At the high school graduation ceremonies last March 18, the guest speaker was Dr. Robert Louis So, recipient of the Xavier-Kuangchi Award for Exemplary Alumni. Some of his remarks have created negative impressions after Mr Ethan Chua, one of the graduates, published a personal reaction online. In the interest of fairness and dialogue, we are publishing (with his permission) the text of Dr. So’s speech and his reaction to Mr Chua.
Dr. Robert Louis So's Speech - 2016 High School Graduation
(Show Video on NBB).
What are you guys studying and graduating for? Money? How useful would your money be if you live in a corrupted world?
Thank you for that very gracious introduction. I began by showing a clip we put together in PhilHealth because I believe, years from now, or worse, immediately after this talk, you will not remember much of what I said or will be saying. I am almost 100% sure you will not remember me. But that’s ok. I hope though that you will remember what you saw and how you feel today. Interspersed with your joy in celebrating success, I hope you see that there is a need for you to help our country be a better place, and I hope you feel excited that you will be the one to make it happen or at least be a part of its success.
Board Chair Johnip Cua, School President Fr. Ari Dy, Principal Aimee Apolinario, Assistant Principals, teachers, parents, friends, ladies and gentlemen, Brothers, graduates and fellow alumni, good afternoon. When I received the invite to speak before you today, I was overwhelmed and admittedly quite hesitant. Why me? I am not a tycoon, I do not own my own company, I do not have a nice sports car, I don’t earn as much as the next guy. I am a nobody that was just part of a team that fought for cheaper medicines, better health care delivery, and now universal health care. Then Mr. Alvin Ang convinced me that this day is not about me, but about you. It is not about who I am, but what experiences and stories I have to tell from my life and from my line of work that can deepen the understanding of you graduates on how Xavier has prepared you to face the realities of the world. More importantly, how you can change the world for the better. On my realization thereafter, it seems I will be your last lesson, not your teacher, where learning something is really up to you. So, having all these in mind, I wholeheartedly accepted. And I thank you all for this honor.
I currently work in government. I am a licensed medical doctor, Career Executive Service eligible (topped the exam 1/888), currently vice-president of PhilHealth, and head of Internal Audit reporting to the PhilHealth President and CEO and Board of Directors. Fine. You heard my curriculum vitae (CV) earlier that’s all in there, but it does not of course tell you the story behind these designations and positions. There are many doctors and vice-presidents out there. What sets us apart are the experiences we have, and the stories we tell.
This is my story.
I always wanted to become a doctor, or at least that’s what my dad told me. After having convinced myself that being a doctor isn’t so bad a career, I aspired to be the best kind of doctor there is and in that time I thought that was to become a brain surgeon. Going through 4 years of College and 5 years of Med School working towards that goal, I changed my mind a bit and wanted to be a heart surgeon instead.
The thing is, upon graduating from Med School, we had 3 months to prepare for the Boards while applying for the residency program we wanted to get into. I was top 6 of 150 students in our surgery rotation during our internship so I believed I had a good chance of getting into the surgery residency program in UP. It was to be the fulfilment of a lifelong investment, preparation and toil. But, two weeks prior to the Board Exams, in that fateful August day of 2002, my right eye developed a condition that made it blurry. I was actually initially amused by it. Every other sentence in a paragraph was blurred. I guess I just didn’t know what was happening. Sadly, I did not seek consult thinking it might just be fatigue since like any good Xaverian, I was cramming. It didn’t even occur to me that I may be having a stroke or some life-threatening condition. I eventually completely became blind on my right eye. To make matters worse, it got complicated. I developed high eye pressure called glaucoma intermittently causing redness, eye pains and debilitating headaches. Every now and then, I could not function normally, and even mundane tasks and engaging in sports would be hard because of the headache on fatigue or exertion. For the record, I was happy to make this speech, what gave me the headache was Principal Apolinario’s request to fit 3,000 words in 4 pages double spaced. That was hard.
So imagine the situation where you worked practically your whole life on something, and just when you are about to go another step closer to its eventual and total fulfilment, the door abruptly closes on you unapologetically without warning. I lost my right eye, and with it, a significant degree of depth perception. I was still a bit hopeful and insistent then, even going to the head of the Surgery Program and asking him if they would still consider having me after my ordeal. As the truth and practicality of it all finally sank in, I knew I was just being stubborn for something quite futile. People will not want to be operated on by a half-blind surgeon. I cannot be a heart surgeon anymore.
Despite my blurry eye, I was able to take and fortunately pass my Medical Board examination making me a licensed doctor. During those times, maybe I was in denial, but I took it all and just tried to look for a good job in order to allow me to earn an income and maybe at least pay for some of the medications I needed. I was also being cared for by my sweet girlfriend then despite everything. She’s an ex-girlfriend now. She’s my wife.
