An Act Establishing a Dialysis Center for BARMM in Cotabato Sanitarium and General Hospital, Pinaring Sultan Kudarat and Appropriating Funds Thereof

This establishes 1 dialysis centre, at the Cotabato Sanitarium and General Hospital in Pinaring, Sultan Kudarat, and it is the only 1 of the 3 dialysis bills that says how it will be paid for.

Section 10 appropriates ₱20,000,000 for the facilities, equipment, machines and supplies needed to open. The hospital provides the building and the space and hires or designates the physicians, nurses and administrative staff, charged against its own budget. All purchased equipment is owned and maintained by the hospital, with deeds of transfer executed as needed.

The pricing rule is the distinctive provision. Section 7 caps the service fee at no more than 110% of the supplier's cost per treatment, and charges nothing at all to indigent patients. Section 8 then lets the collections accrue to the centre's own income, to be used primarily for its operation — so the 10% margin above supplier cost is what funds the centre's running expenses.

Section 9 adds bridging support: the Ministry of Health, through its Ayudang Medikal mula sa Bangsamoro Government programme, allocates funds to augment the centre's expenses during its first year.

A Joint Technical Working Group of the health ministry and the hospital writes the implementing rules, covering hiring, procurement, construction under the national Department of Health's administrative orders, and the centre's licensing and regulation.

The explanatory note gives a figure rather than a principle. Renal disease is among the major causes of disease-related death in the country, and at Cotabato Sanitarium and General Hospital alone there were 162 patients in 2022 needing dialysis.

That is the argument: a specific hospital, a counted caseload, and a facility sized to it. The bill does not claim to solve the region's kidney disease problem; it claims that 162 patients at 1 hospital justify a centre there.

The 110% cap is the most interesting mechanism in any of the 3 dialysis bills, and it is doing 2 jobs at once. It protects the patient — a session cannot be priced at more than a tenth above what the consumables actually cost, which forecloses the margins that make private dialysis unaffordable. And because Section 8 lets the collections stay with the centre, that same 10% is the centre's operating budget. It is a self-financing design, and its weakness is visible on the face of it: 10% of consumable cost will not cover staff, maintenance and machine replacement, which is presumably why the hospital carries the salaries and the health ministry has to bridge year one.

The bill's real virtue is that it is the only 1 of the 3 that is costed and therefore buildable. Bill No. 88 requires a unit in every government hospital in the region and funds it from "current appropriations"; Bill No. 279 requires one in every provincial tertiary hospital within a year and does the same. This bill names ₱20 million, names the hospital, names who owns the equipment afterwards and names the programme that covers the first year. A single facility that opens is worth more to a patient than a regional mandate that does not.

The counted caseload is the other thing to credit. "162 patients for the year 2022" at a named hospital is the kind of number almost no bill in this registry supplies, and it makes the measure checkable — a reader can ask whether a centre sized for 162 patients is enough, which is a question the other 2 bills give no way of asking.

What the bill does not address is everyone outside Sultan Kudarat. A dialysis patient needs treatment 2 or 3 times a week for life, so a centre serves only the people who can reach it that often. For Basilan, Sulu and Tawi-Tawi, a facility at Pinaring is not a service, and the island provinces are exactly where Bill 88's regionwide mandate was aimed.

Three bills in this registry address dialysis and they pick 3 different scales. Bill No. 88, filed by MP Mawallil in October 2022, requires a dialysis unit in every government hospital in the region within 5 years. Bill No. 145, filed by MP Sema in February 2023, builds 1 centre at 1 named hospital with ₱20 million behind it. Bill No. 279, filed by MP Dilangalen in February 2024, requires provincial tertiary hospitals to have a unit within 1 year. All 3 are at Second Reading, Committee Stage, and none has become law.