Take a scalpel to PhilHealth

Something is rotten and festering at the state-owned Philippine Health Insurance Corp. (PhilHealth), which has been entrusted with over P221 billion in funds to implement the Universal Health Care law.

Just over a year after this paper published a series of investigative reports on how PhilHealth had lost P154 billion through various forms of fraud including reimbursements for “ghost dialysis” and false claims, which led to President Duterte making special mention of the agency’s troubles in his fourth State of the Nation Address, PhilHealth is again embroiled in a corruption mess, this time exposed by its former anti-fraud legal officer who has since resigned out of disgust.

In a letter last week to the agency’s president and CEO Ricardo Morales, lawyer Thorrsson Montes Keith said he believes there is “widespread corruption” in the insurance firm, and that Morales—a retired brigadier general appointed by President Duterte to replace the previous PhilHealth chief embroiled in controversy, Roy Ferrer—“may have become the cuddler (sic) or may have been the new leader of the syndicate in (the agency).” Keith said he has “letter documents” proving his allegations.

In May this year, Senate Minority Leader Franklin Drilon had called for a reorganization of PhilHealth over the issue of allegedly overpriced COVID-19 testing packages that cost P8,150. Two weeks later, the cost of the testing package was scaled down to P3,409.

Also in May, government auditors submitted to the PhilHealth board an internal audit report that cited major discrepancies in the agency’s planned acquisition of a P2.1-billion IT system. The allotment included the amount of more than P734 million, which was not contained in the original budget proposal or was approved by the Department of Information and Communications Technology. The Commission on Audit also found that some of the equipment and computer programs PhilHealth was planning to buy were highly overpriced—by as much as P98 million for the computers, scanners, and other items.

More: Auditors took issue with the grant of P9.6 million to Catarman Doctors Hospital, a private hospital in Northern Samar, on April 15, with funds drawn from PhilHealth’s Interim Reimbursement Mechanism (IRM), a P30-billion financial package it has allotted for hospitals attending to COVID-19 patients. “The IRM was distributed to (hospitals) even to those (which) had pending cases, no accreditation and worse, no COVID-19 cases,” noted the auditors.

Taking off from that flagged transaction, Sen. Panfilo Lacson said last Friday that he would seek a fresh investigation into why PhilHealth released over P200 million worth of funds to hospitals treating only one COVID-19 patient each, with the money “released quickly.” In Bicol, P247 million was released in just two weeks, and in Eastern Visayas, P196 million was released in just a week, Lacson said, though “the (hospitals) have only one COVID-19 patient [each].”

Senate President Tito Sotto and Lacson have since sponsored a resolution calling for a hearing on Keith’s accusations next week. A thorough airing of the issues by an independent body is imperative, because Morales himself appears uninterested in scrutinizing the goings-on in his backyard. He quickly dismissed Keith’s charges as the “vengeful” comeback of a disgruntled employee who, he claimed, had wanted to be promoted to a position he “was not qualified for.” The lawyer was just being spiteful, Morales added.

Keith, for his part, claimed it was the agency that had been vengeful, delaying his salary and allowances since he started investigating the anomalies at PhilHealth.

The looming Senate probe would be the second such inquiry into corruption at the state health insurance firm. The hearings last year uncovered several instances of alleged conflict of interest between PhilHealth and the Department of Health, including DOH contracts with a pharmaceutical firm owned by relatives of Health Secretary Francisco Duque III, whose family also owned a building rented by PhilHealth.

Morales’ seemingly nonchalant attitude at the grave allegations facing PhilHealth may stem from the continued “confidence” in him by President Duterte, as expressed through the President’s close aide, Sen. Christopher “Bong” Go. “It’s just, maybe, the people under him (who) should be investigated,” Go told reporters at an online press conference.

Notwithstanding that early absolution, the Senate should leave no stone unturned and spare no one in its planned probe. An ailing PhilHealth, charged with the monumental task of ensuring adequate health care for all citizens but made infirm by internal strife and allegations of wrongdoing, is already a burden to the country in the best of circumstances—but amid a raging pandemic? As Lacson put it: “That such corruption occurred amid the COVID-19 crisis makes it more disgusting and abominable. It’s really revolting.”