Another Funny Thing Filipino Women Need to Know About Their Clever SSS

FILIPINO women living or working in Makati need not know anything more about either how rude that medical-benefit-claim-form lady assessor/clerk at the Social Security System Makati Office is or particularly how she impatiently treats everyone who approaches her desk like the teacher’s most-dreaded stupid pupil come again to ask another stupid question, bless her cursed soul. Should you have the misfortune of needing to claim a medical benefit, your day is sure to get ruined seeing her and her ways, to be saved only by the niceness of the SSS doctor over at desk 2. Oh, no need to tell this, really, because, after all, 99% of us already have ample understanding of how deep the shortage is in government service of people with people skills.

     In fact, just a few days ago, I was at the National Statistics Office at East Avenue in Quezon City to witness a security guard, not a regular staff but a security guard, directing the citizens falling in line in the hall with instructions coursed through a megaphone that went like, “Ano ba naman kayo? Ang nandito sa pila na ‘to ay yung buntis na, hindi yung magpapabuntis pa lang. Yung wala pang form, dun muna ninyo gawin sa kabilang pila, ha. Magpabuntis muna kayo roon!” Witty with a drunkard’s metaphors and humor, eh? But decidedly inappropriate humor in a government service institution, my sir, wouldn’t you agree?
     A rarity, perhaps, then, would be an NSO records supervisor named Beth Galicad who called a peer on the phone to say, “meron tayong client dito na si Mr. …” Wow. While the unworthy security guard looked upon his fellow citizens falling in line outside as the unintelligent mass burden of our republic (not as the very taxpayers paying his salary), Ms. Galicad regarded me, an ordinary citizen with a lost record, as a “client.” How cool is that?

NOPE. This is not to enumerate further shortcomings and personnel shortchanges in government service institutions, for—like I said—I’m sure everyone has his own long list and book of anecdotes that regularly tell us to feel sorry about our wages’ tax deductions every fifteen days, never mind feeling sorry for our country continually being governed by the political elite un-eager to rid us of our feudal culture composed of lordly landlords on this side and ordinary citizens in beggary being lorded over by the landlords’ servants (civil servants, mostly) on that side.
     Instead, this essay is really just seeking to follow up on my wife’s wish for ample information on something that perhaps my blog site could accommodate, which I did promptly offer, information specifically addressed to other Filipino women who might benefit from the knowledge about that medical benefit called “disability”; not so we can sour-grape on her disqualification with her claim, but so we can spread the very knowledge, believe me or not, the knowledge—by the way—the SSS says certainly cannot be on their website as “not everything is there” and “we really don’t put everything there.” [Well, yes, of course, the appropriate answer might perhaps be “we will inform our website managers to put that detail online,” but, c’mon, appropriateness, people—as we probably all know by now—, is not a priority in government service. Well, perhaps not until we get rid of an elite-leaning culture that might then veer away from looking at service institutions as just some people’s milking cows, moving on towards looking at them as truly service institutions. After all, whatever happened to the Marxist influence on the social security concept? Aha! The answer to that question might be obvious to some of us who see everything happening in government as an illness needing a cure, or a corrupt file needing a fix, though often accepted as a sorry state by most who’ve given up on the possibility of seeing any fix. No appropriate line to be expected by the ears, then, no worthy assessor on that many a clerk’s desk, no appropriate answers to very specific questions, except for a rarity that one may be lucky to meet in his lifetime under any Philippine government’s color-coded sun.]

THE simple information my wife really just wanted added to the SSS website was this: … well, okay, maybe I ought to offer a backgrounder first.
     You see, my wife just had a TAH-BSO, or Total Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy. And, in case you don’t know yet, a TAH-BSO qualifies an SSS member to a disability benefit. Many a woman member has, in fact, received an SSS disability pension even from a simple hysterectomy.
     The inclusion of these operations as disabilities in the SSS’ new disability benefits program is culled from the World Health Organization’s expanded definition of disability, viz., as any “restriction or lack (resulting from impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.” According to the SSS, impairment has been further defined by the WHO as any loss or abnormality of psychological, physiological, or anatomical structure or function. Take note of that!
     The aim of the new disability benefits program, says the SSS, is purportedly “to ensure that the right cash benefit for disability is paid to truly deserving members.” And who would be those truly deserving? Supposedly, it adopts the International Statistical Classifications of Diseases and Related Health problems Codes (ICD-10) [check out that list here: http://apps.who.int/classifications/icd10/browse/2010/en].
     The SSS further says that the member with 20% medical impairment is already qualified for functional assessment. Some of the permanent partial disabilities include loss of one thumb, or one index finger, or one middle finger, or one ring finger, or one little finger, or one big toe, among a number more in the list. Meanwhile, apart from complete loss of sight of both eyes and such similarly permanent total disabilities, some cases may actually be classified as belonging to this latter category by the determination and approval of the SSS. Well, those determinations may remain privy to no one other than those who make them, as the SSS does not—cannot—prefer not to?—put everything on its website.

