BONG GO REITERATES APPEAL TO PHILHEALTH: LOWER CONTRIBUTIONS, INCREASE CASE RATES, EXPAND BENEFIT PACKAGES, AND STOP SINGLE CONFINEMENT POLICY

Senator Christopher “Bong” Go continues his ongoing appeal to state insurer Philhealth to implement significant reforms aimed at improving healthcare services for Filipinos amid existence of excess funds.

“Kamakailan ay nalaman natin sa pagdinig sa Senado na ating pinamunuan bilang Chairperson ng Senate Health Committee na may sobra-sobrang pondo ang PhilHealth na nagkakahalaga ng humigit-kumulang 500 bilyong piso na natutulog lang kaya ngayon ay ililipat na ang parte nito na P89.9B sa National Treasury,” Go pointed out.

“Hindi katanggap-tanggap para sa akin na may mga naghihingalong pasyente na humihingi ng tulong sa gobyerno para may ipampagamot samantalang may pondo riyan na pangkalusugan naman na nakatiwangwang lang, planong gamitin sa ibang mga programa, at hindi mapapakinabangan ng mga mahihirap na may sakit,” he added.

His push for change emphasizes the need to maximize available resources to benefit Filipinos who are all members of PhilHealth while also making efforts to lower their premium contributions, increase case rates, expand benefits, and revise the restrictive single period of confinement policy, which Go finds illogical.

“Sana naman ay magising na ang pamunuan ng PhilHealth. Hindi naman sila bangko na dapat mag-ipon lang ng pondo. Gamitin sana nila ito para mas maproteksyunan ang kalusugan at buhay ng bawat Pilipino ayon sa kanilang mandato, at alinsunod din sa Universal Health Care Law,” he emphasized.

In a radio interview on Saturday, August 24, Go expressed his dissatisfaction with the current single confinement policy, labeling it as “no repeat sakit” policy which is unrealistic. He pointed out the flaws in the policy, citing scenarios where patients with recurring conditions, such as complications from pregnancy or recurring illnesses like diarrhea, are unfairly denied coverage the second time around.

“Hindi po ako titigil d’yan sa single confinement policy ng Philhealth. Hindi po katanggap-tanggap ‘yan sa akin. That is very illogical po ‘yan at not acceptable po ‘yan. Tawag nga po d’yan, ‘no repeat sakit’ policy. Kalokohan ‘yan,” Go declared.

Go provided vivid examples to underscore the impracticality of current policies: “Alam n’yo ba, halimbawa, kayo, buntis kayo, maselan ang pagbubuntis n’yo, na-admit kayo tapos bukas, maselan pa rin, nagka-bleeding kayo, bawal na po i-cover ng Philhealth. Ngayon nagka-diarrhea ka, after two weeks nagka-diarrhea ka uli, ayaw nang icover.”

“Mapipigilan mo ba ang diarrhea? Pasintabi lang sa kumakain. Hindi lang po ‘yun, pneumonia bawal po (makakuha ng benepisyo pag naulit). Kaya sabi ko, kalokohan ‘yan (pag-)aralan n’yo ‘yan,” he added.

During the Senate Committee on Health Public Hearing on August 20, Go urged PhilHealth CEO and President Emmanuel R. Ledesma, Jr., to scrap its single period of confinement policy.

A single period of confinement, according to PhilHealth Circular No. 0035, series of 2013, means admissions and re-admissions due to the same illness or procedure within a 90-calendar day period shall only be compensated with one case rate benefit.

Meanwhile, Go highlighted the significant financial resources available to PhilHealth that are not being utilized effectively: “Buti sana gumawa kayo ng polisiyang ‘yan dahil kulang ang pondo ng Philhealth. Mali. Sobra-sobra ang pondo ng Philhealth.”

“For the information po ng lahat, lahat po ng mga kababayan ay miyembro ng Philhealth. Meron pong PhP500 billion reserved fund ang PhilHealth na hindi nagagamit. Ang nangyari ay winalis ng Department of Finance (ang parte nito) para gamitin sa ibang priority projects,” he added.

“Ako naman po, legally, lusot kayo but morally hindi. Dahil para sa akin ang PhilHealth ay para sa health lang po. Ang Philhealth funds ay pondo po ng health ‘yan kaya dapat gamitin po sa health,” he emphasized.

Go further explained that a legal injunction has been filed with the Supreme Court, hoping for a resolution that will stop the transfer of funds to the National Treasury and hopefully direct PhilHealth to utilize its funds appropriately for health services.

In the meantime, he urged Philhealth to fulfill its commitment to review and recommend lowering the premium contributions of direct members as assured by Ledesma earlier.

Moreover, Go said he will monitor the commitment of PhilHealth for an increase in case rates by up to 60% following the initial 30% increase after recent discussions, a move that aims to better support the medical needs of Filipinos.

“Pangalawa, please increase n’yo po ang case rate. Halimbawa, ‘yung iko-cover n’yo ang case rate na ito, sabi nila tinaasan ng 30%. After nung hearing nung Tuesday, sabi nila daragdagan nila, gagawin nilang another 30%, so magiging 60%. Abangan natin ito. At hindi tayo titigil hangga’t hindi nila nai-implement pag-i-increase ng case rate,” he said.

He also advocated for expanded benefit packages to include services like dental care, which are currently not substantially covered by Philhealth.

“Ito pong expanded benefit packages, halimbawa, dental services, ‘di nga ngayon ‘di nila kino-cover ang ilang dental services… halimbawa, cleaning at saka ‘yung iba pang dental services, hindi nila kino-cover,” Go pointed out.

“Sabi ko, dagdagan n’yo po ang inyong benefit packages. Marami pang iba d’yan, sabi nila magdaragdag daw sila. Please lang po, maraming klaseng sakit, hindi lang po limitado ang sakit,” he added.

Lastly, Go stressed the importance of amending the Universal Healthcare Law to reduce the premium contribution rate to 3.25% by 2025, highlighting the necessity of making healthcare more affordable, especially for overseas Filipino workers (OFWs) who contribute from abroad.

“Meron tayong… bill po ito sa senado amending the Universal Healthcare Law. Ang isinusulong po natin, babaan ang pagtaas ng premium contribution sa susunod na taon. Kasi sa batas, naka-peg na po sa 5%. So, isinulong natin na maging 3.25% lang sa 2025,” he said.

“Bakit kamo? Ang dami pang pondo ng Philhealth kaya dapat babaan ang premium contribution dahil bawat piso, bawat sentimo ay napakahaalaga para sa ating Pilipino ‘yan, lalo na po sa mga OFW na nagkocontribute po mula sa abroad at dapat mabigyan po ng maayos na serbisyo ang ating mga kababayan,” explained Go.

To end, Go emphasized the need for transparency and proper allocation of funds to benefit those in need. He stressed the importance of ensuring that the contributions directly aid the contributors, particularly the underprivileged and vulnerable sectors of society.

“Kung ano ang kino-contribute po nila dapat po ay mapakinabangan po nila, ibalik po ito sa tao. ‘Wag n’yong gamiting reserve fund po. Gamitin n’yo po sa mahihirap,” concluded Go.