19/07/2024
A Call to Reform PhilHealth and Protect Benefits Mandated by Law
July 19, 2024
On behalf of millions of Filipinos whose health-related sufferings we witness daily, we, the undersigned medical societies and healthcare professional organizations, urgently appeal to President Ferdinand R. Marcos Jr., to take immediate and decisive action to prevent the diversion of PhP89.9B of unused funds from the Philippine Health Insurance Corporation (PhilHealth) to the National Treasury.
1. We denounce the failure of the Philippine Health Insurance Corporation (PHIC) to use its reserve funds as prescribed by the Universal Health Care (UHC) Act. This has led to insufficient patient benefits, unnecessary increases in premiums, and an “inappropriate fund excess” that could have been used for the health care of individuals in need of financial aid.
PhilHealth’s PhP400 billion worth of unspent funds should not be tagged as “excess” funds, because they are a result of PhilHealth’s inefficiency. PhilHealth has underspent because it has failed to sufficiently expand its benefit packages and reduce out-of-pocket spending as mandated by law.
Every day, we see patients deprived of essential healthcare due to the inefficiencies within our social health insurance system. It is incomprehensible how PhilHealth can accumulate such an excess of funds while so many Filipinos suffer without the care they desperately need. The solution to having an excess in PhilHealth’s funds is not to strip Filipinos of healthcare funding but to implement immediate and substantial PhilHealth reforms such as:
- An urgent increase in the scope and coverage of inpatient benefits, outpatient benefits, including benefits for preventive care;
- Provision of premium relief or reduction for those in difficulty.
- The immediate enhancement of benefit development capacity within the corporation, using existing government research and academic institutions in the interim, and forming an independent agency for this if necessary; and
- Easing of the bureaucratic burden for claims processing in order to incentivize the immediate provision of much needed primary care services, especially for the poor.
2. We denounce the Department of Finance’s diversion of P89.9 billion of this “inappropriate excess” for purposes other than service of the patients we care for. Countless Filipinos suffer because of inadequate financial support for health care needs. These “excess funds” were mandated to be used exclusively for their individual care.
We strongly believe that this move by the DOF violates Section 11 of the Universal Healthcare Act (Republic Act 11223) which states that
“The excess of the PhilHealth reserve fund shall be used to increase the Program’s benefits and to decrease the amount of members’ contribution; no portion of the reserve fund or income thereof shall accrue to the general fund of the National Government or to any of its agencies or instrumentalities, including government-owned or -controlled corporations.”
Remitting PhilHealth’s fund to the national budget also violates Republic Act 11346 which earmarks the revenues of excise taxes on to***co products and sugar-sweetened beverages exclusively to PhilHealth for Universal Healthcare.
In addition, the government cannot take back subsidies it used to pay for premiums of disadvantaged populations. Doing so will inadvertently lay the burden of health care entirely on the shoulders of formal payors, many of whom are in need of help themselves.
In view of these, we call on President Ferdinand Marcos Jr. to:
- Immediately issue a directive to return the entirety of PhilHealth’s P89.9 billion unused fund to PhilHealth, to be used for the individual health care needs of the poor; and
- Decisively and urgently institute measures to assure the immediate enhancement of health benefits, forming an independent agency to do this if necessary.
Signed:
1. Philippine Medical Association
2. Philippine Nurses Association
3. Philippine Pharmacists Association
4. Philippine Physical Therapy Association
5. Philippine Academy of Occupational Therapists
6. Philippine College of Physicians (P*P)
7. Philippine College of Surgeons (PCS)
8. Philippine Pediatric Society (PPS)
9. Philippine Academy of Family Physicians (PAFP)
10. Philippine Obstetrics and Gynecology Society (POGS)
11. Philippine Ambulatory Pediatric Association, Inc (PAPA)
12. Healthcare Professionals for Christ
13. Pediatric Infectious Disease Society of the Philippines (PIDSP)
14. Philippine Urological Association (PUA)
15. Pediatric Nephrology Society of the Philippines (PNSP)
16. Philippine Academy of Pediatric Pulmonologists
17. Society of Gynecologic Oncologists of the Philippines (SGOP)
18. Philippine Society for Cervical Pathology and Colposcopy (PSCPC)
19. Private Hospitals Association of the Philippines (PHAPi)
20. Philippine Addiction Specialists Society (PASS)
21. ANG NARS
22. Society of Pediatric Critical Care Medicine Philippines
23. Philippine Society of Nephrology (PSN)
24. Philippine Society of Experimental and Clinical Pharmacology (PSECP)
25. Philippine Society of Pediatric Hematology
26. Pain Society of the Philippines
27. Asia Pacific Center for Evidence Based Health Care
28. Philippine Society for Reproductive Medicine (PSRM)
29. Philippine Association of Medical Journal Editors
30. Philippine Dermatological Society
31. Philippine Continence Society
32. Philippine Association of Nutrition
33. Philippine Neurological Association
34. Philippine Rheumatology Association
35. Philippine Lipid and Atherosclerosis Society
36. Philippine Society for Urogynecology and Reconstructive Pelvic Surgery
37. Philippine Society of Hypertension
38. Philippine Society of Child and Adolescent Psychiatry (PSCAP)
39. National Hospice and Palliative Care Council of the Philippines (Hospice Philippines Inc.)
40. Philippine Association of Plastic Reconstructive and Aesthetic Surgeons (PAPRAS)
41. Philippine College of Occupational Medicine (PCOM)
42. Philippine Psychiatric Association
43. Community Pediatrics Society of the Philippines (CPSP)
44. Philippine Society of Medical Oncology
45. Philippine Society of Allergy, Asthma & Immunology (PSAAI)
46. Philippine Society for Microbiology and Infectious Diseases (PSMID)
47. Occupational Health Nurses Association of the Philippines (OHNAP, Inc)
48. Philippine College of Geriatric Medicine
49. Child Neurology Society Philippines (CNSP)
50. Philippine Surgical Infection Society
51. Philippine Obstetrical and Gynecological Society (POGS)
52. Philippine Society for Developmental and Behavioral Pediatrics
53. Philippine League against Epilepsy
54. Philippine College of Emergency Medicine (PCEM)
55. Philippine Society of Hospice and Palliative Medicine (PSHPM)
56. Philippine Society of Public Health Physicians (PSPHP)
57. Alliance for Improving Health Outcomes (AIHO)
58. Philippine Society of Climacteric Medicine (PSCM)
59. Philippine Society for General Internal Medicine (PSGIM)
60. Philippine Society for Gastroenterology, Hepatology and Nutrition (PSPGHAN)
61. PGH Physicians’ Association
62. Philippine Academy of Family Physicians
63. Philippine Society of Critical Care Medicine (PSCCM)
64. Confederation of Professional Health Associations
65. Philippine Society of Clinical and Occupational Toxicology
66. Philippine Society of Newborn Medicine
Additional signatory groups:
67. Philippine Heart Association
68. Philippine Society of Reproductive Immunologists
69. Philippine Stakeholders for Nutrition and Dietetics Inc.
70. Philippine Academy of Rehabilitation Medicine (PARM)
