"We should just abolish PhilHealth and create a new agency."
"We should just abolish PhilHealth and create a new agency."From the looks of it, it is not only smoke coming out of PhilHealth but fire—and a big one at that. The performances of those PhilHealth officials who testified in both the Senate and House hearings were so shabby that it ended hurting their credibility.
Take the case of the P10 billion released for pneumonia treatment. When an official who is a medical doctor and in charge of medical policy was asked whether X- ray was part of the diagnosis, he could not give a definite answer. It is no wonder that the agency is losing so much money due to what can only be describe as gross incompetence.
What is also coming out from the hearings is the lack of regulations and standard operating procedures which gives the ExCom or Board a lot of prerogatives to decide on money issues – clearly a recipe for graft. The CEO of PhilHealth once said that there is no fraud-free government health insurance system anywhere in the world. This is true. We often read of people being arrested in the United States for defrauding the government of millions of dollars for false and fraudulent medical insurance claims. In one case not too long ago, a couple of Filipino immigrants to the US who came back to hide in the country were arrested and charged for such offenses. And we are talking of a country that is highly computerized with a very sophisticated system borne by many years of experience.
Compare that with PhilHealth which is just starting to embrace computer technology We can then imagine how easy it is for corrupt public officials to defraud the system.
CEO Ricardo Morales seems to be putting all his marbles in computerization to be able to solve the problems of his organization. But computers can only do so much. Who are needed in PhilHealth are people who can moderate their greed and not steal everything and bankrupt the organization. One difference in the cases that we read about concerning fraud in other government medical insurance systems is that those cases are largely committed outside of the system, in contrast to the current allegations against PhilHealth. In our state insurer, anomalies are being perpetrated by some kind of a mafia inside the organization ensconced in the top echelon of management. This is the reason why the amount involved is mind-boggling. Worse, this has apparently been going on for a long time.
No wonder there is mention that the actuarial life of PhilHealth might not last long.
One good outcome of the two congressional hearings currently going on is that it is showing that the problem within PhilHealth is not only systemic but also deeply rooted. This implies that even with major surgery, it probably cannot be saved anymore. Maybe the government should follow what the good book is saying: “That unless the grain of seed falls and dies, it will not grow.”
We should just abolish PhilHealth and organize a new agency. The President and CEO of PhilHealth has already gone on a two week medical leave followed by some senior level officials. Perhaps the whole Executive Committee should follow suit to pave the way for a reorganization. But almost all the senior officials appear to be resisting calls for their resignation. This is no doubt because of their firm belief that they are not guilty of all the corruption charges being labeled against them, coupled by their assertion that they themselves are the ones instituting reforms.
If they are indeed the good guys, why have they failed considering that they are at the top of the decision-making process of the organization?
They say the truth will set you free but the way many of the resource speakers answer the questions was just an exercise in obfuscation. They were not straightforward, they kept changing their answers, they lied and were beating around the bush.
Nonetheless, four officials of PhilHealth have already been reported to have been charged for falsification of public documents. It is not really much but it is a start. Hopefully, as the Department of Justice investigation moves forward, there will be more serious charges that will be filed.
The most common method used in defrauding the government in PhilHealth appear to be the connivance between officials and private health providers be it dialysis centers or hospitals and falsification of public documents. There may of course, be other ways that have not yet been made public. But things should become clearer as the congressional hearings progresses. In the end, what we should worry about is if after all the investigations, those officials who will be identified as corrupt will not be fired.