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Reproductive Health

                                                                Keynote Speech of
                                                             Hon. Edcel C. Lagman
                                                   Representative, 1st District of Albay
                                            Minority Floor Leader, House of Representatives
                                                Co-Chairperson, PLCPD Board of Trustees

                                                                 on the occasion of
                                         The Third National Multisectoral Policy Conference
                                                           on Human Development
                                                 17-18 August 2010, Crowne Plaza Galleria

 

              It was only yesterday afternoon when the Office of the President sent its regrets to PLCPD that President Benigno Aquino would be unable to come to deliver the Keynote Address. And no administration official was deputized to represent the President.

              President Aquino must be preoccupied with pressing matters of State. This we can fully understand, although we would have appreciated an earlier demurrer.

              When I agreed at the eleventh hour to deliver the Keynote Address, I made it categorical that I was not pitching in for the President. Neither do I have the authority nor inclination to do just that.

              The National Multi-Sectoral Policy Conference on Human Development, now on its third conference after the March 2005 and August 2007 sessions, is of overriding importance in our common and continuing pursuit of the population and development agenda. A conference of this import should not be missed by policy initiators, makers and implementers as well as by civil society and non-government organizations representing the disadvantaged beneficiaries of progressive policies.

              It is significant to note that each Conference is convened proximate to the opening of a new Congress, as much as possible. This is so because the output of the Conference, which is the people’s legislative agenda, is submitted to the Congress as the national policymaking department of the government.

              The Conference in August 2007 can claim a laudable measure of success with the enactment of the Comprehensive Agrarian Reform Program Extension with Reforms (RA 9700), Magna Carta of Women (RA 9710), Anti-Torture Law (RA 9745), Renewable Energy Law (RA 9513), and the Cheaper Medicines Act (RA 9502).

National

SOUND AND FURY OF PRESIDENT AQUINO’S SONA

Counter-SONA Speech delivered by Minority Leader
Edcel C. Lagman on 27 July 2010 at the House of Representatives)


        Mr. Speaker and distinguished colleagues:
 
        The Minority in this House has publicly declared that it will not be obstructionist nor will it be obstinate.  It has offered the hand of amity and cooperation to the Administration. It would support the Administration’s agenda for sustainable human development and programs to alleviate poverty, protect the marginalized and strengthen the economy.
 
       We in the Minority keenly awaited the State of the Nation Address (SONA) to be informed of concrete and meaningful legislative agenda of President Benigno Aquino III – a shopping list of well-explained proposals from which the Minority could select and prioritize what measures it would adopt and jointly advocate.
 
       The SONA frustrated the expectations of the Minority. Instead of being a blueprint for development and policy direction, the SONA was generally a partisan press release, a complaint sheet, a compendium of motherhood statements and a continuation of campaign rhetoric.
 
        Instead of presenting a roadmap on policies and programs, the SONA was a discourse on “inherited problems” which overwhelm the President and painted an atmosphere of woe with very tentative and deficient solutions.
 
       Yung SONA kahapon ng Pangulo ay bitin, kulang at kapos. Ano naman ang susuportahan ng Minorya kung walang binigkas na maliwanag na programa ang Pangulo? Just like a tele-novela: abangan ang susunod na kabanata. Talagang bitin.
 
       The SONA was bereft of specifics or particulars. His proposals were virtually hanging in the air and most probably, he expected Congress to fill in the blanks. Or was it purposely vague or “safe” so that the people could not hold him accountable for a concrete program once it fails?
 
       I have been cautioned to go slow on the SONA because President Aquino enjoys a tremendously high approval rating. But when the Emperor wears no clothes, can I honestly tell you that his robe is regal and majestic? 
 
Yesterday afternoon the sound and fury emanating from the first SONA of President Aquino reverberated in this august Chamber.
 
       “Sound” from the crafted “sound bites” on alleged misdeeds of the previous administration which the current dispensation considers “excesses” to solely rake up and expose, but not as pitfalls to avoid and hard lessons to learn from.
 
