The stink at PhilHealth

Exasperated” was how Harry Roque described President Duterte when he announced on Aug. 7 that a multiagency task force would investigate the corruption at Philippine Health Insurance Corp. It was a rather tame term for a man self-characterized as virtually amok-like in going after a mere “whiff” of rot in a government agency — “Yayariin ko kayo” was the latest threat flung by Mr. Duterte, this time at the bandits at the state health insurer. But the public has to wait for 30 days for Task Force PhilHealth to report on the results of its efforts.

It’s unclear if the public is holding its breath. Official chicanery at PhilHealth had been exposed and discussed, from cataract surgery scams to ghost dialysis treatments to “upcased” pneumonia, even to scandalous sums for an interim president’s travel and hotel arrangements to and from her home province of Bohol to her office in Pasig City. Yet no government action smashing the apparent culture of impunity at PhilHealth has yet been heard as taking place.

Now, with antifraud officer Thorrsson Keith and associates claiming that a “mafia” had made off with as much as P15 billion through the years, the big guns at PhilHealth are suddenly in poor health and pleading inability to take the hot seat in congressional inquiries. The alleged delicate conditions of PhilHealth president Ricardo Morales and chief operating officer Arnel de Jesus have expectedly been looked upon kindly, such being the nature of the caste system in this country. Whistleblowers such as those who detailed supposed PhilHealth payments for fake dialysis treatments were never similarly indulged; at one point, having been removed from the government’s witness protection program, they were served arrest warrants for an estafa case filed by the person they had accused. “What’s happening is meant to silence them,” intoned their lawyer Roque, then in between his past and future stints as Mr. Duterte’s spokesperson.

The ironic workings of the law as experienced by whistleblowers Edwin Roberto and Liezel Santos de Leon, since out on bail, occurred only in October last year. How long ago it seems. Now, their ex-lawyer, in announcing that Task Force PhilHealth would examine official wrongdoing other than what they raised in their complaint, has archly warned the “crocodiles” that the days of gorging are over: “Ang mensahe po sa mga buwaya ng PhilHealth: Tapos na ang mga maliligayang araw nyo dyan. Goodbye!”

We wish. In his State of the Nation Address in July 2019, Mr. Duterte condemned the corruption at PhilHealth involving ghost dialysis treatments — an apparent reference to the Inquirer report by Leila Salaverria and Jovic Yee published a month earlier.

Roberto and De Leon could not accept how a dialysis center in Quezon City was using ghost treatments to mulct the government. In July 2018, they reported the fraud that had been taking place starting March 2016 and submitted documentary evidence to responsible officials of PhilHealth. They were told they could not be extended protection, and indeed were given the runaround, but they held their ground. In January 2019, they followed up on their complaint with PhilHealth and were informed that it was pending. Nevertheless, they found out, the dialysis center’s accreditation had been renewed.

Still according to the Inquirer report, claims made by certain hospitals for cases of pneumonia in 2018 resulted in PhilHealth’s payment of P10.94 billion for the alleged treatments. Per the claims, more than 757,000 persons were afflicted with the respiratory disease in 2018, compared to the more than 295,000 recorded in 2010.

PhilHealth officials fearful to speak on record told the Inquirer that the practice was called “upcasing,” or claiming payment for, say, pneumonia when the patient’s ailment was only a cough or cold. The startling number of claimed cases notwithstanding, the Department of Health didn’t bother to declare a pneumonia outbreak.

Silent all this time, Health Secretary Francisco Duque III, ex-officio chair of PhilHealth and commander of the government response to the COVID-19 pandemic, is expected to be called to the Senate inquiry. This man who continues to enjoy the President’s trust and confidence has much to explain regarding PhilHealth’s purchase of overpriced IT equipment, the questionable release of funds under its interim reimbursement mechanism, the manipulation of its financial status, etc.

Yet weary Filipinos will note that the cards have long been on the table. What will matter is not so much what Duque has to say as what will ultimately result from the hearings: whether PhilHealth will be pulled out gasping from the swamp of plunder or, like many other drawn-out recitations of official misdeeds, be eclipsed by the stink of yet another sordid saga of high crime.

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