By: Atty. Gregorio B. Austral, CPA
The price of staying alive
Consider a story recently aired on national television: A father — working-class and devoted — suffered a stroke worsened by diabetes. His leg was amputated. The hospital bill reached PHP400,000. Even after discounts, his family was short by PHP65,000. They borrowed money to pay, and debt began its cruel descent. But the costs did not end at discharge. Medications, therapy, and home adjustments followed. Unable to cope, they rationed his prescriptions. Not out of neglect, but necessity. Their budget left no other option (Serquiña, GMA News Online, 2025). This is not an isolated tragedy. It echoes across thousands of Filipino households — unheard, unseen, but no less real. It forces us to confront a chilling contradiction: What good is a constitutionally guaranteed right to life when the right to health remains financially unreachable?
This contradiction sits at the heart of Pimentel III v. Matula. The petitions warn that diverting PhilHealth’s reserve funds “threatens the implementation of the Universal Health Care Act” and undermines the people’s “right to health.” These are not abstract claims. They are constitutional alarms triggered by the lived reality of families like the one on television — families who do not need legal theory, only treatment they can afford. When the Court insists on an “actual case or controversy,” it is acknowledging that the stakes are painfully real.
The government’s defense leans on another constitutional phrase: the President’s certification of the budget as “urgent.” But urgency, in constitutional terms, is not a political preference. It must rest on necessity — a safeguard meant to prevent shortcuts in lawmaking. Petitioners argue that no such emergency existed, that the certification lacked a “legitimate basis.” The irony is sharp: urgency was invoked for the budget, but not for the sick. The father on television faced a true emergency — one that demanded immediate action — yet the system offered him only debt, rationed medicine, and the slow erosion of dignity.
The Court’s November 2024 resolution underscores the seriousness of the constitutional questions. It required all parties to answer a uniform set of inquiries to clarify “overarching concepts and principles of social health insurance.” This is not procedural housekeeping. It is the judiciary demanding coherence and constitutional fidelity in a matter that touches the lives of millions. When PhilHealth’s “excess reserve funds” become a fiscal convenience rather than a health guarantee, the Court is right to ask whether the State has forgotten the purpose of those funds: to keep people alive.
Health is not a sectoral concern. It is the infrastructure of human dignity. It is the right that enables all other rights — the right that allows a citizen to work, learn, vote, protest, parent, and survive. When the State underfunds health, it does not merely fail a policy goal; it weakens the Republic’s moral foundation. The father on television is not a statistic. He is the human face of a constitutional promise strained to breaking point.
The price of staying alive should never be a private burden. It should be a public commitment. Pimentel III v. Matula is more than a legal dispute; it is a national reckoning. It forces us to confront the widening gap between constitutional promise and lived reality — between the right to life and the cost of survival. Whether the Court ultimately strikes down the questioned provisions or not, its language already delivers a message the Republic must hear: the right to health is not optional, expendable, or deferrable. It is the price of a just society. (Pimentel III v. Matula, G.R. Nos. 274778, 275405 & 276233, (03 December 2025))