Doctors, healthcare workers urge Marcos to fix PhilHealth fund transfer issue
MANILA, Philippines – Doctors are knocking on the doors of President Ferdinand Marcos Jr. to undo a Department of Finance (DOF) directive to transfer P89.9 billion worth of excess funds from the Philippine Health Insurance Corporation (PhilHealth) to the National Treasury.
“Hinihiling namin na itong tinatawag na excess fund, kung totoo man na may excess fund, [ay] palawakin ‘nyo ang coverage ng PhilHealth insurance natin sa mga sakit ng mamamayang Pilipino,” Maricar Limpin, former president of the Philippine College of Physicians, said in a press conference on Friday, July 19.
(We are asking that this so-called excess fund, if it’s true that there’s an excess fund, be used to expand PhilHealth’s insurance coverage to other illnesses suffered by Filipinos.)
“You are the only one who can prevent this, Mr. President, and we believe that you will find ways to find solutions to this particular problem,” she added.
Over 60 professional medical and healthcare organizations signed the letter to the President, whom they hope will address the issue at his third State of the Nation Address (SONA) on Monday, July 22. If the President does not, the groups are looking to file a petition before the Supreme Court questioning the legality of the DOF directive.
Groups noted that the funds “could have been used for the health care of individuals in need of financial aid” instead of being transferred to the government’s coffers.
63 professional organizations from the healthcare sector are calling on President Ferdinand Marcos Jr. to prevent the diversion of P89.9 billion worth of Philhealth funds to the National Treasury. @rapplerdotcom pic.twitter.com/yKkGnjsGxT
— Kaycee Valmonte (@kayceevalmonte) July 19, 2024
‘Social injustice’
The plea comes after the Department of Finance (DOF) ordered to transfer excess funds from government-owned and controlled corporations (GOCC) to help finance the government’s unprogrammed funds, which is essentially the country’s standby funds for programs that are not specifically stated in the government’s budget.
PhilHealth gets money through member contributions and covers indigent Filipinos through subsidies from the government. “Parang alkansya ‘yan ng taumbayan, ambagan tayo diyan (It’s like the nation’s coinbank, we all contribute there),” said Antonio Dans, president of the Asia Pacific Center for Evidence-based Healthcare.
The DOF said on Monday, July 15, that the funds being transferred are unused government subsidies. PhilHealth acting vice president Rey Baleña also clarified that the funds do not include contributions from paying members of the state insurer.
However, doctors and healthcare workers argue that the DOF’s directive still violates Section 11 of the Universal Health Care (UHC) Act (RA 11223), which provides that “no portion of the reserve fund or income thereof shall accrue to the general fund of the National Government or any of its agencies or instrumentalities, including government-owned or -controlled corporations.”
Under the UHC, excess or reserve funds should be used to increase PhilHealth benefit coverages, on top of cutting costs for contributing members. Should there still be extra funds, PhilHealth is mandated to put these into “investments.”
Doctors and health professionals also highlighted that the fund transfer of unused government subsidies essentially sets aside indigent Filipinos. “Doing so will inadvertently lay the burden of health care entirely on the shoulders of formal payors, many of whom are in need of help themselves.” (READ: [OPINION] Just one medical bill away from hell)
If Marcos were to snub their plea, the groups hope to bring the issue to the High Court.
“Kung pipigilan niya kaagad, wala na tayong basis dyan para sabihin na unconstitutional,” said Bu Castro, former president of the Philippine Medical Association. “Kung wala pa rin at nandiyan pa rin ‘yung pag transfer, then wala kaming choice kundi mag-file [ng petition] after the SONA.”
(If he were to already stop the transfer, then we won’t have any baasis to say that the action was unconstitutional. But if there would be inaction and the transfer would continue, then we don’t have a choice but to file a petition after the SONA.)
Systematic change needed
The groups clarified, however, that they are not pinning the blame on PhilHealth management, but rather “PhilHealth as a corporation.”
“Isa sa aming proposed solutions na systemic solution ay magkaroon ng independent benefit development agency kasi d’yan tayo naiiwan,” Dans said.
(One of our proposed systemic solutions is to have an independent benefit development agency because that’s where we’re lagging)
While the UHC essentially expands insurance coverage to all Filipinos — whether or not they are registered members — doctors noted that patients still pay an average of 50% of their hospital bills, a luxury not all Filipinos have.
Doctors also pointed out that PhilHealth does not cover all illnesses and patient care needed.
“Philhealth’s P400 billion worth of unspent funds should not be tagged as ‘excess’ funds because they are a result of Philhealth’s inefficiency,” their statement read.
— Kaycee Valmonte (@kayceevalmonte) July 19, 2024
The groups are calling for reforms in the state insurer’s system to make the most out of the “excess” funds: pic.twitter.com/eTNrA4Z3PD
PhilHealth’s Baleña said the agency is looking to further expand packages this year, in line with the approved benefit plan in 2023, but doctors want to bring down out-of-pocket costs for patients as soon as possible.
“It’s very technical,” Dans said. “Kulang ang tao natin sa PhilHealth para diyan kaya ang proposal namin pansamantala tumawag sa mga research, academic institute, kapit-bisig tayo (PhilHealth lacks the manpower for that so that’s why we suggest reaching out to research, academic institutions, let’s all work together).” – Rappler.com