title: The financial impact of unrepaired cleft lip and palate in the Philippines.
abstract: OBJECTIVE
  There are over 96 million people in the Philippines. Close to 77 thousand persons in this country have orofacial clefting. We estimate nearly 64 thousand are unrepaired. Unemployment and underemployment because of the communication disorders associated with unrepaired clefts will affect family income and hence tax revenues. The purpose of this study is to understand the financial impact of unrepaired cleft lip and/or palate on families and identify how that would translate to the Philippine government in tax revenues.
  
  
  METHODS
  The incidence of orofacial cleft in the Philippines was estimated to be at least 1 in 750 people, with only 16% anticipated to be repaired under current conditions. Assuming a 21% unemployment rate in subjects with untreated clefts, and a tax rate of 6-12.4%, projected lost personal income and federal tax revenue was calculated.
  
  
  RESULTS
  In 2012 alone the financial impact on the families may be as much as $US 73-88 million in lost revenue from unemployment and underemployment. This would cost the government between $8.0 and $9.8 million dollars in lost tax revenue. Over a 20 year period at least $US 1.7 billion dollars in family income would be affected costing the government at least $US 194 million in taxes.
  
  
  CONCLUSIONS
  By appropriately caring for the cleft population tax revenues should increase substantially. The development of the infrastructure for surgical care of this problem would be costly but could be more than offset by revenues. Inattention to surgically correctable causes of communication disorders is not affordable.
authors.affiliation: Division of Otolaryngology - Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA. Electronic address: harlan.muntz@imail.org.
authors.forename: Harlan R
authors.initials: HR
authors.lastname: Muntz
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Meier
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology*; D002972:Cleft Palate / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology*; D003906:Developing Countries; D005260:Female; D061889:Healthcare Financing; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D020380:Needs Assessment; D010679:Philippines; D011203:Poverty; D016079:Refusal to Treat / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Cleft lip and palate; Costs; Developing countries; Global health