Nearly half of the Filipino population belongs to the middle class, making them a significant driver of economic growth.

The middle class typically has disposable income, which contributes significantly to consumer spending and fuels demand for goods and services. This, in turn, encourages businesses to expand, thereby creating jobs and fostering overall economic development.

Middle-class Filipinos are vital to government revenue through taxes. This tax base helps finance government programs such as infrastructure, health care, social welfare and education.

That is why I welcome Executive Secretary Ralph Recto’s proposal to include the middle class in the Zero Balance Billing (ZBB) policy during recent discussions surrounding the health sector under the Marcos administration.

Under the ZBB policy, all patients in basic ward accommodations will no longer face out-of-pocket expenses. It is a commendable initiative that promises to bring some relief to the people.

On the other hand, the “No Balance Billing (NBB)” policy of the Philippine Health Insurance Corporation (PhilHealth) excludes those who are not categorized as indigent or economically disadvantaged, leaving out a substantial portion of the population that does not qualify but also struggles to pay medical bills.

The coverage gap between the Department of Health’s ZBB and PhilHealth’s “No Balance Billing” (NBB) shows the pressing need to redefine eligibility criteria and expand inclusivity to ensure that all socioeconomic strata receive adequate healthcare support.

Middle-class Filipinos are not exactly wealthy. They are part of the working class, engaged in various jobs. They either work for others or are self-employed.

Middle-class income goes to housing, their children’s education, food, utility bills, and other necessities, leaving little to nothing for savings. Their growing financial vulnerability should not be overlooked.

I have seen countless middle-class families reduced to tears or heavily in debt to credit card companies whenever they fall short of cash or savings to pay hospital expenses. Like indigents, they also line up for medical or hospitalization subsidies to obtain a guarantee letter from legislators, the DoH, the Department of Social Welfare and Development, the Philippine Charity Sweepstakes Office and the Philippine Gaming Corporation.

As Recto aptly puts it, middle-class Filipinos can indeed find themselves “just one hospitalization away from financial ruin.” The burden of medical expenses can push many families into bankruptcy as healthcare costs continue to rise.

Healthcare should be affordable and should not impose excessive financial strain on individuals. The healthcare system should prioritize people’s well-being and medical care without fear of overwhelming costs.

Achieving a sustainable and equitable healthcare landscape requires comprehensive collaboration among various stakeholders, including government entities, healthcare providers, and families.

By working together, these groups can address disparities, promote preventive care, and develop solutions that meet the diverse needs of communities, creating a more inclusive and effective healthcare system for everyone.

It is high time our healthcare providers shift their mindset to view medical care not just as a service, but as a right for every Filipino, regardless of financial standing.

Yes, please include the middle class in the ZBB. As President Ferdinand Marcos Jr. himself said, no one should be left behind in the pursuit of a healthy life.