A lawmaker expressed grave concern on Wednesday over the financial health of the Philippine Health Insurance Corp. (PhilHealth) that could put at risk the implementation of universal health-care program.
Rep. Josephine Ramirez-Sato of the Lone District of Occidental Mindoro, in a statement, asked the Department of Health (DOH) to look into the financial status of the PhilHealth and come up with a recommendation to address the problem.
Sato said the PhilHealth is operating on a net loss and that this has direct bearing on the implementation of a universal health care for all Filipinos even before the universal health-care bill is enacted.
According to Sato, the PhilHealth reported net income from 2010 to 2015, but that in 2016 it posted a net loss of P1.4 billion.
But she claimed the premium income of the PhilHealth was actually overstated for 2015 and 2016 by P13 billion per year.
The lawmaker said the amount represents premium collection from senior citizens to be collected from the Department of Budget and Management (DBM).
“The PhilHealth is only registering a positive income because it has included the P13-billion contributions from senior citizens, which has not been collected for two years now,” she said.
With this, Sato said the PhilHealth is actually operating on a net loss of approximately P26.4 billion as of end-December last year.
“This is troublesome. The PhilHealth will play a very crucial role in providing universal health care for all Filipinos. How can we provide people with crucial public health care if it is running into financial troubles?” said Sato, coauthor of the universal health-care bill.
Sato added a competent manager, not only with experience in the health sector but in sound financial management, should be running the PhilHealth.
The lower chamber approved on final reading House Bill 5784, or the universal health coverage (UHC) bill, which seeks to amend Republic Act 7875, or the National Health Insurance Act of 1995.
Under the bill, every Filipino is provided access to a comprehensive set of health services the cost of which will not cause financial hardship.
The measure provides inpatient health services shall be made available at zero copayment for the noncontributory group and for those who opt for basic accommodation, and at fixed coinsurance rates for all who opt for higher types of accommodation while outpatient health services shall be made available at zero copayment in public facilities, and fixed coinsurance in private facilities.
The bill said every Filipino shall be automatically included in the National Health Security Program. Members of the program will be categorized as contributory or those who are gainfully employed, and noncontributory, referring to indigents, senior citizens and others to be identified by the Department of Social Welfare and Development.
The measure said the program shall serve as a means for the healthy to help pay for the care of the sick and for those who can afford medical care to subsidize those who cannot.
It also mandates that within three years from its effectivity as a law, every Filipino shall have a guaranteed primary care provider. Within two years, the Philippine Health Security Corp. (PHSC) will implement a comprehensive outpatient benefit, including outpatient drug benefit, in accordance with the recommendations of the Health Technology Assessment Council.
The bill also creates the National Health Security Fund that will get funding from contributions from the program, national government allocation and health assistance funds from the Philippine Charity Sweepstakes Office, the Philippine Amusement and Gaming Corp. and local government units.
It said the Department of Health will supervise the whole health system by setting standards for the implementation of the program.
Moreover, House Bill 4784 provides for the adoption and institutionalization of Health Technology Assessment (HTA) and the creation of the Health Technology Assessment Council (HTAC).
HTA denotes any process of examining or reporting properties of a medical technology used in health care, including safety, efficacy, feasibility and indications for use; cost-effectiveness; as well as social, economic and ethical consequences, whether intended or unintended.
HB 5784 provides for the institutionalization of HTA to guide decision-makers, particularly in the procurement of medical devices, commodities, drugs and vaccines. The HTAC will serve as advisory body to the health secretary and the board of directors of the PHSC on the priority entitlements for universal health coverage.