PHILHEALTH should be called ‘ PhilSick’- HEAD
MANILA – The group called Health Alliance for Democracy or HEAD has strongly condemned two recently released circulars by the Philippine Health Insurance Corporation or PHILHEALTH as arbitrary, anti- patient and anti-member.
It said PHILHEALTH Circulars 2016- 001 and 002 or the Policy State- ment on the Diagnosis and Management of Acute Gastroenteritis or AGE and Urinary Tract Infection or UTI, respectively, require a minimum hospital stay of 3 days for AGE and 4 days for uncomplicated UTI. Otherwise, claims will be denied.
“Since when did it become PHILHEALTH’s role to determine and set limits to the diagnosis and manage- ment of patients?” HEAD Secretary- General Dr. Joseph Carabeo asked.
He said in the first place, AGE and UTI do not often warrant hospital admission and “when they do, the management is based on the status of the patient, therefore, pre- determining the length of hospitalization is preposterous.”
“Additional, but unnecessary burden is placed on healthcare providers. Longer hospital stay means use of more hospital resources. At the same time, patients are put on an even higher risk of hospital- acquired infection.”
“A health financing agency, a state- run one at that, should not in any influence patient care. PHILHEALTH is now acting like a private health maintenance organi- zation or HMO that dictates the quality of care for its members,” Carabeo said, adding, PHILHEALTH is putting lives at risk. “Rather than promote health, the agency is promoting illness. It should be called PhilSick instead of PHILHEALTH,” he said. There was no immediate statement from PHILHEALTH on the issues raised by Carabeo’s group. Just recently, the Com- mission on Audit also questioned PHILHEALTH’s authorized bonuses to executives and employees in 2013 that reached over 1.7 billion. It said the bonuses were given on the basis of PHILHEALTH’s board resolutions which violated Presidential Decrees 1597 or the law rationalizing the compensation system and classification of position in the government.