Philippine Health Insurance’s stability questioned


“A THREAT to PhilHealth’s (Philippine Health Insurance) stability is a threat to the lives of many, if not all, Filipinos. This sudden pronouncement on the vigor of our public health care system is very worrisome and its inaccuracy is alarming.”

Senator Teofisto “TG” Guingona III, Chairman of the Senate Committee on Health, expressed his dismay over the reported disclosure of PhilHealth Board Member Ed Dorotan that the national health insurance program “is dying.”

According to reports, PhilHealth paid out a total of PHP 97 billion pesos to claimants as opposed to its PHP 96-billion pesos earnings in 2015. It was further stated that premium payments were allotted to the lifetime insurance of senior citizens and a huge portion of the payout in the last two to three years went to the enrollment of five million Conditional Cash Transfer (CCT) beneficiaries.

“You can’t just threaten that PhilHealth has only ‘months to live’ because of the billion-peso loss, and you can’t just attribute its cause to the benefits received by our elderly and indigent beneficiaries. That would be unfair because more than deserving the assistance, it is their right,” said Guingona.

The re-electionist lawmaker and co-author of the Mandatory PhilHealth Coverage for Senior Citizens said that instead of spreading undue panic, everyone must focus on further improving the system.

For his part, he vowed continuous coordination with the health care agency to close any legislative gap.

Activist law-maker Gabriela Rep. Emmi de Jesus sought a congressional probe into the claim that the state-run Philippine Health Insurance Corp. is in dire financial straits and may continue to exist for only a few more months.

She said the public, especially the PhilHealth members, have a right to know what is the real financial condition of the state health insurance agency.

Citing data from the Department of Health, De Jesus said PhilHealth received 42.5 percent of the DoH budget amounting to 35.2 billion in 2014 and 42 percent, or 37.4 billion, in 2015. In 2016, the DoH allocated 43.8 billion for PhilHealth.

Given these data, De Jesus said she finds it unacceptable that the PhilHealth, which is supposedly in charge of the government’s universal health program, is running out of funds when its annual budget is increasing.

“The government allocates a huge budget for PhilHealth annually. While PhilHealth is a dismal failure in responding to the health needs of the Filipino people, its government funding is depleting, and we want to know why and how,” De Jesus said.

De Jesus also lamented how PhilHealth executives have rewarded themselves with bonuses amid such mismanagement in the health insurance’ funds.

“We have long questioned the PhilHealth’s viability. This was a tragedy bound to happen in the midst of unchecked corruption, questionable bonuses and the large scale private sector intrusion into the public health care system,” De Jesus said.

But PhilHealth denied the claim and assured the public. “We would like to clarify some news reports that came out recently that might have caused panic among our members, especially where the stability of the health insurance funds is concerned,” said PhilHealth President Alexander Padilla.

“PhilHealth’s finances are as robust, healthy and substantial as ever. Proof of this is our ability to pay for the benefit claims of our members at an amount that has been steadily growing over the last five years,” he said.

Padilla noted that PhilHealth paid about PHP 34 billion pesos in benefit claims in 2011, about PHP 44 billion pesos in 2012, up to PHP 55 billion pesos in 2013, PHP 77 billion pesos in 2014 and about PHP 97 billion pesos in 2015.

While other social protection programs maintain probably higher levels of reserve funds, Padilla said they operate on a pay-as-you-go system where PhilHealth can immediately translate what they collect into benefit payments for members. (MCA)