nobel Laureate award in 1993. He died on 7 August 2019.

    Dr. Mulis did not say that quote, however. Instead, it came from a 1996 article by John Lauritsen, award-winning American reporter.

    Anyhow, that quote is not entirely false either. Lauritsen intended to clarify that the PCR test does not detect the whole virion but genetic pieces unique to the virion.

    So, it’s true that the PCR test “cannot detect free infectious viruses.” It can be likened to the analogy that finding dog fur in a location doesn’t mean the dog is still there. Similarly, detecting genetic pieces of SARS-CoV-2 doesn’t mean that the complete SARS-CoV-2 virion is still there. Maybe SARS-CoV-2 was already destroyed by the immune system, leaving dead viral fragments. This is undoubtedly one major flaw of the PCR test.

    “It is important to note that detecting viral material by PCR does not indicate that the virus is fully intact and infectious, i.e., able to cause infection in other people,” the Public Health England spokesperson told Reuters on November 2020. “The isolation of infectious virus from positive individuals requires virus culture methods. These methods can only be conducted in laboratories with specialist containment facilities and are time-consuming and complex.”

    Indeed, there’s a discrepancy between the positive PCR (specifically, RT-PCR) test and culturable SARS-CoV-2. In virology, culturable virus means that the virus can replicate in cells in a lab dish — indicating that the virus is infectious. After all, viruses can’t survive without a cell host.

    An editorial in the International Journal of Infectious Diseases reviewed various studies and stated that SARS-CoV-2 is often not culturable after the 8–10th day of illness, despite on-going positive RT-PCR test results. This is because SARS-CoV-2 may have disseminated deep into the lungs or elsewhere in the body to be sampled from the nose.

    Therefore, persons who tested positive for SARS-CoV-2 by RT-PCR may not harbor infectious viruses. The RT-PCR test can’t conclude but can only tell that there might be active or infectious SARS-CoV-2 in the body.

    2. It has not been compared to a definitive test?

    The accuracy of a particular pregnancy test, for example, is determined by comparing its results to a gold-standard, definitive test. In this case, the definitive test is the visible pregnancy itself. By comparing a particular test to a definitive test, we can discern how accurate it is, such as its false positive and false negative rates.

    Admittedly, this comparison has not been made with the current PCR test. But that’s because there’s actually no definitive test for Covid-19 or SARS-CoV-2. Why?

    Covid-19 or SARS-CoV-2 can be detected in at least two other ways, although they are not definitive as well:

    • A chest CT (computerized tomography) scan showing lung abnormalities typical of Covid-19. But infected people can still spread the virus to others even before symptoms develop and the lungs start showing abnormalities observable with chest scan. About 59% of SARS-CoV-2 transmissions are caused by infected persons who had no symptoms — asymptomatic.
    • An attempt to culture viruses from the respiratory samples. But the absence of culturable SARS-CoV-2 doesn’t indicate that the patient is no longer sick. As mentioned, SARS-CoV-2 is not typically culturable after the 8–10th day of illness from nasal swabs, but Covid-19 lasts for a few weeks. This is because the virus may have reached deeper parts of the body, such as the lungs or air sacs, to be culturable from nasal swabs.

    Thus, infected persons might not develop an illness, yet they can transmit the virus to others. And sick patients might not harbor culturable viruses. These reasons are why there’s no definitive test for Covid-19 or SARS-CoV-2.

    The PCR test may be the best cost-effective option we have to detect possible SARS-CoV-2 infection. It’s only ‘possible’ because the detected SARS-CoV-2 genetic material might be dead, and not culturable or capable of causing Covid-19.

    3. It’s qualitative, not quantitative?

    Yes, the PCR test is qualitative as it only indicates either the gene of interest is present or absent. Thus, “they don’t show how many viral particles are in the body,” journalists wrote elsewhere.

    But the type of PCR test used to detect SARS-CoV-2 is RT-PCR, which is semi-quantitative. One added functionality of RT-PCR is the cycle threshold (CT) value that indicates the number of amplification that occurred from the PCR.