       “Sound” echoing the voices of presidential subalterns who were specifically ordered to find past faults of the agencies they are now heading, for inclusion as inputs in the SONA, which contributions could have been contrived or hastily prepared.
 
       And “sound” from the much-ballyhooed “speech from the heart”, which was indeed more cardiac than cerebral.
 
       “Fury” from the ferocious campaign of perceived vengeance spearheaded by the Presidency whose “prosecutor’s complex” projects the creation of a “Truth Commission” which will only duplicate, if not supersede, the statutory and constitutional mandates of existing government prosecutorial and judicial agencies, aside from becoming a convenient launching pad for conviction by publicity of expected respondents.
 
       “Fury” from the divisive disposition of the Presidency which plants a wedge among our people and leaders, instead of integrating and unifying sectors of society and institutions.  The SONA must integrate, not divide, the nation.
 
       “Fury” from misleading accusations and denunciations which defy the facts, violate the truth and trivialize probity.
 
       We do not intend to defend the officials of the previous administration who could ably defend themselves from denunciations and innuendoes. What we are going to do is to clarify the statements of the President to establish the accurate facts and figures; buoy up the people’s faith in government institutions; maintain investors’ confidence and prevent capital flight consequent to an errant presentation engendering doubt and despair.
 

Reproductive Health
“THE CONTROVERSY BEHIND THE
REPRODUCTIVE HEALTH BILL”
(Speech delivered by REP. EDCEL C. LAGMAN at the Graduate School of Nursing Seminar, Arellano University on 20 February 2010)


To label the RH bill controversial is both an accurate assessment and an erroneous attribution.

It is a correct observation because something which is controversial is also perceived to be divisive and problematic – so much so that during public debates, our presidentiables dread questions on whether or not they support the enactment of the RH bill or if they are for or against family planning. Such questions are cause for concern that even the most eloquent and straightforward among them fumbles for words and answers with uncharacteristic ambivalence.

It is accurate to brand the issue of reproductive health as controversial because it is highly contentious and regularly strikes a discordant note with adverse partisans. In my experience speaking in forums on the RH bill, people are either strongly supportive of the bill or rabidly against it. Most of the time, people have strongly-held opinions on the matter. There are almost no instances when people are merely lukewarm about the issue of family planning and reproductive health. They are either advocates or detractors.

But it is also an erroneous attribution to describe the bill as controversial because a controversy implies that there is something offensive and scandalous about the measure when in fact the RH bill is a rational, health and rights-based and human development oriented policy.

Reproductive Health
Reproductive Health, Maternal and Child Health
and Family Planning: The Inverse Relationship of Number of Children With Income and Quality of Life
By: REP. EDCEL C. LAGMAN


“The more, the merrier” is an adage of the past. Now, it is more apt to say “the more, the more miserable.” Likewise, “cheaper by the dozen” has lost its charm as a simple economic formula. Each new child is an additional expense poor families can ill-afford.

These two traditional sayings are not prescriptions for development.

Truly, there is an inverse relationship of number of children with income and quality of life.

Indeed, the Philippines cannot achieve sustainable development if the government and policymakers continue to default in addressing and solving with strong political will the grave population problem.

With the current total fertility rate at 3.3 children per woman, the specter of our population hitting a staggering 94 million this year is not only menacing but ominously explosive.

POPULATION AND DEVELOPMENT NEXUS

It was a Filipino, the late Rafael Salas, the first Executive Director of the United Nations Population Fund (UNFPA), who enunciated 40 years ago that there are “crucial links between population and development” and there is “a need to take population factors into account in development plans.”

Studies have consistently shown that unbridled population growth stunts socio-economic development, aggravates poverty and demeans quality of life, thus making it more difficult for government to address the problem of underdevelopment.

In 2002 the UNFPA unequivocally stated that “family planning and reproductive health are essential to reducing poverty” and “countries that invest in reproductive health and family planning and in women's development register slower population growth and faster economic growth”.

The Family Income and Expenditures Surveys (FIES) from 1985 to 2000 also clearly show that poverty incidence steadily increases with each additional child in the family.

