Full PhilHealth coverage for cancer treatment, major surgeries pushed

The Philippine Health Insurance Corp. (PhilHealth) should have full coverage of cancer treatments, heart bypass and other major operations, a party-list lawmaker said yesterday.

PhilHealth coverage only ranges from P150,000 to P600,000 while major procedures cost millions of pesos, Agri party-list Rep. Wilbert Lee said.

He noted that during the House of Representatives deliberation on the proposed 2024 budget of the Department of Health in September 2023, it was found that PhilHealth had P466 billion in investible funds and P68.4 billion net income, making his proposal possible.

Lee said that during the hearing, he had proposed the expansion of PhilHealth’s coverage following complaints that some hospitals were no longer accepting PhilHealth members because of the state insurer’s failure to settle their bills.

“But we learned that contrary to what we all believe, PhilHealth has a lot of money,” he said in a statement.

The lawmaker filed House Resolution 1407 in October 2023, urging PhilHealth to update and increase its coverage by 30 percent.

He underscored that its case rate “is no longer responsive to the hospitalization cost of the beneficiaries.”

Starting Feb. 14, PhilHealth will implement such increase but Lee said that he would seek more adjustments.

“I have been watching this. We won’t stop with the 30 percent coverage increase because there are so many cases that even if the agency doubles the coverage, members would still be short of paying their bills,” he added.

Lee also urged President Marcos to temporarily suspend the implementation of PhilHealth’s premium rate hike from four percent last year to five percent this year.

“We must lighten the burden of Filipinos, many of whom are in deep debts from paying hospital bills and treatments,” he maintained.

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