By all means, the Philippine Health Insurance Corp. (PhilHealth) should immediately implement its plan to provide 100 percent coverage for dialysis sessions to help hard-up Filipinos suffering from chronic kidney disease (CKD).
Last Tuesday, PhilHealth executive vice president Eli Dino Santos said in a press conference that the state health insurer plans to double to P5,200 its P2,600 benefit package for PhilHealth patients and qualified dependents diagnosed with CKD stage 5.
The current package covers 156 hemodialysis sessions per year, from only 90 sessions in 2023. All told, the PhilHealth coverage for patients with stage 5 CKD has increased to P405,600 per year from P234,000 previously.
In the joint press conference with Santos, ACT-CIS Rep. Erwin Tulfo pointed out that the P2,600 benefit package for dialysis was not enough as it does not cover the erythropoietin injections given to patients with low red blood cells after the procedure, an out-of-pocket expense of some P900 to P1,500. As a result, patients end up soliciting aid from other government agencies to cover this extra cost, Tulfo said.
Premium rate hike
With PhilHealth doubling the P2,600 package to P5,200, “[d]iabetic and dialysis patients don’t have to cash out anything,” Tulfo added.
While the plan for the expanded package still needs to be discussed by the PhilHealth board, Santos said he and Tulfo have agreed that this could be implemented within 30 days.
With PhilHealth reportedly having at least P463 million in reserve funds, there really is no reason why it cannot expand this particular package. It is after all just one of the many benefits that this state health insurer offers both its paying and nonpaying members as part of the universal health coverage for all Filipinos. Santos added that PhilHealth can expand the dialysis coverage to P5,200 without having to raise its members’ contributions.
This is good news indeed, as PhilHealth has ordered a premium rate hike of from 4 to 5 percent effective Jan. 1 this year despite objections and reservations raised by, among others, Health Secretary Teodoro Herbosa. The hike will mean a P500 monthly contribution from its members.
It’s a position that President Marcos seems to support, having earlier said that the rate hike was “under review,” and adding that he wanted to see the “cause-benefit analysis” of raising the premium.
Public trust
“If there is a benefit, [and if] we can justify the increase, then we’ll do it. But if we cannot, then we won’t. It’s that simple,’’ Mr. Marcos said in February. The Presidential Communications Office said the decision has not been made.But PhilHealth said it has received a letter from Executive Secretary Lucas Bersamin, indicating that the President posed no objection to the increase. So which is which?
For sure, PhilHealth coverage is an indispensable help to Filipinos, the majority of whom cannot afford the prohibitive cost of hospitalization, treatment, and medication. With unconscionable corruption allegedly involving top PhilHealth officials being exposed recently, the health insurer must first demonstrate its prudent use of funds before seeking to increase its members’ contributions.
Expanding benefit packages for chronic ailments, such as CKD, is one sure way of regaining public trust.
Epidemic of renal failure
But beyond providing hospitalization and treatment packages, the government, through the Department of Health, must be proactive in promoting health and the prevention of life-threatening and chronic illnesses.
Kidney disease is the seventh leading cause of death among Filipinos, according to the National Kidney and Transplant Institute (NKTI), which reported that one Filipino develops chronic renal failure every hour, which translates to 120 Filipinos per million population in a year.
As of 2021, at least seven million Filipinos are afflicted with CKD, according to Philippine Society of Nephrology fellow Dr. Vimar Luz. But this figure is well below actual count, as only about 10 percent are properly diagnosed, he added. Diabetes and hypertension are the top causes of kidney disease, Luz said. Noted NKTI: “The cost of medical treatment for kidney disease is really exorbitant, beyond the reach of ordinary patients. Renal transplantation is limited due to the expense and the shortage of donors.”
Efforts must thus be focused on the prevention and progression of renal diseases, it added.
“Strict blood pressure and glycemic control and the adoption of [a] ‘healthy lifestyle’ play a major role in reducing if not totally controlling the epidemic of renal failure[,] and this can be achieved through proper education,’’ the NKTI said.
So even while some Filipinos can count on PhilHealth to help them cope with medical expenses, the best strategy is to stay healthy and seek early consultations to avoid life-threatening and costly illnesses.