My job search eventually lead me to the Department of Health (DOH) where a doctor friend who worked there was about to go to London to take masterals. He endorsed me to replace him as the executive assistant of the Secretary of Health, Secretary Manuel Dayrit.
So in my 7 year stint in DOH, I worked, not really as a doctor. I wrote speeches and talking points for the bosses, coordinated instructions and feedback, headed critical programs assigned to me, among many things. I have mentioned this many times and have come to realize that the skills I use day in and day out were actually the critical thinking and leadership skills I learned in Xavier. I wrote speeches with bold beginnings, mighty middles and exciting endings, I lead people recognizing my strengths and weaknesses through self-awareness and reflection, but best of all, I learned to serve the Filipino people, especially the poor, with compassion, diligence and sacrifice. The Xavier indoctrination of Men-for-others? There were no weekends, and no vacations in those 7 years, and there was even a time when even my measly 15,500 peso a month salary at that time was reduced despite doing more overtime work because there are limits to what government can pay employees. I was angry, so I prayed. My actions were defined by Xavier and I was not conscious about it until later on.
Fellow Xaverians, we are fortunate. As other schools are slowly being equally competitive in different subjects, and with the K to 12 Program trying to catch up with global standards for quality education, Xaverians have always had a competitive advantage. I headed Programs in DOH barely a month into the work, I was asked to lead people half my age, or engage leaders intelligently. With all modesty I think we did a good job. We were a bit more mature, a bit more compassionate, a bit more persistent and determined even when sometimes we were not the tops of our classes. The completeness of our person, not merely our intellect or resources, made us more effective in our work. And you have that. You already have what you need to face this unforgiving world.
During my stint in DOH, I got the privilege to meet various special individuals, among them, Dr. Alfredo Bengzon, a former Secretary of Health himself credited in the establishment of the Medical City and the Ateneo School of Medicine. In one of our encounters, he made a speech that really struck me. He said, and I quote, there are two types of successes. The success of goals and the success of gifts. The Success of goals is when one works hard for the attainment of set goals like aspiring to become a heart surgeon. You work for it, study how to best achieve it. And the success comes when you become a heart surgeon.
But then, he says, there is also the success of gifts. When something unplanned, unanticipated, suddenly, by the grace of God falls on your lap. And you embrace it. You work hard still to do the best job you can on what has been given to you. And the success comes when you achieve the results. He even goes on to say that sometimes, the mere effort to do your best is success enough. There is no room for mediocrity.
I came to reflect after that. Becoming half blind (not totally blind) 2 weeks prior to the Medical Boards, just before applying to become a surgeon, able to study and pass the exam but not pursue heart surgery, getting into DOH at that right time when someone was about to leave and be assigned to look into an important program with nothing but my Medical degree and Xavier education. The timing was flawless. I rationalized, but whatever conclusions I may have reached, it ended the same way, this was God’s gift to me. And I needed to work for my success of gifts.
So as I worked hard, people tend to start seeing me as a bright flame or star in the expanse of a dark government. But this was maybe because of the preconceived notions that government is corrupt and filled with bad evil lazy incompetent people. The media revelations for some government leaders coupled with rumors and bashing help feed this concept. Having someone just do his job, like what I try to do, suddenly makes me seem like a bright star. It sounds good and I do appreciate it, but in truth, there are a lot of bright stars in government. There are dedicated frontliners busy toiling, sacrificing, doing the risky jobs, shunning away temptations and corruption. And when you can get the chance to work with them and get close, you will realize they may even be supernovas, shining so brightly, fighting for what is right.
Some bright stars I had the pleasure of working with include, Secretary Dayrit, a public health person who would go out in the field to make sure every single child is vaccinated against diseases like polio, diphtheria, pertusis and the like. We went door-to-door to make sure no one was missed out. He taught me, if you do your job everyday, you do not need to keep bringing all your notes and data and figures. You will know all this by heart.
I served under Secretary Duque, a health financing person who came up with the idea to have government pay the premiums of the poor so that they can be covered by PhilHealth. In doing so, someone would now be paying for the health services to the poor. He taught me, as a businessman doctor, that integrity and honesty are important. No legitimate business will want to deal with crooks and liars.
I served under Undersecretary and now Philhealth President Alex Padilla, a lawyer with a heart of gold, who taught me, those who have less in life must have more in government and reminded me that we (in government) must have an inherent bias for the poor. Together, we fought for improved breastfeeding rates by regulating advertisements of infant milk formulas (that’s why you do not see that anymore), reduced teenage smoking by implementing the regulatory provisions of the Tobacco Regulations Act (we removed the TV advertisements of cigarettes that fooled you into thinking smoking is cool), and of course, we fought for access to cheaper quality medicines.
