APPARENTLY frustrated as the Philippine Health Insurance Corp (PhilHealth) management is trying to work a “broken system,” Health Secretary Teodoro J. Herbosa on Friday hit the management of the state-run health insurer for treating its funds “like a pension fund.
APPARENTLY frustrated as the Philippine Health Insurance Corp management is trying to work a “broken system,” Health Secretary Teodoro J. Herbosa on Friday hit the management of the state-run health insurer for treating its funds “like a pension fund.
” “That’s why their emphasis has been to protect the fund and resist paying the health benefits of its members!” Herbosa’s statement read, clarifying that Philhealth Management is distinct from the board of directors. “We need to fix this broken system,” added Herbosa, who is also the chairman of the PhilHealth board of directors.“It seems many do not understand the difference between pension and health insurance. Pension insurance and health insurance serve distinct purposes, providing financial protection in different ways,” he said. PhilHealth, he stressed, is not like a pension insurance like Social Security System and Government Service Insurance System .Also on Friday, the Medical Action Group and Action for Economic Reforms called the 2025 Corporate Operating Budget of the Philippine Health Insurance Corporation a “do nothing” budget. It’s a “do nothing” budget because it shows an increase of only 10 percent when its expenditure for 2024 was already higher by 22 percent over the previous year, with two months yet to go . The new packages approved in the last six months are likely to increase reimbursements in 2025 to well over P200 billion. Direct contributors–many of whom are from the working class, OFWs, and informal workers–are expected to cover P202 billion of the PhilHealth budget, which will cover their own reimbursements as well as the reimbursements of indirect contributors–the indigents, older persons, and persons with disabilities, according to AER and MAG. Reimbursements by indirect contributors have exceeded those of the direct members in 2024, with seniors getting 30 percent of all reimbursements. This trend will likely continue in 2025. PhilHealth’s 2025 COB can only support the existing packages since the increase of 10 percent from 2024 will be insufficient to cover the increase in benefits payouts which increased during the last six months of 2024. This limited budget will further delay any significant rollout of the primary care benefit package–the Konsulta package–that supports the mandate of the Universal Health Care to register all Filipinos with a primary care provider. Currently, Konsulta provides reimbursements for only one percent of the Filipino population. The full implementation of the Konsulta package will cost PhilHealth P194 billion annually, providing a P1,700 primary care package for each of the 114 million Filipinos. The package was approved in 2022, and if it had been rolled out nationwide then, PhilHealth would not be accused of a “surplus” of P150 billion and reserves of hundreds of billions of pesos, the two groups pointed out. “The Konsulta package can drastically change the face of primary care in the country, which the Department of Health admits is underfunded. The country spends $6 per capita for primary care while average expenditure of primary care in Asean is $20 per capita a year. “Underspending in primary care has resulted in overcrowded government hospitals. DOH has reported that hospitals in Central Visayas, Eastern Visayas, and Bicol have occupancy rates of over 180 percent. This leaves no room for mass casualties and epidemic surges.” The actual premium contribution collected from 36,738,227 direct contributors now stands at P192 billion. Without any premiums for 25,340,992 indirect contributors from the government, the entire 2025 contribution of direct members will be fully expended next year on reimbursements alone. The bicameral conference committee’s defunding of PhilHealth, added the advocates, “destroys social health insurance, particularly the principle of solidarity and the pooling of resources, leaving the working class to carry the burden of funding PhilHealth through contributions deducted from their hard-earned monthly salaries.” In addition, even the full service coverage of longstanding and Sustainable Development Goals-related benefits and packages like the maternal care and newborn care package and TB Benefit will not be sufficiently funded in this status quo budget. This underfunding already manifests itself in the country’s increasing maternal and infant mortality rates, higher incidence of tuberculosis, and rising occupancy rates of DOH hospitals. Despite his criticism of the executive officers of PhilHealth, Herbosa as chairman was also slammed by the two groups: “It is most shameful that the PhilHealth President, Emmanuel Ledesma, Jr. and concurrent PhilHealth Chairman, Health Secretary Teodoro Herbosa have condoned, and have even excused, the emaciated PhilHealth budget. We thus direct our appeal to President Ferdinand Marcos, Jr. to immediately correct this unfair and unlawful budget by ordering Congress to restore the full premium subsidy of P150 billion for 25 million indirect contributors.”Claudeth Mocon-Ciriaco is a grant recipient and fellow of 2017 media fellowship program by Probe Media Foundation Inc. She is a graduate of Bachelor of Mass Communication from the Pamantasan ng Lungsod ng Maynila . After graduating in 2000 she immediately worked as a newspaper correspondent for Today Newspaper until 2005. Within those five years in Today Newspaper, she was assigned to cover the Eastern Police and Metropolitan Manila Development Authority , the Catholic Bishops Conference of the Philippines , Rizal Province, and the Departments of Labor and Employment and Tourism . In October of 2005, she became a correspondent for the Philippine Business Daily Mirror Publishing, Inc. She covers Health, Education, MMDA, the local government units in the eastern and southern portions of the metropolis, and Rizal Province.EU delays by one year sked of exports’ deforestation rules
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