BONG GO CALLS FOR EXPANDED HEALTHCARE BENEFITS FROM PHILHEALTH AMID COA FINDINGS OF UNUTILIZED FUNDS

Senator Christopher “Bong” Go, Chairperson of the Senate Committee on Health and Demography, once again called out the Philippine Health Insurance Corporation (PhilHealth) for its underutilization of funds following findings from the Commission on Audit (COA).

COA reported that PhilHealth had PHP 89.9 billion in unutilized subsidies, which were supposed to be transferred to the Bureau of Treasury, depriving members of much-needed healthcare benefits.

Earlier, Go welcomed the Supreme Court’s issuance of a temporary restraining order (TRO) against the transfer of PhilHealth’s excess funds to the National Treasury. While the TRO marked a victory for his advocacy, he emphasized the need for further action to ensure that PhilHealth fulfills its commitments.

“Ang PhilHealth po ay para sa health. Paulit-ulit ko pong sinasabi ‘yan. Ang pera ng PhilHealth ay dapat ibinabalik sa tao sa anyo ng mas maraming benepisyo,” Go emphasized during a hearing.

COA’s audit raised concerns over PhilHealth’s compliance with the Universal Health Care (UHC) Act, highlighting the delayed expansion of benefits programs and investment activities that failed to consider projected program expenditures. Go criticized the agency for failing to prioritize the expansion of benefit packages and urged PhilHealth to ensure that its reserves directly benefit members.

“Habang natutulog ‘yung pera ninyo, ilang buhay na naman po ang mawawala ng mga kababayan nating may sakit,” he remarked, reiterating his persistent call for PhilHealth to maximize its resources for the benefit of Filipinos.

The COA report revealed that despite increasing members’ contributions since 2019, PhilHealth spent less on benefit claims in 2023 (PHP 118.90 billion) compared to 2022 (PHP 130.56 billion). Additionally, the report noted PhilHealth’s limited rollout of new benefit packages, with most initiatives tied to COVID-19. For instance, the Outpatient Benefits Package for Mental Health implemented in 2023 reported no paid claims during the year.

“Ang daming mahihirap na Pilipino na nasa ospital at naghihingalo dahil hindi alam kung paano babayaran ang gastusin. ‘Wag niyo pahirapan ang mga kababayan nating naghihirap na,” Go stressed.

He urged PhilHealth to adopt common-sense reforms and innovate new benefit packages to align with the UHC Act’s goal of providing equitable healthcare access.

“Matapos nating madiskubre na 500 billion ang reserve funds ng PhilHealth… ipinaalala natin sa kanila na dapat ibalik po yan sa tao. Contribution po ‘yan ng Pilipino. Hindi po ‘yan para sa inyo,” he added, expressing frustration over the bureaucracy and inefficiency within PhilHealth.

“Ba’t hindi niyo gawan ng mga programa para maagapan ang sakit? Prevention is key para hindi lumala ang gastusin,” he added and pointed out that focusing on preventive care would save lives and reduce long-term costs for PhilHealth.

During a series of committee hearings, he consistently pressed the state insurer to expand its benefits and address long-standing issues in its policies.

“Sa mga pagdinig, paulit-ulit kong ipinaalala sa PhilHealth na dapat gamitin ang kanilang pondo upang mapalawak pa ang kanilang serbisyo. Gaya ng lagi kong sinasabi, hindi pwedeng pangako lang. Dapat may aksyon, may resulta, at higit sa lahat, may malasakit,” Go said.

Recently, Go lauded PhilHealth’s announcements such as expanded benefits for rare diseases, inclusion of oral and dental care, scrapping of its Single Period of Confinement Policy, and provision of assistive devices. He however reminded them of their other promises delivered under oath.

“Nagpaalala tayo sa PhilHealth na tuparin ang mga ipinangakong reporma tulad ng pagtaas ng kanilang case rates; pagpapalawak ng benefit packages; pagbaba ng premium contribution; pagkakaloob ng emergency at preventive care; pagbibigay ng dental, visual care, libreng gamot, assistive devices at iba pang pangangailangang pangkalusugan sa mahihirap; pagsasaayos ng mga outdated na polisiya nila bukod pa sa 24-hour confinement rule na ipinangako nilang repasuhin at ang single period of confinement policy na kanilang naibasura kamakailan lamang matapos ang ating apela, at marami pang iba!,” he cited.

Go urged PhilHealth to act swiftly in improving its services and implementing reforms. “Please shape up, gamitin niyo po ang pondo ninyo para sa mga mahihirap nating kababayan. Pera po ng tao ‘yan. Hindi niyo po pera yan,” he concluded, reaffirming his commitment to his health reforms crusade.

“Dapat nating gawing mas responsive ang PhilHealth sa mga tunay na pangangailangan ng ating mga kababayan. Ang pera ng PhilHealth ay para sa taumbayan—bawat sentimo dapat nagagamit sa makabuluhang paraan,” Go added.