The current issue involving the supposed “excess funds” of the Philippine Health Insurance Corp. (PhilHealth) is a self-fulfilling prophecy resulting from government’s neglect of health across several administrations, from Gloria Macapagal Arroyo to President Marcos.
Arroyo started the ball rolling by making PhilHealth the platform through which she tried to deodorize her rule. She then insidiously transferred funds from the Overseas Workers Welfare Administration to PhilHealth. Benigno Aquino III made PhilHealth the focal point of his Kalusugang Pangkalahatan program and turned a blind eye to the agency’s many infirmities. Rodrigo Duterte continued to capitalize on PhilHealth through largely performative, populist programs that culminated in the fast-tracked Universal Health Care (UHC) Act. All that Mr. Marcos had to do was reap the rewards.
Two laws enabled the government to fatten the calf before bleeding it. The sin tax law was meant to provide much-needed additional funds for health. New revenues were earmarked for public health spending but landed in the coffers of PhilHealth instead. Similarly, under Section 37 Chapter IX of the UHC Act, funds of the Philippine Amusement and Gaming Corp. and the Philippine Charity Sweepstakes Office intended for indigent patients would go to PhilHealth, further increasing its funds. All of these should have translated to higher support value for Filipinos, less out-of-pocket expenses, and broader, more accessible services. But these did not happen and the bloated funds are now ripe for the taking as “excess.”
To be clear, there is no such thing as “excess funds” in health care. Whether in public health or health service delivery, whether for hospitals or barangay health centers, the public health-care system is grossly underfunded and resource-poor. Government hospitals are given only a fraction of the amount they need to operate. This burden is being passed on to Filipino patients, not PhilHealth. The so-called success of Malasakit Centers is proof of this.
No government facility is given 100 percent of what it needs to function—not in funds, not in health personnel, not in equipment and supplies. On the other hand, Filipinos are paying for their health care three times: through taxes, through PhilHealth premiums, and from out-of-pocket expenditure when they actually get sick. In short, “excess funds” are due to unjust government exactions and undelivered government services.
“’Pag ayaw, maraming dahilan. ’Pag gusto, maraming paraan.” The current brouhaha over health funds reveals that the current dispensation is no different from previous administrations as to how it uses health care: always in the name of the people but never truly for them.
Gene Alzona Nisperos M.D., College of Medicine University of the Philippines Manila