These were just a few of the great people in public service I had the privilege of working with and learning from. Their words resonated with me and reminded me of the Ignatian spirit we all wanted to live by. And as I was fortunate to work with these decent and motivated people, life became exciting and meaningful. They too were God’s gifts I believe.
(Show Slide on Price Reductions)
So, these were some of the results of our work: (Xavier taught us how to think, and from this, we innovated some out-of-the-box solutions)
We faced the Goliath giant multinational companies. As you can read, a list of commonly used medicines, some of them some of you may be using, have had their prices slashed by around 50% from 2010 retail prices through mandatory or voluntary price reductions. Medicines against hypertension, asthma, antibiotics and even some anti-cancers therapies. A 5mg Amlodipine for example used to be 45 pesos in 2007 despite being off-patent, now the innovator is 22.85 and from there, generic counterparts of good quality can be bought from 5 pesos to 19 pesos. As much as 9 more tablets can be bought for the same price. It didn’t come easy of course, they didn’t just lie there and accepted what we did. So you could see, although the populace would be happy with the results, there will be companies and interest groups who would be understandably angry. Such is my work. I am not out to please everyone.
Like prophets, we spread the word of generic drugs through establishment of community drugs outlets ran by locals who then spread the word themselves. We established Village drug outlets called Botika ng Barangays nationwide, from 0 outlets in 2002 to 16,000 in 2010 to show people that generic medicines are of good quality, that they can bring relief or cure but are much cheaper than innovator branded ones. We wanted to change behaviour. People kept on hearing back then about generic medicines but didn’t try these out and would not part with their peso for it. People preferred expensive highly marketed branded medicines. With the Village Drug outlets, Generic awareness and use increased from 33% to 55% (SWS survey 2005/6) in the first 2 years of implementation. Most importantly, we showed that people were willing to buy generic medicines and so we believe this contributed to the growth of The Generics Pharmacy and other such similar drug stores today. We were the proof of concept that there is a market for generic drugs, and people, especially in the provinces, improved their access to such medications. Now common medicines like paracetamols can be bought at 50 cents. Amoxicillins/antibiotics at 2-3 pesos per tablet. But government should not run drugstores, so having achieved the aspiration, the government outlets are being scaled down.
We fought against doubting Thomases inside the government and made them believe. Some of our own colleagues were sceptical that we can work with pharmaceutical companies to get desired results. Some people in Philhealth on the other hand believed the social health insurance will run bankrupt if we paid benefits at higher rates. Besides, what use are lower prices if people still do not have enough money to pay?
I have 3 examples to share on this.
First, we negotiated the price reduction of some drugs to allow Philhealth to pay for these under the Catastrophic Z benefits. A renal transplant for example used to be around 2.5 million pesos and a needed medicine is about 140,000 pesos per vial and usually one would need 2 vials for the operation. We were able to ask a pharmaceutical company selling the important anti-rejection medication to reduce their price so we can include it in a PhilHealth benefit package for renal transplant. The concept was that mark-ups were high because not too many people pay or use the medicine. If we have a package in PhilHealth and more people use it, they may be able to reduce their prices in exchange for the volume. So a standard risk transplant patient that used to pay 2.5 Million before can now pay just 0-600,000 pesos for the same quality care. The anti- rejection medicine was reduced by 70% of its price back then. The National Kidney and Transplant Institute used to do only 5 charity transplants per year, now they can do around 60-100.
2nd example
We now also have Z benefits for congenital heart surgeries like those with holes in their hearts and a condition called Tetralogy of Fallot (their vessels are all mixed up). The Philippine Heart Center used to do only 4 surgeries for children with heart problems a month due to lack of funds, with PhilHealth Z they are now doing 4-5 per day. So I may not be a heart surgeon, but I am happy these children operated on will now have better quality of lives, better learning capacities, and better opportunities. I guess God found a way to allow me to still help fix broken hearts.
3rd Example
9 of 10 children with leukemia in the Philippine Children’s Medical Center used to die because of lack of meds. Now 8 of 10 survive.
We wrote the implementing rules and regulation of the Cheaper Medicines Law and were a principal input in all of the hearings in Congress when they were studying ways of addressing the medicines problem in the country back in 2007-2008.
