Big money, bigger problem
More frown lines must have formed on President Rodrigo Duterte’s forehead as he contemplated on the best solution to the perennially controversial Philippine Health Insurance Corp. (PhilHealth).
“Privatize or abolish” came the headlines as the headache that had been PhilHealth continued to throb with intrigue.
“Not yet,” replied Senate President Tito Sotto.
Shall we see how it goes till yearend then consider taking the reins from the Department of Health to the Department of Finance?
Will it change the system that has led to nonstop allegations of fraud and corruption in the state-run health insurer?
The country’s primary health care provider has faced serious issues over the years, all boiling down to money matters, to be so general about it.
PhilHealth has some 41 million members and 93 million beneficiaries that include overseas workers and unemployed or indigent Filipinos.
Since its creation in 1995, the government owned and operated corporation (GOCC) has been headed by various presidents and chief executive officers, beginning with Atty. Jose A. Fabia from 1996 to 1997, followed by Enrique Zalamea for one year as well until 1999.
Fabia, a lawyer and entrepreneur, later served as Commission on Audit (CoA) — appointed without opposition — commissioner and ended his term on 2 February 2020 “following six successful years spearheading initiatives to enable CoA become a more impactful organization,” states the agency.
He is further described as having “contributed effectively in the fields of public accountability, communications and health care.”
Fabia seems to be an upstanding man who once said,
“This talk of changing the guard in PhilHealth should still leave another potential worry line on President Duterte’s forehead.
after he joined CoA, “The only way to gain their respect is by competence, by transparency and by doing your job beyond the call of duty,” he noted.
Zalamea, meanwhile, has extensive experience in actuarial work. Unlike most of the individuals who headed PhilHealth, he is also not a medical doctor. The MD in the lineup that followed him are Francisco Duque III, Rey Aquino, Eduardo Banzon, Celestina La Serna and Roy Ferrer.
Erstwhile CEO Ricardo Morales is a retired military general, followed by current head Dante Gierran, formerly of the National Bureau of Investigation.
The longest to hold the position of PhilHealth chief is Duque, from 2000 to 2005.
The rest lasted a year or so only.
The latest two presidents/CEO — a military man and then the former chief of our country’s investigative agency — funnily seem to reflect Duterte’s state of mind when it comes to the national health insurance corporation.
He is building up to a rampage, it seems — the impatience showing such as that of a congressman during the budget hearings last week.
House Deputy Speaker Jesus Crispin Remulla, according to news on GMA online, “vowed to sue PhilHealth after he interrupted Health Secretary Francisco Duque III — who also sits as chairman of the PhilHealth board — while answering his question on how PhilHealth is addressing fraud cases involving hospital and health facility claims during the hearing on the Department of Health’s proposed P127 billion budget for 2021.”
In typical academic style, the DoH chief rattled off nothing definite: “Fraud could result in suspension of the health care facility’s PhilHealth accreditation, or penalty of P50,000 to P100,000 for each fraudulent act...” blah blah blah.
Remulla, before walking out, stopped the guy by saying, “I am not satisfied with the answers. I’ll just see them in court.”
The alleged misuse of billions of PhilHealth’s funds is being investigated, as the corporation’s Internal Reimbursement Mechanism is being singled out as the faucet through which billions of pesos flow supposedly as advance payment to hospitals and other health care facilities that lawmakers flagged for not really catering to COVID-19 cases, among other legal issues.
With the past week filled with distasteful arguments over money over at the House of Representatives, this talk of changing the guard in PhilHealth should still leave another potential worry line on President Duterte’s forehead.
For when there is a whiff of money in the argument, it doesn’t seem to matter who’s who in the picture.
“Will it change the system that has led to nonstop allegations of fraud and corruption in the state-run health insurer?