President Ferdinand R. Marcos Jr. has announced the “zero balance billing” policy in all Department of Health (DOH)-owned and operated hospitals. In my book, that’s already close to having “universal health care”.

Finally, with the help of some friends at PhilHealth, I was able to clarify that the Zero Balance Billing (ZBB) program of the government applies not only to the public hospitals that are owned and operated by the DOH, but to all public hospitals, provided that the patients are confined in ward type accommodations, and not in private rooms.

Furthermore, the ZBB program includes all professional fees involved during the surgery or confinement, provided that no other doctors are involved in the surgery or confinement, aside from those who are already working in the hospital concerned.

What that means is that if there is any other doctor or specialist who is called in from the outside, his or her professional fees will not be covered by the ZBB program.

But what if for any reason, the patient or the family of the patient has no choice but to bring him or her to a private hospital?

It is not yet very clear, but I think that the government is working on that to be covered by ZBB too, if the patient is also billeted in a ward type of accommodation, and not in a private room.

One thing that is already in the law — and not open to interpretation — is that no hospital, public or private, may turn away a patient who enters their premises. The real question is: what happens if the patient is indigent and cannot afford to pay?

On paper, that’s not supposed to be a problem. PhilHealth can reimburse most of the bills — medicines, professional fees, and all — except for private room costs. For indigent patients, private rooms are usually out of the question anyway.

If PhilHealth can’t cover everything, there’s always the Philippine Charity Sweepstakes Office (PCSO), which can issue a Guarantee Letter to shoulder some expenses.

Again, private rooms and professional fees may not be included — but in theory, an indigent patient can still walk out of a private hospital with zero to pay, provided they weren’t in a private room.

That’s in theory. Reality, however, tends to throw in a lot of ifs and buts. What if the hospital only has private rooms?

What if ordinary rooms are full and the patient ends up in a private one?

I’ve seen this happen and trust me — things can get messy very quickly.

So, here’s my proposed solution — one I wish hospital administrators would take seriously: bring back the charity wards.

Back in the day, every hospital had them. They weren’t just a token bed or two; they were actual wards — multiple beds set aside for indigent patients.

This wasn’t just good practice; it was once official policy. In fact, DOH Administrative Order No. 2007-0041 still requires all private hospitals to allocate at least 10% of their authorized bed capacity as “charity beds.”