Virus victim: Health care law

Philippine Health Insurance Corp. (PhilHealth) on Tuesday moved to postpone the implementation of the universal health care (UHC) law after its premium collection this year fell 90 percent due to the new coronavirus disease (COVID-19) crisis.The UHC was crafted to provide health insurance benefits to all 104 million Filipinos starting this year.

Facing lawmakers in an online hearing, PhilHealth president Ricardo Morales disclosed that the state insurer’s revenue might decline by about P100 billion this year until 2024, an outcome that would severely affect the agency’s capacity to provide primary health benefits to all Filipinos.

As directed by President Duterte, Morales also said PhilHealth had already dropped its plan to require overseas Filipino workers (OFWs) to settle their contributions before they could leave the country.

“PhilHealth recommends a general delay in the implementation of the UHC … and the primary care benefit expansion (program),” Morales told the joint congressional oversight committee on the UHC law chaired by Sen. Bong Go.

“We will be running a deficit by the end of 2020 and we will be maintaining the deficit up to 2024,” he said.

Many not paying premiums

PhilHealth’s current collection was just about 10 percent of what it was last year, Morales said. “The collection from the direct contributors is not significant. Since business activities stopped, they did not pay their premiums.”

He said the payment of PhilHealth’s voluntary members also “suffered a downturn,” as the new coronavirus pandemic resulted in an economic downturn and job losses.

Morales said the state insurer was expected to spend about P40.7 billion to pay for the medical bills of COVID-19 patients and other expenses related to the pandemic from February this year until January 2021.

He said this would financially burden the agency as Congress had allocated only P71.35 billion for UHC implementation this year, or less than half of its original budget request of P153 billion.

For 2021, Morales said PhilHealth had asked for more than P138 billion to finance various health programs under the UHC.

Calling on DOF, DBM

Go called on the Department of Finance (DOF) and the Department of Budget and Management (DBM) to immediately address the budget concerns of PhilHealth, reminding them that Congress had approved the UHC law to ensure the delivery of health services to poor Filipinos.

“It will be unacceptable if we will be suddenly told that PhilHealth has run out of funds. Our health-care system is very important,” Go told finance officials during the hearing. “We cannot afford to falter and fail (to fund UHC) in the succeeding years,” he said.

Go questioned PhilHealth’s previous directive mandating all OFWs to pay their premium contributions before they could be issued with overseas employment certificate (OEC).

“This is found in the IRR (implementing rules and regulations). But the UHC does not require OFWs to pay their premium prior to the issuance of (OECs),” Go told Morales.

“Why is there a provision in the IRR requiring the payment of contributions for OEC issuance?” he asked.

Morales did not directly answer Go, but reiterated that PhilHealth had made the premium payment of migrant workers voluntary during the pandemic.

Primary health care

Sen. Risa Hontiveros and Quezon Rep. Helen Tan, cochair of the joint congressional panel, both quizzed Morales for his recommendation to move the implementation of the UHC to a later date. They pointed out that Filipinos would need medical assistance from the government amid the health crisis.

“If PhilHealth would be spending for COVID-19, it would be wiser to spend for primary health care in order to preempt higher expenditure for serious health-care expenses,” Hontiveros said.

A lawmaker from Mindanao urged PhilHealth to settle billions of pesos in reimbursement claims of hospitals all over the country, lest they be forced to close down or downscale services in the middle of a pandemic.

“We don’t want our hospitals to close, downscale services nor lay off medical personnel because of nonpayment of claims by PhilHealth,” Cagayan de Oro Rep. Rufus Rodriguez said in a statement.

In House Resolution No. 970, Rodriguez asked his colleagues in the House of Representatives to express their collective sense urging the state insurer to settle the hospitals’ unpaid claims. 

He quoted a statement by the Philippine Hospitals Association of the Philippines that PhilHealth owed its members P14 billion as of December 2018 and P4 billion at the end of 2019. The group is composed of 733 hospitals with 44,700 beds nationwide.

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