ADVERSE EFFECTS OF HIGH FERTILITY
AND LARGE FAMILY SIZE

The following are the adverse effects of high fertility and large family size, particularly on women and children:

1. High fertility impacts negatively on the lives of women. Multiparity is associated with maternal mortality because with each additional pregnancy, a woman’s lifetime risk of dying from maternal causes progressively increases.

Although pregnancy is not a disease, the fact that 11 women die daily in the Philippines from pregnancy and childbirth complications is akin to a crime. The WHO, UNFPA and Lancet are unanimous in stating that correct and consistent use of contraceptives can prevent as much as 35% of maternal deaths.

2. High fertility impacts negatively on the lives of children. Researchers conclude that “(c)hildren from large families are at significantly greater risk of living in poverty than children from small families.”

They do not only suffer from poor health, their educational opportunities are also limited. Because these children are more likely to suffer from poor nutrition and substandard childcare, they do not perform as well in school compared to children from small families. Their future and quality of life are jeopardized.

3. High fertility adversely affects quality of life – even across generations. Dr. Aniceto Orbeta asserts that large family size “has been identified as the main mechanism of the inter-generational transmission of poverty.”

The lack of education, poor nutrition and general ill-health that normally plague large families make it virtually impossible for its members to lift the family out of the quagmire of destitution. Indeed, large families perpetuate poverty across generations.

4. Large family size is a primary factor in the decline in household savings.     The costs of raising a child are high and can financially drain the family. While households with one child devote 10% of total household expenditures to childrearing, allocation for children jumps to 18% with the birth of a second child and increases to 26% for four children. Large families virtually have no savings.

5. Large families are more vulnerable to external economic shocks. Without adequate savings, large families are ill-prepared for the loss of employment or sickness or disability in the family. They will have more difficulty coping with the unexpected because they lack the buffer funds needed to tide them over hard times.

6. Large number of children is associated with decreased incomes and less investment in human capital. Pernia, et al. also documented that mean education spending per student per year drops from P1,787 for a family of four to P682 for a family size of 9 and above. Moreover, average health spending per sick family member falls from P1,464 to P756 over the same family size range.

7. Rapid population growth and high fertility impact negatively on economic growth. Population and poverty are intertwined in a vicious cycle. Excessive population growth exacerbates poverty while poverty spawns rapid population growth. They are the negative tandem of the “low level equilibrium trap”. 

The foregoing adverse effects are mainly due to and are further aggravated by lack of RH and FP information and services, particularly to poor and marginalized couples and communities.

RH IS ESSENTIAL TO DEVELOPMENT,
OVERALL HEALTH AND WELLBEING

RH is essential to women’s and children’s overall health. If it is neglected, primary aspects of their general welfare would be irrevocably compromised.

RH and FP reduce maternal and infant mortality and improve the health status of mothers and children. Contraceptive use leads not only to a decrease in pregnancy rates but also an even greater decrease in maternal mortality, simply by reducing the number of high-risk pregnancies according to the WHO.

The death of a mother has untold effects on her children. According to the UNFPA, “saving a mother’s life usually means saving the life of her newborn and older children. Children who have lost their mothers are up to ten times more likely to die prematurely than those who haven’t.”

Thus, preventing maternal death through effective family planning will also be a significant step in protecting children and ensuring a better quality of life for them.

Lower fertility would mean more educational
and employment opportunities for women

Providing women the chance to plan and space their children will give them more opportunities to finish their education and secure productive work as they are liberated from unremitting pregnancies. Lower fertility ensures maternal health and frees women to pursue opportunities in education and employment and thus will enhance their self-esteem and uplift their social and economic status and that of their families.

FROM VICIOUS CYCLE TO VIRTUOUS CYCLE: CHILDREN REAP THE BENEFITS OF THEIR MOTHERS’ FAMILY PLANNING DECISIONS

We are currently trapped in a vicious cycle of high fertility and poverty – poor people continue to be impoverished because the cost of having many children drains their already depleted resources and at the same time poor people have more children than they can afford precisely because their being poor denies them access to family planning information and services.

But there is also a so-called “virtuous cycle” linking the family planning decisions of mothers with their children. It emphasizes the benefits reaped by children whose mothers practiced family planning.