    Therefore, the higher the CT value, the more amplification was needed to detect the gene of interest — indicating that this gene is found in low amounts in the clinical sample. Likewise, the lower the CT value, the less amplification was necessary since the gene of interest is abundant in the sample.

    While the RT-PCR test for SARS-CoV-2 or Covid-19 doesn’t indicate the exact number of viruses present, it tells us its abundance. So it's semi-quantitative that offers value in semi-quantifying viral load. Indeed, the Ct value can predict Covid-19 duration, severity, or death, but such clinical utility remains debated since the Ct value can vary between RT-PCR protocols.

    4. The Ct threshold value is too high?

    As follows, too high of a Ct value indicates minuscule SARS-CoV-2 genetic material in the sample, which might mean that it’s clinically meaningless. Yet, it’s still a positive result.

    Anthony Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases and medical advisor of the White House, admitted that the Ct value of >35 most likely indicates “dead nucleotides,” which means harmless virus fragments. Some even consider that the Ct value of over 30 is too high. Indeed, a review of multiple studies concluded that SARS-CoV-2 is usually not culturable at a Ct value of >30 or >33.

    “Most [RT-PCR] tests set the [Ct value] limit at 40, a few at 37. This means that you are positive for the coronavirus if the test process required up to 40 cycles, or 37, to detect the virus,” the New York Times reported. Apparently, the FDA did not set the Ct value limit for a positive SARS-CoV-2 test, and that “commercial manufacturers and laboratories set their own.”

    Hence, setting the Ct value up to 40 may have overestimated the true number of SARS-CoV-2 cases. If the New York Times is correct in that most RT-PCR tests did that, then the majority of tests might have detected some false positives.

    To give an idea of how frequently is the ‘some false positives,’ the Wadsworth Center in New York has kept records of their Ct values. In July 2020, Wadsworth Center detected 872 positive RT-PCR tests for SARS-CoV-2 with Ct value set at 40. However, about 43% and 63% of those positives were no longer positive if the Ct value cutoff is set at 35 and 30, respectively. This means that if the Ct value was set more appropriately at 30–35, we might have recorded about 43–63% fewer SARS-CoV-2 cases today. This is in line with the estimation that 49% of SARS-CoV-2 cases are asymptomatic.

    But, newly infected people might show a high Ct value of 37, for example, which may reach 30 or less in the following days as the virus replicates. Recall that higher Ct values mean lesser viral load. Alternatively, the nasal swab may not reach deep enough to sample sufficient viruses. So, the RT-PCR test can pick up every single ‘potentially’ infectious or contagious case.

    It’s indeed a dilemmatic situation — to minimize risk by counting every single ‘potentially’ infectious case as true cases or to take some risk by setting the Ct value lower and miss out on some true infectious cases.

    Some experts have suggested that persons with high Ct value upon RT-PCR test be tested again soon. Even a rapid test — such as the rapid antigen test — with lower sensitivity can be useful in identifying the most infectious cases, rather than every single potentially infectious case. Indeed, the rapid antigen test works best in high viral load cases with a Ct value of <25.

    5. Detected genes don’t belong to SARS-CoV-2?

    Opponents of the RT-PCR test have claimed that there’s no proof that the detected gene belongs to SARS-CoV-2. Because nobody has ever purified SARS-CoV-2, to begin with. They went on to argue that SARS-CoV-2, the causative agent of Covid-19, does not exist because it doesn’t fulfill Koch’s postulates for a pathogen.

    However, viruses exist following the revised Koch postulates since the original postulates were formed when researchers didn't know viruses exist. As pathogen-host interactions are complex, not even every bacteria can fulfill Koch’s postulates.

    Also, unlike bacteria or fungi, viruses can only survive and replicate inside a living cell. Viruses can’t survive in the environment outside cells, except for a brief moment when viruses propagate from cell to cell. In this sense, viruses can’t be purified purely alive like bacteria or fungi, but they can be cultured in a set of living cells.