It was never smooth sailing. We did receive threats and bribes for all our efforts too. We shunned them all. One pharmaceutical company owner came to me offering 30% (what will amount to a few millions) of what they will get as long as we choose them to supply the medicinal needs of DOH while another, a savy speaking doctor sounding full of compassion, came to my office one time offering a lifetime supply of eye medications and professional care as long as we listen to their proposal and not include their drugs for price regulation. DOH was among the top 5 institutions of government in terms of transparency and integrity during those times. And we were proud of that and worked to maintain it. In my mind, I cannot face my family and my God if I succumbed to such criminal temptations. Besides, how can you fight for what is right if you do not live by it? And think of the world of your children. So we sternly rejected all bribery attempts and reported these to our bosses. We faced all the threats too head on, some in the form of law suits, others in the form of messages conveying physical harm and some others implying vengeance through professional destruction saying they will return in power and impede professional growth or worse destroy our reputations. I will admit, I felt anxious, but as my bosses advised me, the best defense is always transparency. Live a simple life of transparency.
I now work in PhilHealth where the fight is in attaining Universal Health Care. Basically, the clip I showed you is in the heart of what we want to achieve, Filipinos especially the poor, to get quality health care without worrying over the costs. I’ll tell you how it goes one day.
Now at 40, what’s in store for me? Midlife crisis definitely. But more than that, I really do not know. Yet with a loving wife, and a third child coming, I am excited to face all these uncertainties. My eldest son is an incoming grade 5 Xaverian, my second kid hopefully gets in Xavier next year. When I graduated like you, I went to a lot of weddings and christenings and children’s parties. Lately, more of hospital visits and funerals.
But hey, to quote a famous movie during our time entitled Patch Adams, made after the amazing story of Dr. Hunter Patch Adams, “What’s wrong with death sir? What are we so mortally afraid of? Why can’t we treat death with a certain amount of humanity and dignity, and decency, and God forbid, maybe even humor. Death is not the enemy gentlemen. If we’re going to fight a disease, let’s fight one of the most terrible diseases of all, indifference.”
There is also an irony in my life. My mother has cancer and her medications are 120,000 pesos a month, an amount I cannot afford. The current processes and rules do not allow the regulations of her medicines or reimbursement of my own mother’s needs. So I pray. I am happy to share, some of my mentors have shared in the cost of my mom’s medications, without being asked. So God does find a way to give us our daily bread.
Before I end, as A public health advocate, doctor and public servant, I cannot leave without sharing some advise on taboo topics that may be white elephants in discussions in your homes but surely very important for you to know how to face. Sex, Drugs, Alcohol, smoking, driving, and homosexuality are among the issues and realities you would come to witness or experience.
Although this is the time for you to make mistakes and get up and learn from them, there are mistakes that you should not make at all. Let’s try to get each and everyone of you to live a long, happy and meaningful life. In my stint in the hospital, I have seen teenagers and young adults die or waste their lives by making wrong choices they thought were innocuous or that they can control.
Illegal drugs sound enticing to try at least once, but don’t. Report to authorities people offering you drugs and do not involve yourselves in drug activities. It is not so easy to stand up after falling to addiction. The repercussions are wide and disastrous. The easier route is just say no.
You will be partying a lot, but make sure if you drink alcohol, you should know your limits. It only takes one crucial mistake in a drunk state to lose your arm, your legs, your friends, or worse, your life. You may feel invincible but you are not.
Even when you are not drunk, driving safely is important. Road accidents are among the top killers of our country. That includes young drivers racing recklessly.
Some of you are probably smoking already. Just as a reminder, recent studies show that smoking, regardless of how many sticks you consume, increases the risk of many different diseases including cancer, smoking-related difficulty in breathing called COPD, gastritis, and many others. They say smoking is the one product consumers use that really has no physiological benefits at all. I cannot control you nor stop you from smoking, that is a personal choice, but think of your family. When my brother found out my mom has cancer, he stopped smoking cold turkey because he says he did not want his daughter to experience the same things we are now experiencing as a family. Just think about it.
HIV AIDS is a growing threat in the country. There is still no cure, but it can be prevented. Having a lot of different sexual partners, including hiring prostitutes, is a risk factor for getting HIV AIDS. And 90% of HIV-AIDS recorded in the country were acquired and transmitted through homosexual acts. No judgment please, these are just the facts/figures.
Teenage pregnancy and lack of family planning can keep you from fulfilling your full potential. Respect women. Be patient. Violence against women and children (VAWC) is a crime.
So my message to you graduates of 2016:
Care! and with this care, come actions. Indifference is the enemy.
Work for your success of goals, embrace your success of gifts.
Make mistakes when you are young, when you are in College, and learn from them so you do not make the same ones later on when it really counts, but there are mistakes you should not make.
