Just when we thought we’d seen enough trouble at the doorstep of Health Secretary Francisco Duque III, we learned over the weekend that hospitals and doctors may no longer wish to work with the state-run Philippine Health Insurance Corp. (PhilHealth).
Duque, who has been staving off calls for his resignation over audit findings that his department mishandled P67.3 billion in funds earmarked for the country’s COVID-19 response, has called on PhilHealth and the hospitals to continue discussions amid a worsening dispute over the non-payment of billions of pesos worth of claims.
On Saturday, the Philippine Medical Association (PMA), the Philippine Hospital Association (PHA) and the Private Hospital Association of the Philippines (PHAP) said they were considering disengaging with PhilHealth after the state insurer issued a circular on the temporary suspension of the payment of claims over fraud concerns.
But the hospitals said the accusations of fraud were unacceptable and saw this as “another ploy to deny or delay the payment of claims.”
Members of the Philippine Hospitals Association said they worried that their COVID-related claims would be unfairly tagged as fraudulent as a way to delay payments due them.
“The bridge between the health-care providers and PhilHealth now has serious cracks caused by a feeling of mistrust by PhilHealth against health-care providers. The bridge is bound to collapse, maybe it is time to review the engagement with PhilHealth and level the playing field,” the groups said in their statement.
They promised to continue to treat PhilHealth-covered patients, but only while their contracts with PhilHealth—which expire in December 2021–are in effect.
As chairman of PhilHealth, Duque cannot simply wash his hands of the dispute, which could hobble the national response to the COVID-19 pandemic.
Even before the PhilHealth circular was issued to suspend payments, relations between the state insurance company and hospitals had soured over some P25.6 billion in unpaid claims, which they said would hurt their operations as they geared up for another COVID-19 surge.
It is understandable that PhilHealth, racked by a corruption scandal in September 2020, may now be erring on the side of caution.
On the other hand, if every claim is subject to exacting scrutiny, this could delay the flow of funds used to deal with the COVID-19 pandemic, with potentially dire consequences.
Secretary Duque’s call for further discussions seems almost nugatory given the chasm of trust dividing both sides.
Throughout all his travails, Secretary Duque has enjoyed the unflinching support of the President, who routinely clears him of any fault or wrongdoing, even before any investigation can begin.
We wonder, though, in the privacy of the President’s office in the Palace, if he doesn’t chide his teary-eyed Health secretary and say: “Now here’s another fine mess you’ve got me into.”
