People Are Dying, and It’s Not Just the Disease

How Governance Shapes Health Outcomes in a Free Society

It has been going on for a while now, the noise. The kind that makes the Philippine government famous, not in a way we should be proud of, but in a way that makes us uneasy, tired, and quietly fearful. The kind of noise that drowns out reason, compassion, and accountability.

Those before us fought hard for what we now call freedom. They marched, resisted, suffered, and died so that future generations could speak, vote, organize, and live without the constant shadow of colonization and dictatorship. We grew up enjoying the fruits of their sacrifices, often without fully understanding the cost at which these were earned.

And yet, I find myself asking an uncomfortable question:

Is it the very freedom we enjoy that has brought us to where we are now?

Democracy was never meant to be easy. It assumes an informed public, ethical leadership, strong institutions, and a shared commitment to the common good. But how much democracy can a society handle when truth is diluted, accountability is optional, and power is treated as an entitlement rather than a responsibility?

At what point does freedom become vulnerable? Not because it is excessive, but because it is unprotected?

We often talk about governance as if it were separate from daily life, as if it existed only in policy papers, press briefings, and election cycles. But governance is often found in hospitals that lack medicines, in communities flooded without warning, and in families forced to choose between food and healthcare.

It lives in who gets to live longer and who does not.

Michael Marmot famously stated that health is a political issue. It is a statement that unsettles many, because it forces us to confront an inconvenient truth:

People do not die simply because they are sick. They die because systems fail them.

When budgets prioritize power over people, when corruption weakens institutions meant to protect the most vulnerable, when access to healthcare depends on geography, income, or political visibility, death becomes systemic.

So how is it that a government established to protect its people becomes a space where people are harmed by neglect, indifference, or structural violence?

This is not about one administration, one policy, or one official. It is about a system that has learned to survive without accountability. A democracy that allows impunity to coexist with elections. A society that has normalized injustice as background noise.

And perhaps the hardest truth of all: democracy does not collapse overnight. It erodes quietly when we excuse wrongdoing because it is familiar or convenient, when we mistake silence for peace, when we confuse popularity with legitimacy.

Freedom without responsibility is fragile. Democracy without justice is hollow. And governance without compassion becomes theft. Theft of dignity, of opportunity, of life itself.

The question, then, is not whether we have too much freedom.
It is whether we have done enough to protect it, educate for it, and demand better within it.

Because people are dying, not just from disease, but from a system that has forgotten who it exists to serve.

And that, more than any noise, should disturb us all.