Women who are able to avoid unplanned pregnancies will be able to give their children quality childcare, invest more in their education and ensure that they are better-fed and healthy. As adults, these children will also be better prepared to manage their own fertility and be more responsible parents themselves; be gainfully employed; and will be more equipped to ensure a better future for their own children.

To be able to jumpstart this virtuous cycle, policymakers must stop dillydallying on House Bill 5043 because RH, FP, population and human development are all intertwined and should be integral components of government’s development plans and poverty alleviation programs.

It is therefore imperative that Congress enacts public policies that help people better manage their fertility and have good reproductive health, especially the poorest women who have almost three times more children than they want.

Affording parents the right to freely and responsibly determine the number and spacing of their children will certainly have positive multiplier effects on the lives of the most vulnerable members of society – poor mothers and their children.

House

Prioritizing Growth and Congressional Supremacy Over the Budget
(Sponsorship Speech delivered on 06 October 2009 by Rep. Edcel C. Lagman on HB 6767 or
the proposed FY 2010 General Appropriations Bill)

 

The President’s National Expenditure Program (NEP) for 2010, which is initially adopted by tradition as the proposed General Appropriations Bill (GAB), is torn between the drive for more expenditures to propel growth and the constraint to limit expenditures to contain the fiscal deficit.

As it now appears from the Executive’s budget proposal, expenditures to enhance development have been held back in favor of what conservative economists call a “manageable fiscal deficit”.

Major departments have suffered reduced allocations compared to their current appropriations like the following:

1. Department of Transportation and Communications (DOTC) –39.3% reduction;
2. Department of Tourism (DOT) – 25.7%;
3. Department of Public Works and Highways (DPWH) – 23.5%;
4. Department of Environment and Natural Resources (DENR) – 16.4%;
5. Department of Science and Technology (DOST) – 15.8%; and
6. Department of Agriculture (DA) – 11.1%.

 

The Department of Health (DOH) stagnated at its 2009 level while the Department of Education (DepEd) has a measly increase of 0.8%.

The fetish for a smaller fiscal deficit must not be allowed to prevail over the critical necessity of accelerating the momentum of growth.

Prioritizing growth and development becomes more imperative in the wake of the recent tragic calamities which call for rehabilitation and reconstruction, which in effect impede growth because ordinarily there is no 100% restoration of a damaged infrastructure, facility and production.

Verily, it is imperative to allocate or reallocate sufficient funds for the principal indicators of human development like quality education, adequate health care, extensive mass housing, stable food supply, and high level of employment.

The 2009 Human Development Report (HDR) released yesterday by the United Nations Development Program (UNDP) places the Philippines’ human development index (HDI) at a low rank of 105th out of 185 countries, lower than Singapore (23rd), Brunei (30th), Malaysia (66th) and Thailand (87th).

We are lagging behind our commitment to achieve the Millennium Development Goals (MDGs), particularly on eradication of extreme hunger and poverty, achievement of universal primary education, reduction of infant mortality and improvement of maternal health.

Although the superior and advanced economies are the principal culprits in the problem of climate change, it is developing nations like the Philippines which bear the brunt of this global phenomenon as attested to by the recent typhoons and floods. Consequently, we must fund adequately through our own efforts climate change mitigation and adaptation in order to protect our people, particularly the marginalized and disadvantaged.

We have also to revisit the cuts on capital outlay and make restorations in order not to stifle a principal engine of growth.

The opportunity to maximize growth in human capital and infrastructure once lost may be irremediable, while a relatively higher fiscal deficit is reversible through improved tax collection efficiency, rational selective borrowings and purging unproductive and insensitive expenditures.

Due to the foregoing overriding reasons, Mr. Speaker and distinguished colleagues, your Committee on Appropriations is disposed to recast the NEP with your support and concurrence.

Together, let us exercise fully and judiciously the constitutional power of Congress, particularly of the House of Representatives, to appropriate public funds.

