PhilHealth and public trust

The Philippine Health Insurance Corp. (PhilHealth) announced last week an increase in premium contributions—“to ensure sufficient funding for the health care benefits” provided under the Universal Health Care (UHC) law, it said—and promptly found itself again at the center of a public storm.

The UHC law does mandate that PhilHealth increase members’ contributions at 0.5 percent increments beginning 2021, until it reaches the 5 percent limit in 2025. Under the new payment scheme that raised contributions to 3.5 percent, those earning below P10,000 will have to pay P350 per month, while those earning P70,000 per month or higher have to contribute P2,450 a month. People earning between those sums are expected to pay the state health insurer from P350 to P2,449.99 a month.

The increase has been described as “inhumane,” “untimely,” and “onerous,” coming as it did in the midst of the coronavirus pandemic which has thrown the country into an economic tailspin, with businesses closing down amid quarantine restrictions, Filipinos losing their jobs, and people barely subsisting on government handouts.

So fierce has been the backlash against the PhilHealth rate hike that President Duterte, who has consistently defended its top officials embroiled in corruption scandals, on Monday ordered the agency to postpone the collection of increased premiums, despite the lack of a law needed to defer it. Sen. Bong Go, chair of the Senate committee on health, said the President was willing to sign a measure deferring the hike in premiums, or to approve more funds to help out the agency which has been besieged by fraud allegations.

While insisting that PhilHealth stands to lose P13 billion with the deferment, its spokesperson Rey Balena said it would revert back to collecting the current 3 percent premium, an arrangement that would be in place until Congress passes a law allowing the postponement of the scheduled adjustment.

“Should there be no new legislation passed for this purpose, the state health insurer will proceed with the scheduled premium rate and ceiling as provided for in the UHC law,” Balena added.

Despite the prospect of a well-funded UHC providing Filipinos affordable and adequate health care, why is there so much resistance and umbrage about increased premiums that would have made that prospect a reality?

That might well be a P15-billion question. That’s the amount allegedly involved in the plethora of irregularities that PhilHealth has yet to answer for. In a Senate inquiry in August last year, the agency’s former anti-fraud officer Thorrsson Montes Keith claimed that its top executives might have pocketed some P15 billion in funds through fraudulent schemes involving false or overblown claims from nonaccredited hospitals. Several of these officials, including its resigned former president and CEO Ricardo Morales, are now facing administrative charges.

As Sen. Panfilo Lacson put it, “Why punish members with higher premiums for the benefit of the corrupt and the incompetent?”

The agency insists that the P15 billion allegedly siphoned off by corrupt officials has been properly accounted for. A statement it released last Monday claimed that P13.03 billion, or some 87 percent of the disputed P14.97 billion, have been released to health care institutions and liquidated, “as of Dec. 13, 2020.”

But the agency’s record of “rampant corruption through the years,” as some senators have described it, has simply mowed down its credibility. In fact, its continued operational losses, presumably from corrupt practices that have bled it dry, have prompted some lawmakers to urge the government to throw it a lifeline.

“We cannot afford to let PhilHealth continue operating on losses,” said Senate Minority Leader Franklin Drilon. “If PhilHealth’s fund is not raised by way of substantial government intervention, its credibility to reimburse hospitals will be put into question.” Drilon said the state health insurer was allocated only P71 billion in the 2021 budget and was expecting a net operating loss of P90 billion in 2020 and P147 billion in 2021. It also has an outstanding debt of almost P800 million to the Philippine Red Cross for its COVID-19 testing services.

Amid such dire straits, the state health insurer has tremendous odds to buck to regain the public’s trust, and thence to be able to impose, without public opposition, a premium hike that would ensure its continued operations and much needed services. Unless the government comes down hard on PhilHealth to get it to shape up and heal itself—that is, that it begins showing convincing resolve to weed out corruption in its ranks, account for the use of taxpayer money in an honest, transparent manner, and improve its services to the people—its actions, while well-meaning and legally sound based on the UHC law, can only be met with suspicion and resistance.