MANILA, Philippines — Jorge “Jojy” Azurin, a 56-year-old health technology entrepreneur and father of five, considers himself lucky despite the grueling 18 days he was confined at The Medical City (TMC) battling the new coronavirus disease (COVID-19).

By his own computations, the businessman said his recovery from the severe respiratory ailment at the hospital in Pasig City from late March to early April had cost “between P1.2 million and P1.5 million.”

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Thirty percent of his expenses went to medicines and 25 percent to his accommodation, including eight days in the emergency room, five days at the intensive care unit (ICU) and five days in a private room, Azurin said in a phone interview on Tuesday.

Another 15 percent went to nursing services and medical supplies, 10 percent for professional fees of the medical staff and the rest for other expenses, including charges from the hospital’s cardiac center and pulmonary diagnostic center.

P70,000-P80,000 per day

On average, his confinement had cost P70,000 to P80,000 per day, Azurin said.

“I could just imagine the hospital bills of the others who are still there, around 25 patients. I remain hopeful that my survival would also be their story,” he said. “This is now my second life.”

Azurin, president and CEO of MediXserve.com, said he was still recuperating in isolation at home and had lost a lot of weight. Sometimes he steps out in the garden, “just to listen to the children’s voices, feel the grass beneath my feet and enjoy the breeze,” he said.

That feeling is a far and thankful cry from those days in the hospital, when aside from his agony, Azurin was worrying about the mounting bills. Although he had personal health insurance, the coverage was usually just over P100,000 and would be used up in just two days, he said.

“We had to put a hefty down payment (to TMC). My eldest son said not to worry about it, and we’ll take care of the problem of expenses later,” Azurin said.

PhilHealth coverage

And as fate would have it, he was one of the “fortunate” COVID-19 patients whose total hospital expenses were still shouldered by the state-run Philippine Health Insurance Corp. (PhilHealth) before it set limits to the amounts it would pay after April 14.

Days after he was discharged on April 5, PhilHealth announced it would no longer pay the full cost of treatment of COVID-19 cases beginning April 15.

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Invoking the need to remain sustainable, the state health insurance company said it would implement a “new case rate benefit package” to subsidize COVID-19 cases, depending on the severity of the illness.

PhilHealth president and CEO Ricardo Morales announced the four new categories on April 8: P43,997 for “mild” pneumonia; P143,267 for “moderate” pneumonia; P333,519 for “severe” pneumonia; and P786,384 for “critical” pneumonia.

In his case, Azurin said he would have been under the severe pneumonia package.

Trips without mask

In a social media post, Azurin said it was possible he acquired the virus during several domestic trips he made without a protective mask about two weeks before Luzon was placed under lockdown. He began feeling “chills and fatigue” on March 5.

While it was still unclear whether he was positive for SARS-CoV-2, the virus that causes COVID-19, Azurin said his family took a “proactive” stance and brought him to Quirino Medical Center in Quezon City. He was turned down for admission because he was asymptomatic and did not travel abroad.

On March 16, Azurin went to TMC’s satellite office in Cainta, Rizal province, where his chest X-ray and blood samples were taken.

A representative from the Department of Health arrived at his doorstep two days later to take a swab sample as his results at the satellite office showed he already had pneumonia. By that time, he was already breathing hard and coughing heavily.

Azurin said the family took him to TMC in Pasig on March 19. “We didn’t want to wait until I got worse. It was a good decision on our part,” he said.

Hospital emergency room

But TMC’s ICU was already full of patients then. His eldest son inquired from 21 other hospitals for any vacancy. Finding none, Azurin decided to stay at the TMC emergency room (ER).

“I spent eight days there, but (the medical staff) cannot treat me, only to intubate. Their job only was to keep me alive until a slot at the ICU becomes available,” he recalled.

Azurin said he never had a good night’s sleep at the ER. Within his small space, he endured three to four tubes in his mouth and two more in his nostrils.

“I was fed with Ensure milk through the nose. Sometimes I would gag on my own phlegm and saliva. They would pump me with a foul-smelling liquid so I would throw up all saliva and phlegm so these would not collect inside my lungs,” he said.

“It was a struggle to breathe. Life at the ER was a horrible experience. Your body is not well, sometimes you are in pain. I could feel the tubes stuck into me,” he added.

Surprised doctors

Azurin said doctors noted that his condition was improving while still at the ER.

“They were surprised. By the time I was transferred to the ICU, I responded positively to the medicines. On my third day in the ICU, they removed my tubes,” he said.

By the fourth day, he said he was breathing normally and was wheeled out of the ICU the next day.

“It astounded everyone. They said I was the only one wheeled out alive,” he said.

Azurin said the ICU staff greeted him “Happy birthday!” when he transferred to a regular private room. He was also surprised to learn that his bill for accommodation in the ICU was much smaller than in the ER—P6,000 to P7,000 a day.

“I was charged more than P20,000 a day, I think, at the ER and it was just a small space covered by a curtain,” he said.

Azurin said his eldest child later explained that his stay at the ICU was still costly as his medicines amounted to over P300,000, aside from expenses for the use of a ventilator and laboratory works, and nursing services.

When he left the ICU, PhilHealth declared that it would pay all the expenses of COVID-19 patients.

“That saved the day for us,” he said.

Expense caps opposed

When he was discharged, his family gave a promissory note to the hospital although they knew that PhilHealth would pay for all his expenses.

One legislator, however, wants to ensure that PhilHealth does pay for all COVID-19 cases and without any cap.

On Wednesday, Cagayan de Oro Rep. Rufus Rodriguez urged President Duterte to reverse PhilHealth’s decision to set limits to its COVID-19 payments.

“It is the poor who will suffer from that decision, and I am sure the President will not allow that,” he said.

Rodriguez made the statement in reaction to news reports that an unnamed private hospital in Metro Manila billed a “moderate case” for P1.1 million for an 18-day confinement and treatment.

“Patients who are poor and even those belonging to the middle class certainly cannot afford P61,000 or even much less than that a day. The government, through PhilHealth, has to help them by shouldering the full cost of treatment,” Rodriguez said.

Azurin felt confident that his family’s “huge down payment” to TMC would be refunded by the hospital.

He said he felt sad imagining the huge bills awaiting other patients.

Looking at his “second life” makes him muse about what may be in store in his future.

“When I reflect, I think maybe it would be revealed to me in the coming days why I am still here,” Azurin said.

“I’m happy to be alive, to see my family. I also feel bittersweet for the others who did not make it. I can just imagine the sorrow of those families. There is just this gratitude that I am alive,” he said. —WITH A REPORT FROM MELVIN GASCON

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