By: Atty. Gregorio B. Austral, CPA
Health is not spare change
The Supreme Court’s ruling in Pimentel III v. Matula is a reminder that the right to health is not a decorative clause tucked into the Constitution. It is a lived right, one that determines whether families survive illness with dignity or collapse under the weight of medical debt. The Court opened its decision with a stark truth: in a country where 42.7% of healthcare spending comes directly from the pockets of Filipino families, “wealth is health” is not a proverb—it is a warning. And when Congress authorized the transfer of PhilHealth’s PHP89.9 billion fund balance to the National Treasury, that warning became a constitutional crisis.
The Court did not mince words. It recognized the human cost behind the numbers: the father who lost his leg, the family drowning in a PHP400,000 hospital bill, the impossible choice between medication and food. These stories are not anecdotes. They are evidence. They show the chasm between the constitutional promise of the right to health and the lived reality of Filipinos who ration medicine because the system rations compassion. When government treats health funds as a convenient source of fiscal padding, it is not merely reallocating money—it is reallocating suffering.
At the heart of the case was a simple but powerful principle: funds earmarked for universal health care are not loose coins that Congress may sweep into the Treasury. They are held in trust for the people. The Universal Health Care Act and the Sin Tax Laws were crafted precisely to ensure stable, predictable financing for PhilHealth. Diverting these funds through a last-minute budget rider was not only a violation of statutory earmarking—it was a direct assault on the constitutional right to health. The Court called out this maneuver for what it was: an unconstitutional shortcut that undermined both the law and the people it was meant to protect.
The decision also exposed a deeper truth: the right to health is enabling. It is the right that makes all other rights possible. Without health, the right to work is hollow, the right to education is unreachable, and the right to life becomes a technicality. The Court described the right to health as “primus inter pares”—first among equals—because it sustains the very capacity of citizens to participate in society. When PhilHealth’s reserves are siphoned off, it is not bureaucracy that suffers. It is the diabetic worker, the senior citizen, the child whose parents must choose between antibiotics and rent.
What the Court restored was not merely PHP89.9 billion. It restored coherence to the legal framework that funds universal health care. It reaffirmed that Congress cannot amend substantive law through a budget provision. It reminded the Executive that circulars cannot override statutory earmarks. And it reasserted that constitutional rights cannot be subordinated to fiscal improvisation. In short, the Court drew a line: health funds are not spare change. They are the backbone of a system meant to keep people alive.
In a country where illness remains one of the fastest routes to poverty, this ruling is more than a legal victory. It is a moral correction. It tells government that the right to health is immediate, intimate, and non-negotiable. And it tells the public that the Constitution still has teeth—especially when the stakes are measured not in pesos, but in lives. (Reference: Pimentel III, et al. v. Matula, et al., G.R. Nos. 274778, 275405, 276233, December 3, 2025.)