In cases that a patient or their kin is economically disadvantaged, no hospital may be allowed to refuse medical services, disallow them from being discharged, or detain them in exchange for full payment. Any act which undermines the principles of equality and fairness in the right for every Filipino to access healthcare, coupled with the threat of being arbitrarily detained, is an outright violation of one’s fundamental human rights.

As the country’s independent national human rights institution, the Commission on Human Rights has initiated investigations into three cases of economic discrimination, denial of timely medical care, and unlawful detention against ACE Medical Center in Valenzuela. The Commission has found that the hospital has long implemented a practice, which prioritizes financial considerations over patient welfare—practices that are antithetical to a rights-based approach to healthcare.

One such case involves the complaint of Nerriza Zafra, whose newborn daughter was refused discharge by ACE Medical Center due to the family’s inability to settle the full payment of hospital bills in August 2017. The said newborn was born prematurely at 30 weeks and was diagnosed with neonatal sepsis, neonatal pneumonia, and pneumothorax, which led to a significant increase in Zafra’s hospital bills. It was only after the submission of a demand letter from the Public Attorney’s Office that the hospital allowed the baby to go home, despite the remaining balance. However, the child’s birth certificate had yet to be registered by the hospital, requiring full payment of the bills as a condition for doing so.

As a result, the child is at risk of being unable to enroll in Grade I and continue her education. The CHR has ruled this case as a clear violation of the child’s fundamental and humanitarian rights under the Convention on the Rights of the Child, particularly on the non-registration of the birth certificate. This has unfairly denied the child an opportunity to pursue education, merely due to financial hardships in the household, and also indirectly hampers the child’s future access to healthcare services.

Similarly, Richel Mae Alvaro faced a situation on 14 February 2024 when her husband required immediate medical treatment for heart complications. Despite assurances of payment via PhilHealth and a promissory note, the hospital detained her within its premises on the grounds of non-payment. ACE Medical Center also required various documents from Alvaro, which she was unable to provide after being prohibited by the hospital to leave her husband unattended. Alvaro was also unable to immediately fulfill the funeral arrangements for her husband after being instructed that she could not leave the hospital premises without a relative to replace her. The hospital’s demands exacerbated the family’s suffering, infringing upon the rights to liberty and security, as well as the right to dignity.

In another complaint, Lovery Magtangob was prevented from leaving the hospital premises after her sister-in-law passed away. The hospital delayed the release of the body and issued only a provisional death certificate due to unpaid bills. Magtangob was also prohibited from leaving the hospital and was prevented from eating outside, being instructed to dine only at the hospital canteen. This treatment had caused her significant stress and fear due to the strict refusal of the guards.

ACE Medical Center released her sister-in-law’s body only after a partial payment was made and a new promissory note was signed, stating that the additional balance would be paid the next day and the remaining amount will be settled afterward. Only then was Magtangob allowed to leave the hospital.

These cases investigated by the CHR illustrate egregious violations of patients’ and families’ fundamental rights under Philippine law and international human rights frameworks. ACE Medical Center’s actions violated the right to liberty and security, as well as freedom from arbitrary detention, as enshrined in Articles 3 and 9 of the Universal Declaration of Human Rights (UDHR) and the International Covenant on Civil and Political Rights (ICCPR). By detaining patients and withholding essential documentation, the hospital also violated the right to dignity and healthcare, creating unnecessary financial and emotional burdens.

Moreover, the hospital’s refusal to discharge patients or release bodies based on financial capacity contravenes the right to health, as outlined in Article 12(1) of the International Covenant on Economic, Social, and Cultural Rights (ICESCR). This focus on monetary gain, at the expense of care, erodes public trust in healthcare systems and exacerbates inequalities, especially among economically disadvantaged individuals and families.

In all these cases, Ace Medical Center has implemented a practice that discriminates based on economic status, which contradicts the principles of equality and fairness in healthcare access, and contributes to a cycle of poverty and poor health. Specifically, these violate the patients’ and their families’ right to non-discrimination under Articles 2 and 7 of the UDHR and Article 9 of ICCPR.

The CHR stresses that healthcare is a universal right, one guaranteed to all Filipinos, regardless of economic status. The principles of accessibility, affordability, and adaptability must guide healthcare provision, especially under the Universal Health Care Act. As we work toward a sustainable healthcare system, it is critical that a human rights-based approach is embedded within its framework, ensuring that no individual is denied care or subjected to degrading treatment due to financial hardships.

Hospitals and healthcare providers have a duty to offer care with compassion and integrity, prioritizing patient welfare over financial gain. It is through this commitment to equality and fairness that we can build healthier communities where financial barriers do not hinder access to essential healthcare services.

CHR reaffirms its commitment to upholding and protecting the human rights of all individuals, especially the disadvantaged sector, and urges hospitals and medical institutions to align their practices with the highest ethical standards of patient care.###