‘Philhealth holiday will hurt public’; ₧84-B UHC gap cited

AHUGE P84-billion funding gap threatens to shut down the Universal Healthcare program passed barely two years ago, the Senate’s chief budget critic said Monday, as he noted this must be a priority concern of the next administration.

This, as the state-run Philippine Health Insurance Corp. urged the Private Hospital Association of the Philippines (PHAPI) to rethink its call for its members to go on a “Philhealth holiday.”

Should PHAPI’S member hospitals heed the call to refrain from accepting Philhealth deductions for health services, the state health insurer warned on Monday that it is the public that would eventually bear the brunt, the state health insurer pointed out.

In an out-of-town press conference, Senator Panfilo Lacson lamented that the Universal Health Care Act (UHCA) is “still underfunded by about P84 billion—a gap that must be addressed by the next administration to stop hospitals from leaving the state health insurance system for good and prevent the public from suffering even more amid the coronavirus pandemic.”

Running for president in the upcoming national elections as Partido Reporma standard-bearer, Lacson tackled the issue in a press conference after a campaign sortie in Lingayen, Pangasinan. He noted with concern that more private hospitals are cutting ties with the Philippine Health Insurance Corp. (Philhealth) over unpaid hospitalization claims amounting to P20 billion as of November.

The senator reminded the Executive that the full implementation of the UHCA was crucial for the country to address the pandemic, and Lacson added this will be his priority if elected President in the 2022 national elections.

Fielding questions from Pangasinan media, Lacson affirmed that “our primary program, of course, is to address the pandemic.”

He continued: “We have a Universal Health Care Act that was passed in 2018 [but] until now it is not fully funded, although it can be.” He noted that “its full implementation is worth P257 billion but the fund allocated for it in 2022 is just P173 billion.”

At the same time, the senator recalled that private hospitals in Iloilo were “rebelling” against Philhealth and withdrawing from the state health insurer which, he stressed, “should be chaired by a competent fund manager or financial expert” from the Department of Finance (DOF) and not by the Secretary of Health.

In voting to pass the Universal Health Care Law, Lacson likewise wondered why the law “could not be funded correctly,” asserting that a fully-funded health care act “means that all barangays in the country would be covered and that there would be one hospital bed for every 800 population.”

In contrast, he cited 2020 statistics showing that in the country’s poorest regions such as Mimaropa (Region 4B), the ratio was one hospital bed per 10,000 people—way below the proportion of one bed for every 1,000 prescribed by the World Health Organization (WHO).

Lacson asked: “Philhealth— isn’t it an insurance [company] as its name suggests? But why is the ex-officio the DOH [Department of Health] Secretary? Shouldn’t it be under the DOF? It’s insurance, so it is more financing than health, that’s why it’s all messed up. It has so many anomalies.”

Moreover, Lacson lamented that “the hospitals in Iloilo are rebelling,” noting that “they are withdrawing their membership from Philhealth. What if other hospitals leave Philhealth? Surely our countrymen will suffer.”

Earlier, PHAPI President Dr. Jose De Grano encouraged the group’s member hospitals to go on Philhealth holiday from January 1 to 5 to support hospitals that plan to cut ties with the state health insurer.

Far Eastern University–dr. Nicanor Reyes Medical Foundation (FEUNRMF) Center earlier said it would disengage with Philhealth while seven hospitals in Iloilo City have also said they would no longer renew their Philhealth accreditation due to unpaid claims.

“We hope Dr. De Grano will rethink his call to his member hospitals to go on Philhealth holiday. Eventually, it will be the Filipino people who will suffer the consequences of such a call,” Philhealth said in a statement on Monday.

Philhealth assured the public that it is constantly conducting reconciliation meetings on claims reimbursement issues with all its hospital partners nationwide to ensure continuity in availment of members’ benefits.

As of December 24, Philhealth said it has fast-tracked the release of P11.64 billion for payment of claims through the Debit Credit Payment Method (DCPM) to hospitals nationwide.

Under the third wave of DPCM, all hospitals treating Covid patients and those offering the Philhealth testing package can now avail of subsidy. To date, 182 hospitals have submitted their letter of intent to participate in the third wave of DCPM.