Metro Manila, Philippines – Baguio City Mayor Benjamin Magalong on Monday rejected Health Secretary Teodoro Herbosa’s statement that patients no longer need guarantee letters from politicians to access services in government hospitals, saying the practice remains in place on the ground and exposes deeper problems in the health assistance system.
In an interview on The Newsmaker, Magalong said Herbosa’s statement was inconsistent with the situation in Baguio and other local governments.
“I was surprised by that pronouncement because it’s not true,” Magalong said. “Here in Baguio – and based on what we’re hearing from other mayors – guarantee letters are still required.”
He said the Baguio city government continues to issue guarantee letters for indigent patients referred to the Baguio General Hospital, showing thick files of documents issued in 2025 alone.
“These guarantee letters are required so patients can receive treatment,” he said. “I don’t know where that statement is coming from.”
Magalong said hospitals still ask patients whether they have a guarantee letter before treatment is processed.
“That’s why they come to us,” he said.
Herbosa earlier said the Department of Health does not use guarantee letters in DOH-run hospitals and that the government’s zero-balance billing policy, in effect since July 2025, allows patients in basic accommodation to receive care without paying out of pocket.
Magalong admitted that guarantee letters create opportunities for political patronage and corruption, particularly in the distribution of medical assistance funds.
“That system is prone to abuse,” he said, alleging that some lawmakers convert medical assistance into so-called medical missions where costs are padded and portions are kicked back to politicians.
“In some cases, the so-called rebate reaches as high as 30%,” the mayor said.
He said the practice fosters “utang na loob,” or political indebtedness, among patients.
“That’s exactly what we want to avoid,” Magalong said. “Medical services should be equitable and not tied to politicians.”
Magalong called for the abolition of the guarantee letter system and channel instead assistance directly to hospitals with strict monitoring.
“The best solution is to remove politicians entirely and release the funds straight to hospitals,” he said. “But there must be strong auditing because corruption can also happen there.”
