PhilHealth@ 21: A Coming of Age
THE NUMBER 21 is closely associated with the traits of maturity, stability and resilience. It denotes a coming of age, a stage when a person is usually all fired up to explore what life has to offer. It is at this very interesting phase in life when one is eager to find out what the world has to offer, and how prepared one is for these challenges.
Now at the prime of its youth, the Philippine Health Insurance Corp. ( PhilHealth) is pretty much on the same stage— it has gone a long way in implementing the National Health Insurance Program ( NHIP), and has made countless reforms that have practically made PhilHealth a byword in every Filipino household.
At the very start ( 1972) was the Medicare Program which assured every Filipino of adequate and quality healthcare at the time of need. With the passage of the National Health Insurance Act in 1995, the country’s only health insurance was transformed into a national program, a more robust organization to stand as overseer of health benefits and privileges that every Filipino should have the right to access. Since then, PhilHealth has been faithful in providing its members with adequate benefits to help them with their in- hospital and outpatient medical care needs.
Now that the organization has matured, it has articulated its readiness for the challenges ahead, particularly in ensuring that it is able to provide financial risk protection for its members. A soon- to- be- released report on an assessment study conducted by the National Institutes of Health, UP Manila by Dr. Leonardo Estacio Jr., Dr. Hilton Lam and team showed that “average out- of- pocket expenses of indigent members is 83 percent lower compared to those without PhilHealth coverage.” The same study found out that “PhilHealth members are 10 times less likely to experience financial catastrophe compared to those without PhilHealth coverage.” If this is any indication of PhilHealth’s performance as administrator of the NHIP, then it clearly shows that PhilHealth delivered on its mandate to make sure that every Filipino, especially those who have less in life, are adequately protected from the rising cost of healthcare and health services.
“We have indeed come of age. At 21, we have become more mature, stable, and discerning without losing sight of why and for whom the NHIP exists. Over the years, we have imbibed that sense of responsibility for the healthcare of the 89 million members who bank on our program for their financial risk protection against the increasing cost of health care services,” said PhilHealth president and CEO Alexander A. Padilla.
Among the major reforms that PhilHealth has undertaken over the last 21 years are the development of benefit packages that are constantly being reviewed and updated; the enhancement of its information technology and other systems to ensure that services, both to the members and to its partner- providers are fast, convenient and seamless; introduction of policies that reiterate its commitment to safeguard the health insur- ance fund entrusted to it by its members; expansion of its office network in various parts of the country to reach more members; the quest for total quality management; the continued promotion of PhilHealth until it became a household name; and the provision of learning and growth opportunities for its employees.
Still, the road ahead is full of interesting turns that PhilHealth is willing and ready to face head- on. Padilla acknowledged that “there is room for improvement in our systems, our processes, and in the standards that we have set as we implement the NHIP.”
Recognizing that there is still a portion of the entire Philippine population that needs to be covered, the PhilHealth chief has noted that the state- run agency needs to “recognize that compliance to labor and related laws by certain companies who have contractual workers continues to challenge us where enrollment and premium remittance ( in the formal economy) are concerned.” Despite the fact that PhilHealth has already set in place the mandatory coverage of these workers, the organization needs “to work more closely with the principal players in the labor industry to fully implement this provision.”
As it takes its first step towards the next 21 years, PhilHealth musters enough strength and confidence which it draws from the support of its various stakeholders and program co- implementers, to face the challenges that the next few years will bring. For the meantime, it articulates its current state with confidence, emphasizing that at 21, it is definitely able to bring about “Mas Matatag na Kaseguruhan sa Kalusugan.”