AMID EXCESS FUNDS, BONG GO CHALLENGES PHILHEALTH: “EXPAND BENEFITS, ENHANCE COVERAGE BY INCREASING CASE RATES, AND REDUCE MEMBER CONTRIBUTIONS”

Senator Christopher “Bong” Go has called on the Philippine Health Insurance Corp. (PhilHealth) to expand healthcare benefits, increase case rates, and lower contributions for members following revelations of excess unutilized funds.

As the chairperson of the Senate Health Committee, Go was critical of the substantial unused funds, emphasizing the need to maximize available resources to help impoverished Filipinos who struggle to afford necessary medical care.

“Bilang chairperson ng naturang komite, hindi po katanggap-tanggap na sobra-sobra ang pondo ng PhilHealth na hindi naman nagagamit pero napakaraming Pilipino ang naghihingalo at hindi makapagpagamot dahil walang pambayad sa ospital,” he stated, emphasizing the mismatch between available resources and actual healthcare delivery.

“Tandaan po natin na sa alinsunod sa Universal Health Care Law, lahat ng Pilipino ay miyembro ng PhilHealth. Dapat gamitin nang tama ang sapat na pondo ng PhilHealth para mapakinabangan ng mga mahihirap na Pilipinong may sakit,” he added.

Go argued for that instead of having excess funds to be returned to the National Treasury to be used for other programs of government, PhilHealth must utilize its resources to benefit its members in accordance with the Universal Healthcare Act which mandates all Filipinos to become beneficiary members of PhilHealth.

“Naiintindihan ko ang trabaho ng ating finance managers kung bakit nila kailangang walisin ang mga natutulog na pondo sa iba’t ibang ahensya para magamit sa priority programs ng gobyerno. Kung legal man ito, morally para sa akin ay hindi katanggap tanggap na ang pondong para sa kalusugan ay gagamitin sa ibang paraan habang maraming kababayan natin ang humihingi ng tulong pampagamot,” he stressed.

During a public hearing on July 30 conducted by the Senate Committee on Health, it was disclosed that PhilHealth has Php 90 billion in excess funds scheduled to be returned to the National Treasury as well as around Php 500 billion in reserves.

“Kaya ang apela natin sa PhilHealth, gamitin ang kanilang pondo nang tama — taasan ang case rates, i-expand ang benefit packages, at irekomendang babaan ang kontribusyon ng mga miyembro lalo na’t may sapat na pondo naman pala sila,” he appealed.

Go argued for the necessity of enhancing PhilHealth’s service offerings, particularly by expanding the coverage of dialysis treatments, mental health services, and Z-benefit packages for various severe illnesses.

“Sa packages pa lamang ng PhilHealth, maraming buhay ang maliligtas kung magagamit ang pondo para sa pagpapalawak ng mga benepisyo para sa may sakit,” he explained.

Further, he suggested an increase in PhilHealth’s case rates to expand coverage of those availing of medical assistance from government. Particularly, he reminded PhilHealth that it is part of the 166 existing Malasakit Centers where Filipinos often go to to avail of such medical-related support to cover their hospital bills.

“Sana ay taasan rin ng PhilHealth ang coverage ng kasalukuyang case rates nito para lalo pang mabawasan ang out-of-pocket o dudukiting pera mula mismo sa bulsa ng pasyente. Bakit hindi nila dagdagan ang tulong pinansyal na makukuha ng mga pasyente mula PhilHealth sa Malasakit Centers?,” Go argued.

“Higit kumulang sampung milyong Pilipino na ang nakabenepisyo sa medical assistance mula sa Malasakit Centers na ating isinabatas noong 2019 na aking pangunahing ini-sponsor at iniakda sa Senado,” he cited.

“Kung palalawakin ang benepisyo mula PhilHealth at tataasan ang case rates, hindi na sana kailangang pumila at magmamakaawa pa ang mga may sakit para humingi ng tulong. Pera naman ng Pilipino yan, dapat ibalik sa kanila sa pamamagitan ng maayos na serbisyo,” he added.

He then highlighted the critical needs of the healthcare sector, pointing out that many patients struggle to afford essential services despite PhilHealth’s substantial reserve funds: “Ang dami po mga benefit packages… I’m sure, sa nakikinig na mga doktor dito, ang daming request nila na sana naman i-increase naman itong mga benefit packages namin.”

Meanwhile, Go also welcomed the commitment from PhilHealth’s management to recommend to President Ferdinand Marcos Jr. a reduction in the premium contributions of PhilHealth members.

“Tututukan rin natin ang PhilHealth sa kanilang pangako na irerekomenda sa Pangulo na babaan ang premium contribution ng PhilHealth members,” he said.

Go concluded, emphasizing the importance of every peso for ordinary Filipinos contributing to and relying on PhilHealth.

“Bawat piso po ay napakahalaga lalo na sa karaniwang Pilipino. Kaya babantayan natin ang binitawang mga salita ng PhilHealth at patuloy nating sisiguruhin na ang pondong para sa kalusugan ay magagamit sa mga programang pangkalusugan,” concluded Go.

During the Senate hearing, Department of Finance Secretary Ralph Recto reassured that PhilHealth remains financially stable with a significant benefit chest fund. Meanwhile, PhilHealth President Emmanuel Ledesma confirmed the existence of a substantial reserve fund and emphasized ongoing efforts to enhance benefit packages.