For most of its post-independence existence, this country has had no national health care system.
One of the principal hallmarks of an advanced and progressive modern-day society is a first-rate general health care system. One of the first things that come to the forefront in discussions of the best features of countries like the United Kingdom, the U.S., Canada and the Scandinavian states is the quality of their national health care systems.
For most of its post-independence existence, this country has had no national health care system. To correct that situation, Congress passed the Universal Health Care (UHC) Act and created the Philippine Health Insurance Corporation (Philhealth) to implement the worthy intentions of the new law’s authors.
Philhealth’s progress during its first two decades of operations has by no means been smooth or steady. On the contrary, the new government corporation’s operations have been marred by complaints of inefficiency and mismanagement, especially mismanagement of its finances, which consist of premiums paid by its members—mainly employers and employees—and an annual subsidy from the national government.
The most serious complaints have been about the extent of Philhealth’s medical coverage – the non-inclusion of some medical conditions and low benefit levels—and the slowness of its reimbursements to hospitals and other health care institutions. And, of course, there have been allegations of corruption; a few years ago, there was a major scandal concerning the pricing of Philheath’s computer purchases.
Through all these negative occurrences, the Filipino people have by and large maintained their trust and confidence in the government’s commitment to provide them with a reasonably wide array of health services through a universal health insurance system. But two recent occurrences have shaken that trust and that confidence.
The first was the move of the Department of Finance (DOF) – with the support of the Department of Budget and Management (DBM) —to divert to the Treasury P120 billion worth of “excess” Philhealth funds to unprogrammed General Appropriations Act (GAA) appropriations unrelated to health care.
A total of P90 billion had been diverted by Oct. 29, 2024, when the Supreme Court, acting on these petitions challenging the diversion’s Constitutionality, issued a temporary restraining order (TRO) stopping the diversion of the final P30 billion tranche and setting the consolidated cases for oral arguments on Jan. 14, 2025. The petitioners seek the return to Philhealth of the already diverted P90 billion.
In their pleadings, the petitioners argued that under the UHC Act “excess” Philhealth funds can be used only to widen and increase health average or reduce premiums.
The second negative occurrence was the news emerging from the Senate that a number of senators, including the Senate President, are opposed to giving Philhealth a subsidy in next year’s budget.
These occurrences have had the combined effect of eroding the Filipino people’s trust and confidence in the strength of the government’s commitment to providing them with a stable efficient and steadily growing health insurances system. In their view, Philhealth is still a long way from first rate status and any financial moves by the government should be in the direction of increasing, not decreasing, Philhealth’s financial capability.
As things stand, they say, Philhealth’s medical coverage needs substantial broadening and the corporation remains unable to reimburse hospitals promptly. There is still some distance for Philhealth to travel, they contend.
The employers, employees and other Filipinos who account for Philhealth’s premium income are arguably the principal stakeholders of this country’s universal health insurance institution. Their trust and confidence is all important, and the government must avoid moves that diminish them.
The existence of “excess” funds is a separate issue. The government, especially Congress, should seek to find out why such funds exist.
(llagasjessa@yahoo.com)