    Therefore, SARS-CoV-2 exists as proven via culturing it in living cells in a lab dish. Electron microscopy can then reveal viral-like particles in SARS-CoV-2 infected cells. Alternatively, SARS-CoV-2 can be separated from the cells before visualization. Genetic material inside infected cells or viruses can then be sequenced to derive the full genome of SARS-CoV-2. SARS-CoV-2 replication inside cells can also be inhibited with drugs or reacted with antibodies. Plus, SARS-CoV-2 can be transmitted among susceptible animal species, causing Covid-like diseases. So, yes, SARS-CoV-2 is real.

    Since the full genome of SARS-CoV-2 has been sequenced, we can compare it to the other sequenced viruses in genomic databases. The PCR or RT-PCR test can then be designed to amplify a gene unique to SARS-CoV-2.

    Short abstract

    Given the topic complexity, it’s expected that there are misunderstandings. People can be misled into believing that the RT-PCR test for SARS-CoV-2 is a fraud. Indeed, reasons for believing the fraud are not entirely wrong either:

    1. It’s true that the RT-PCR test can’t detect infectious SARS-CoV-2, but it can detect genes specific for SARS-CoV-2.
    2. It’s true that the RT-PCR test has not been compared to a gold-standard, definitive test. But that’s because there’s no such definitive test.
    3. It’s true that the RT-PCR test is qualitative, but it’s also semi-quantitative with a cycle threshold (Ct) value.
    4. It’s true that the Ct value set is high, making the test very sensitive that it might pick up signals from dead viral fragments. This may have led to SARS-CoV-2 overdiagnoses. But setting the Ct value lower also comes at the risk of overlooking probable infectious cases.
    5. It’s not true that SARS-CoV-2 has never been ‘purified’; however, that term may mean. SARS-CoV-2 exists, and there are genes specific to SARS-CoV-2 that can be targeted with RT-PCR.

    Overall, the RT-PCR test is reliable, although it’s not perfect and may have overestimated the true SARS-CoV-2 case numbers to some extent. Rather than fixating on its flaws, however, proper use and interpretation of RT-PCR tests should be the focus. Public education and correcting misinformation, while easier said than done, also matters.

    Thanks to Philip George Hayward for informing me of the concerns surrounding the RT-PCR coronavirus test’s scientific validity.

    If you have made it this far, I appreciate it. Subscribe to my Medium email list here. If you want to become a member to get unlimited access to Medium, you can use my referral link and I will receive a small commission.

    BONG BONG MARCOS AT SARA DUTERTE AY PATULOY ANG DUTERTE FATHER DECEPTION OF THE PILIPPINES PEOPLE UPPHOLDING THE FAKE PCR TEST: KAHIT SINO NA PATULOY NA TINIGYAN ITO AY KINAKAILALA ANG SARILI AT KRIMINAL NA PANLOLOKO.

     

    • Saliva RT-PCR Test

    Saliva RT-PCR Test

    The Department of Health (DOH) recently gave Philippine Red Cross (PRC) the green light to use saliva tests in detecting Covid-19.

    This means the cheaper and less invasive saliva-based Covid-19 test – an alternative to the real-time reverse transcription-polymerase chain reaction (RT-PCR) swab tests – can already be offered to the public.

    PRC’s saliva Covid-19 test costs P2,000 while the RT-PCR test costs around P3,800 to P5,000.

    Countries like the United States, Singapore, Hong Kong, Taiwan, and Japan have either approved or have been using this method of using saliva samples to test for SARS-CoV-2, the new coronavirus that causes respiratory illness Covid-19, as an alternative to RT-PCR test, which is still considered the gold standard in coronavirus detection.

    How is it done?

    Compared to the nasopharyngeal swab, wherein a sterile swab is inserted through a nostril and into the nasopharynx, the saliva test is considered less invasive, therefore, less painful if not totally painless.

    Patients only have to spit into a sterile vial that will then be submitted to a PCR laboratory for analysis. According to Senator Richard Gordon, who also chairs PRC, the result of a saliva Covid-19 test just takes few hours.

    But Gordon reminded the public there are some guidelines that should be followed before undergoing the saliva test.

    “Do not drink any liquid…eat, brush teeth, gargle, smoke tobacco half an hour before the test,” he said in a television interview over ABS-CBN News Channel.

    How accurate is it?