           

AND so now we go back to the TAH-BSO, or the simple hysterectomy, for that matter, both of which, by the way, cannot be categorized with losing a pinky, for all intents and purposes.

     What, according to the SSS, would disqualify one from claiming medical benefits after undergoing one of these above operations?
     Well, guess what. Age, that’s what! The SSS has determined, by some law I have yet to see, that only members 44 years old and below can avail of the benefit by one of those –tomies. [We did not ask if one can claim a disability benefit from losing a pinky at age 46]. The SSS law I have yet to see supposedly has this rationale or interpretation of the WHO expanded definition: we at the SSS believe, or that law you have yet to read believes, that the WHO’s definition is implying the fact that women who have undergone one of those above –tomies cannot anymore bear children. By that inability, the inability to bear children, we have accepted the inclusion of these –tomies as resulting in a disability. The age limitation was arrived at allegedly after talking to a majority of OB-Gyns regarding the average birthing age of women. [I didn’t ask if the SSS ever asked surgeons about the average age of typists who cannot afford to lose their pinky—can they still lose it at age 46 and claim benefits?] Never mind, too, that the SSS might accept the fact that there have been a number of women in their 50s who have had their menopause delayed and had babies at that age period, but the law is the law, the SSS says, talking like a lawyer instead of a medical-benefits provider, except for the fact that it couldn’t give us the Republic Act number of that law we have yet to see.
     Never mind, likewise, the fact that many doctors who advise a hysterectomy procedure with additional ovarian removal ask for the patient’s approval first, and once the approval is gained often advise the patient in turn to keep one of the ovaries if “possible”. True, some doctors, especially oncologists looking at a patient with a family history of oncologic cases, may advise a drastic TAH-BSO as an option for a mere case of adenomyosis, as for instance if the patient does not have the financial capacity to get a later oophorectomy should that be needed in the future.
     The reason for this is really simple, which simplicity may have escaped the SSS and some legislators. (But not so simple if you’d be seeking an opinion on ovary function from the SSS doctor based in SSS Meycauyan, which opinion would really be hard to come by, the doctor being hard to catch—the SSS Meycauayan assessor agrees that one simply has to get a continuing leave of absence from one’s work to gamble on catching the doctor at his/her SSS Meycauayan room. Simpler, it would have been, if the first clerk already had knowledge of the fact that you can actually “file anywhere”; complex it is for members to fall in line with others seeking a conference with the branch manager just to get that simple information.)
     The simple reason why many doctors try not to remove both ovaries, as much as “possible,” is because the ovary is not just for producing eggs. In fact, the loss of both ovaries renders a woman at high risk of getting any one of the cardiovascular diseases as well as bone diseases. And while the ovaries are not the sole sources of estrogen, they are the prime sources of it, and you might have an idea of what may happen to a woman when her supply of estrogen is drastically diminished, albeit loss of ovaries does not have a uniform effect on all women. If you were a doctor not constrained by (subjective? interpretative?) SSS rulings, you would definitely know that the loss of both ovaries is already a great “restriction or lack (resulting from impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.” Likewise, that it is already “loss or abnormality of psychological, physiological, or anatomical structure or function.” Go ahead and google it. Better yet, get more information about ovary function from your OB-Gyn, beyond just asking about the average age of women birthing. Conversely, don’t try to get more information on it from an SSS doctor constrained by a simple-headed law that I have yet to see.

     Oh, by the way, we ought to thank that oft-referenced law for supposedly enabling the WHO’s expanded definition of disability for SSS’ use, although I’d have to laugh that that same law virtually put limitations (almost as a sort of counter-measure) on the WHO expansion. Isn’t it funny? An expansion tries to expand, and its enabler tries to limit it. Isn’t it funny? Or should I say, aren’t we a clever people?
     After all, I found out at waiting areas that it’s not just me who’s been wondering why the SSS has placed all its friendly faces in Payment and some of its rude ones at Claims. So much for that Marxist influence on the social security concept. [X]