In upholding the legislative primacy in appropriating the people’s money, the Supreme Court in Philippine Constitution Association vs. Enriquez (235 SCRA 506), unequivocally pronounced:

“Under the Constitution, the spending power called by James Madison as the power of the purse, belongs to Congress, subject only to the veto power of the President. The President may propose the budget, but still the final say in the matter of appropriations is lodged in the
Congress.

“The power of appropriation carries with it the power to specify the project or activity to be funded under the appropriation law. It can be as detailed and as broad as Congress wants it to be.

“x x x                x x x                x x x

“It is also a recognition that individual members of Congress, far more than the President and their congressional colleagues are more likely to be knowledgeable about the needs of their respective constituents and the priority to be given each project.”

 

Nobody would disagree that the National Expenditure Program or the President’s annual budget proposal is not sacrosanct. The Congress, more specifically this August Chamber, can subject the proposed allocations in the NEP to realignment, modification, reduction and/or augmentation within the budgetary ceiling proposed by the President.

These revisions which the House of Representatives may effect on the NEP are in the exercise of what is traditionally known as the “Power of the Purse”.

Unfortunately, however, once the enrolled General Appropriations Bill is submitted to the President, Congress virtually loses its control over the annual budget. The congressional power of the purse dies with the drying of the Presidential ink which seals the approval of the General Appropriations Act.

The Presidential authority to release funds or “the power to disburse” becomes more ascendant than the legislative power of the purse.

All the revisions made by Congress not in align with the NEP are lumped together as congressional initiatives whose releases are subject to Presidential approval or impoundment.

Once impounded as “forced savings” these congressional initiative allocations may never see the light of day or the impounded amounts constitute an off-budget new lump sum which can be used by the Executive to fund projects which may not even find anchorage in the General Appropriations Act.

There are educated estimates that the amount of impounded funds since 2008 alone total to P140 billion.

The impounded congressional initiatives appear to be lost in perpetuity so much so that many of our colleagues call them “Mona Lisa” allocations because they just lie there and they die there.

Perforce, the derogation by the Executive of the congressional power to appropriate must end. This is a constitutional aberration which must not be allowed to perpetuate.

Accordingly, we must provide in the General Appropriations Bill a comprehensive prohibition barring the impoundment of congressional allocations not found in NEP or which modify, alter, realign, or revise items in the NEP.

When the Honorable Budget Secretary Rolando Andaya, Jr. was Chairman of the Committee on Appropriations in 2003, 2005 and 2007, he initiated the inclusion of a “Prohibition Against Impoundment of Appropriations” under the General Provisions of the GAA. Unfortunately, this bar was never realized because its effectivity was subject to the rules and guidelines to be issued by DBM, which were never formulated and issued. The same enfeebled proviso appeared in the 2008 and 2009 GAA.

As a result of the sharp clashes between Congress and the White House over President Nixon’s aggressive impoundment of appropriated monies, the US Congress passed the Congressional Budget and Impoundment Control Act of 1974. The major objective of this Act was to reassert the congressional role in budgeting and to constrain the use of impoundments.

This Act divided “impoundments into two distinct classes with different procedures for congressional consideration: rescissions or permanent cancellations of budgetary authority which would require congressional approval, and temporary deferrals of expenditures which would remain in force unless rejected by Congress.” In either case, the final authority is Congress.

We anticipate this anti-impoundment provision to be vetoed but we expect members of Congress to summon strong political will to override the veto.

Let this be not just wishful thinking.

Let us set the proper stage for a constitutionally correct and respectful Legislative-Executive relationship on the annual budget, albeit belatedly, for the remaining few months of the present administration, but well in advance for the next President, whoever he may be.

Let me hasten to appeal that we have to pass the General Appropriations Bill, as amended at the proper time, in order to foreclose the eventuality of the 2009 General Appropriations Act being reenacted.

A reenacted budget is a self-derogation of the power of Congress to appropriate due to its own default. We must prevent this from happening.

Moreover, a reenacted budget unduly favors the Executive because it is given a spending authority with the widest latitude that Congress could not adequately monitor.

Accordingly, it is earnestly recommended that we pass on time the General Appropriations Bill with the requisite and vital amendments.

Thank you, Mr. Speaker and distinguished colleagues.