Pray. God works his miracles through his angels on earth. Always fight for what is right and do not despair, have faith. BIL
There is more to life than earning money, find meaning. Let your conscience be your guide. The fight is not here but out there. The true test is when you experience life.
As Xaverians, you have been given the skills, the knowledge, and the heart to make the world and the country a better place. You are more ready than others in facing challenges. In a world clothed in darkness mired in intolerance, discrimination, violence, hunger, inequity, hatred, you are our hope. This darkness is your opportunity to shine. Luceat Lux.
So that’s my story. What’s yours? Make it great!
Response to Mr. Ethan Chua’s Reaction to Dr. So’s Speech
Good day to all. Allow me to begin by sharing with you that I got a message from Fr. Aristotle Dy last Saturday saying a new graduate, Mr. Ethan Chua, has posted a response to my speech last Friday. He asked me to send a copy of my speech and a reaction/response just to clear the air. I immediately read the reaction of Mr. Chua. As a disclaimer, this response and even the contents of the speech I wrote is my personal work and by no means reflect the views of DOH or PhilHealth. Please find attached my speech and the following reaction:
It’s surely a very powerful piece and truly amazing. It was insightful and written from the heart. As a speaker, and I mentioned it in the speech, what I hoped the graduates would remember that night would be how they felt and from that feeling, to act. The main enemy is indifference. So, the fact that a heartfelt reaction came out is very much welcome to me.
Mr. Chua’s piece is a reaction paper. If he does have some scathing words against my person, I can only blame myself. He merely reacted to what he heard coupled with the critical thinking skills I admire we Xaverians were taught to do. As a speaker, we are vulnerable to different interpretations of our words or the context by which we put it. And so I do appreciate Fr. Dy and Mr. Chua’s offer to respond. In the end, I can only offer my half of how I put my speech together and its motivations, the other half is up for the readers and their interpretation.
In good conscience I wanted to increase the awareness of the graduates, and quote, “on taboo topics that may be white elephants in discussions in your homes but surely very important for you to know how to face. Sex, Drugs, Alcohol, smoking, driving and homosexuality are among the issues and realities you would come to witness or experience”. In retrospect, and Mr. Chua is right, perhaps I should not have presented it as an enumeration. Besides, I admit, the whole sentence is poorly written. It was not my intent to categorize homosexuality as a vice or even as an action for that matter but a taboo topic that should be discussed. I didn’t use the word “vice” but I do understand how it can be interpreted that way. I admit in this sense, I failed to get the right message through. It’s a relief Mr. Chua corrected me then.
I then mentioned, “HIV AIDS is a growing threat in the country. There is still no cure but it can be prevented. Having a lot of different sexual partners, including hiring prostitutes, is a risk factor for getting HIV AIDS. And 90% of HIV AIDS recorded in the country were acquired and transmitted through homosexual acts. No judgment please, these are just the facts/figures. Teenage Pregnancy and lack of family planning can keep you from fulfilling your full potential. Be patient. As it is also Women’s Health month, Respect for women is important. Violence against women is a crime.” I cited the data not to condemn but to inform. The whole paragraph that included the data was premised on respecting sex.
From those above, it was imputed that I was a bigot and hateful of homosexuals and LGBT. Later on, it was also insinuated that the latter was my personal view of the matter and had no place in public discourse. Finally, it was then concluded to remind us all that public policy should not be discriminatory against LGBT/homosexuals. These are very strong words indeed that I believe have been borne out of the way I constructed my speech. I see now that it opens up doors to allow my words to be interpreted the way it was. With all my heart, I deserve every bit of criticism indeed.
With the opportunity given me by Fr. Dy and Mr. Chua, allow me to just pray for everyone to understand that there was no bad faith in the way I placed the words together. I do not hate LGBT or homosexuals. Also, I did not give any personal view on the matter of homosexuality or the homosexual act, much less inferred anything on these. And of course, I have never written or even entertained the writing of policies discriminatory against LGBT. All my life, I have never been hateful nor discriminatory of anyone and I believe my previous works will be a testament to that.
So for all the confusion and hurt I may have caused, I do apologize, especially to Mr. Ethan Chua. I am also quite pleased that he has initiated the discussion on the bigger social issues such as access to reproductive health for all and the homosexual act. We will all surely be guided through its thorough discussion. I do hope the discussion continues.
I do believe and appreciate Mr. Chua when he says he maintains his respect for me despite all the confusion. But what I equally appreciate is that despite the length of my speech, he was quite attentive and listened intently to actually have an accurate recollection and a powerful
reaction to it. He is a brilliant person willing to act for what is right and I am comforted that my future and ours are in his able hands. Keep up the good work, Ethan.