Any person who is sick or who has a family member or loved one suffering from cancer, heart, kidney or lung disease is considered an indigent.
Senate President Francis Escudero made this observation during a hearing of the Committee on Health, adding that such recognition “should be the new outlook of the government toward healthcare.”
The senator urged the Philippine Health Insurance Corp. (PhilHealth) to rethink what it means to be indigent when it comes to the health requirements of Filipinos.
He noted that insofar as public health is concerned, being indigent takes on a whole different meaning.
“Even if that individual is earning P28,000, P68,000 pesos or even P100,000 per month, given the daily expenses for food, housing, medicines and other bills, that person is cancer indigent, heart disease indigent, lung disease indigent or kidney failure indigent,” Escudero stressed.
In its current effort to adjust the case rates for inpatient members, Escudero said PhilHealth should take into account the amount of contributions members make on a regular basis.
Similar to how it works with various insurance products, the Senate President said the level of benefits received would vary based on how much premium is being paid by the clients.
During a hearing of the Committee on Health, Escudero asked PhilHealth officials if they did the math in determining how much benefits a member should receive.
If the level of contributions to PhilHealth by employees is based on the amount of compensation they receive, Escudero asked why the state health insurance firm has only a single case rate that applies to all members.
PhilHealth started implementing the All Case Rates policy in 2013 in lieu of the fee-for-service provider mechanism.
Since 2013, most case rates have not been adjusted and so the PhilHealth board, through PBR No. 2871 s. 2024 (Resolution Adopting a 30 percent Inflation Adjustment Factor for Select Case Rates) approved an inflation adjustment factor of 30 percent for existing case rates to account for price changes over the past decade.
“For most employees of government for instance, they are not considered indigent. Whatever amount they earn, it’s never going to be enough to pay the medical expenses if you’re a cancer patient or if you need a heart operation,” Escudero said
He pointed out that PhilHealth has the funds to cover for the adjustments in its case rates as seen in the ballooning of its reserve fund over the years.
PhilHealth’s reserve fund has reached close to P500 billion, an amount which Escudero noted is so huge that if left unutilized, it would lose value due to inflation.
Based on a four-percent inflation rate, Escudero told PhilHealth it is losing P20 billion, in terms of value.
“That’s why the Department of Finance considered getting the money because it is saying,” Escudero said.
