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Saturday, December 21, 2024

PhilHealth asked to stop contribution hike

The Philippine Chamber of Commerce and Industry (PCCI) asked the Philippine Health Insurance Corp. (PhilHealth) to suspend the increase in member contributions, given the latter’s substantial reserve fund.

PCCI president Enunina Mangio said the agency has substantial reserve funds, including a net income of P173.46 billion and an accumulated fund of P700 billion as of December 2023.

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“These funds are contributions from the hard-earned money of its members,” Mangio said, emphasizing the need to reinvest these funds into higher benefits and expanded illness coverage.

Mangio said given PhilHealth’s annual operating cash flow exceeding P70 billion, the government should suspend the remaining 1-percent increase in member contributions.

The PCCI said these funds should be reinvested into enhancing benefits and broadening the scope of covered illnesses.

PCCI said efficient fund management and good governance could enable PhilHealth to fulfill its mandate and effectively address both current and future healthcare needs.

Meanwhile, PhilHealth president and chief executive Emmanuel Ledesma Jr., reaffirmed the agency’s commitment to expanding its benefit packages following a series of enhancements introduced since last year.

“It cannot be denied that members are beginning to experience significant improvements in their PhilHealth benefits. We started with dialysis by fully covering all sessions for the year and increasing the payment per session,” Ledesma said.

PhilHealth’s coverage for dialysis increased from 90 to 156 sessions, and payment per session was raised by 51 percent from P2,600 to P4,000.

This means patients can now enjoy up to P624,000 in annual coverage from the previous P405,600. The benefit has been institutionalized and subject to “no balance billing” which means patients no longer have to pay on top of the increased package rate.

“We hear the concerns of our kababayans about the high cost of medical treatment. We see and feel this in our interviews with patients. We are expediting the improvement of benefits. We started with chronic illnesses because treatments for breast cancer, pneumonia, stroke, asthma, and others can be financially draining,” said Ledesma.

“We ask for a little understanding from our kababayans because the expansion of services goes through a thorough process of study, not only to ensure it is done properly but also to launch it in a way that will benefit the majority. Our team is working tirelessly to ensure that patients feel the care of our national health insurance system,” he saidl.

PhilHealth also doubled coverage for hemorrhagic stroke (P80,000 from P38,000), ischemic stroke (P76,000 from P28,000), bronchial asthma (P22,488 from P9,000), and neonatal sepsis (P25,793 from P11,700), among others.

Coverage under its Z Benefit Package for breast cancer was increased from P100,000 to up to P1.4 million. It also added ultrasound and mammogram to the Konsulta Package to promote early detection of breast cancer among women.

These additions are on top of the existing 13 laboratory tests and 21 medicines already available from over 2,000 Konsulta providers across the country that can be availed of free-of-charge once recommended by the provider.

PhilHealth also raised the case rates packages by 30 percent. Another round of 30 percent increase is set before the end of 2024. Private Hospitals Association of the Philippines (PHAPI) President Dr. Jose Rene de Grano confirmed during a recent meeting that, “there was an increase by 30 percent and I think another 30 percent, so magiging malaki na ‘yan, magiging 60 percent na ‘yan. Okay na ho ‘yan basta walang babayaran halos ang pasyente,” he said.

Members can also expect an increase in benefits for chemotherapy covering lung, liver, cervical, and prostate cancers, along with emergency care, open-heart surgeries, ischemic heart disease, cataract extractions, peritoneal dialysis, post-kidney transplant care, and severe dengue treatment also this year.

Ledesma said these measures aim to ease patients’ financial burdens, allowing them to allocate their money to other essential needs.

“With these improved benefits, Filipinos no longer need to resort to loans or pawn their properties. PhilHealth will cover a substantial portion of the medical costs especially in hospital ward accommodations, whether in public or private facilities. Above all, they can focus on their recovery,” he said.

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