Cayetano bloc returns to Senate session hall with irate Pia

MANILA, Philippines —The minority bloc returned to the Senate floor on Wednesday afternoon, June 17, with Sen. Pia Cayetano visibly irate as she pelted Sen. Risa Hontiveros with terse questions over two health-related bills. 

The afternoon turnout of the Cayetano-led group came hours after Sen. Sherwin Gatchalian was elected Senate president, replacing Sen. Alan Peter Cayetano — Pia Cayetano's brother — in a morning vote the bloc skipped. 

Sen. Joel Villanueva, a Cayetano ally, had crossed to the new majority to provide the 13th and decisive vote.

Minority members Sens. Pia Cayetano, Loren Legarda, Imee Marcos and Camille Villar attended the 3 p.m. resumption of the special session.  

Before this, Sens. Rodante Marcoleta and Imee Marcos had appeared at the Commission on Appointments hearing during the Senate's midday suspension, with Marcoleta seen mingling with members of the new majority.  

Asked to comment on the leadership change before the plenary session, Sen. Pia Cayetano told reporters: "There are thirteen, right? Common sense, right? What's in the rules? What's in the Constitution? When you have 13, that's it."

"If you don't follow the rules, that's where we have a problem. But if you follow the constitution and rules, no problem. That's just how it is," Cayetano said in mixed English and Filipino.

Members of the minority told reporters during session that they've accepted the new Senate leader as the Gatchalian group had already clinched the 13 needed to elect him.

Pia's amendments  

Cayetano's first floor exchange of the afternoon was over Senate Bill 1905 or the Magna Carta of Barangay Health Workers, a Hontiveros-sponsored bill approved on second reading in the morning, a session which she and other minority members snubbed.

Cayetano told the plenary that Hontiveros had closed the period of amendments in the morning "despite our name being there" on the list of senators set to propound amendments.

"Earlier this morning, her honor put on record that no amendments were submitted. None may have been submitted, but our name is on the list to propose amendments," Cayetano said.

Hontiveros said she had announced more than once during the morning session that no senator had submitted amendments before she moved to close the period, and that she had given way as soon as Zubiri raised the issue on Cayetano's behalf.

"By all means, I gave way to the reconsideration," she said.

Cayetano went on to introduce an amendment requiring the Department of Health to ensure that all registered barangay health workers have access to psychosocial support and mental health services.

Hontiveros accepted the amendment, and the bill was approved on second reading subject to style.

'Disaster' bill on hospital detentions? 

The sharper exchange took place in the deliberations of Senate Bill 1511, which amends Republic Act No. 9439, the 2007 law prohibiting hospitals from detaining patients over unpaid bills.

Cayetano authored the original law as then-chair of the Senate health committee. Hontiveros is sponsor of the amendments.

Cayetano said she supported the bill but pressed Hontiveros on a provision exempting indigent patients endorsed by hospital social services to the Department of Social Welfare and Development from executing a promissory note. Her central question was on which entity would pay the private hospitals.

"Magkano ang impact nito sa ating private hospitals na wala nang promissory note?" Cayetano asked, citing 864 private hospitals nationwide.

Hontiveros said the bill provided five mechanisms to secure the promissory note — a mortgage, a co-maker's guarantee, a deed of assignment from the SSS or GSIS, a guarantee letter from the Philippine Charity Sweepstakes Office, or one from the DSWD or Department of Health. For indigent patients, she said, government institutions would in effect step in to back the note.

Cayetano became irate, telling Hontiveros the alternatives she was describing were not specified in the bill. The bill removed the promissory note for indigents, she said, meaning the five guarantee mechanisms had nothing to attach to.

"Should we suspend? Because what her honor is saying is not written in the bill," Cayetano said. "Kindly read it. Kindly read it. Kindly read it into the record then."

Hontiveros conceded the wording could be clarified, offering to replace "promissory note" with "guarantee note" throughout.

Cayetano then pressed on whether the proposal had been taken up at committee hearings. Hontiveros said it had not been specifically discussed; only an earlier draft applying to senior indigent patients had been taken up.

"Hindi niyo nga na-take up iyan, pero ang impact nito napakalaki sa private hospitals. Wala silang chance na marinig ang side nila kasi hindi iyan na-take up during the hearing," Cayetano said.

Hontiveros countered that private hospitals had been invited to the hearings and had no opposition to changing the promissory note system in general, but acknowledged the broader provision on "no promissory note for all indigent [patients]" not been specifically discussed.

Cayetano warned the bill could be a "disaster" for small private hospitals.

"Otherwise, this is a disaster because ang mangyayari, pipila lang sila sa Malacañang, magmamakaawa sila na huwag ipasa 'to," Cayetano said.

Hontiveros pushed back against the use of the word: "Definitely this is not going to turn out to be a disaster. The whole point of the bill ... is to amend and update the original law."

Cayetano doubled down on her point, citing the small private hospitals that closed during the pandemic when PhilHealth reimbursements lagged.

"The only reason I use the word disaster ... is because time and again, the small private hospitals have practically bent — kneel down in front of us, begging us for support," she said. "Kung disaster 'yun para sa kanila, disaster 'yun sa healthcare system natin because we are partners."

Senate President Sherwin Gatchalian intervened to suggest tweaking the bill's language: government would assume payment for indigents through the DSWD, while non-indigents would still execute a promissory note backed by the five guarantees.

Hontiveros said she welcomed the suggestion but flagged that even middle-class non-indigent patients could sometimes be unable to pay.