    According to PRC lead researcher Michael Tee, the saliva Covid-19 test’s accuracy rate is 98.23 percent.

    In an earlier statement, PRC biomolecular laboratories chief Paulyn Ubial said their study showed that the saliva-based test was 98.11 percent accurate in testing for coronavirus.

    On the other hand, the RT-PCR swab test has a 99-percent accuracy rate.

    “Sa calculation po namin, although nagtatalo pa ang mga statistician at mga doctor at this point—mamayang hapon namin ipe-present sa Covid lab expert panel ng Department of Health—meron pong accuracy ang saliva versus the swab of 98.11 percent,” Ubial said over ABS-CBN’s Teleradyo on January 20.

    (Based on our calculation, although it is still being debated by statisticians and doctors at this point, the accuracy of saliva test versus swab test is 98.11 percent. We will present these findings to the Covid lab expert panel of the DOH later in the afternoon.)

    On August 15 last year, the U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) to SalivaDirect – a saliva-based method of Covid-19 testing developed at the Yale School of Public Health.

    According to Yale, the procedure is “ideal for large-scale testing and offers a number of advantages over traditional testing methods.”

    Where and how to undergo saliva tests?

    People can now avail themselves of the saliva-based test by booking an appointment on the PCR’s official website. The tests can be carried out either at the PCR’s headquarters in Mandaluyong City or their molecular laboratory in Port Area in Manila.

    Prior to booking an appointment, a patient should first answer and submit an e-CIF Form.

    Payment for the saliva Covid-19 test should be made online: GCash via PayMongo or GrabPay via PayMongo.

    Booking an appointment and filling of E-CIF form is done through the Dashlabs platform.

    BONG BONG MARCOS AT SARA DUTERTE AY PATULOY ANG DUTERTE FATHER DECEPTION OF THE PILIPPINES PEOPLE UPPHOLDING THE FAKE PCR TEST: KAHIT SINO NA PATULOY NA TINIGYAN ITO AY KINAKAILALA ANG SARILI AT KRIMINAL NA PANLOLOKO.

     

    Government urged to allow use of Pinoy-made test kits

    Cecille Suerte Felipe - The Philippine Star
    Government urged to allow use of Pinoy-made test kits
    COVID-19 test kit developed by experts from the Philippine Genome Center and the National Institutes of Health of the University of the Philippines Manila.
    Manila HealthTek Inc., Facebook

    MANILA, Philippines – Senators belonging to the minority bloc urged the government to allow the use of Filipino-made, world-class coronavirus disease 2019 (COVID-19) test kits, especially at a time when resources are scarce.

    In a joint statement, Senate Minority Leader Frank Drilon and Sens. Francis Pangilinan and Risa Hontiveros questioned what was holding Health Secretary Francisco Duque III and the DOH back from giving the go-signal for the use and mass production of this Filipino-made, quality yet less expensive test kit.

    “Is there someone making money from expensive and imported test kits? The savings that could be generated from this kit are crucial in augmenting our COVID-19 response especially at a time when resources are scarce,” the senators added.

    The senators said Filipino scientists and doctors started developing the test kits as early as December last year when reports about the coronavirus surfaced.

    “The country is ramping up COVID-19 testing, but locally manufactured, world-class P1,320 PCR test kits are gathering dust in laboratories due to the inaction of Health Secretary Duque,” the lawmakers said.

    Developed by the University of the Philippines National Institute for Health and funded by the Department of Science and Technology, the Filipino test kit continues to face hurdles even as imported brands coming from China and Korea, costing more than double at between P4,000 and P8,000, enter the country without difficulty.

    The kits have undergone trials and tests, with an interim report showing that they have up to 93.96 percent sensitivity and up to 98.04 percent specificity, at a confidence interval of 95 percent, ranking among the world’s best and performing better than some of the imported kits.

    “Is there someone being favored here at the expense of Filipinos who every day face the dangers of getting infected, or who could already be carriers of the virus but are not yet being tested?” they asked.

    With the number of COVID-19 cases continuously rising, the senators said the DOH could not afford more missteps in handling the situation because lives are at stake.

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