House Deputy Majority Leader and Tingog party-list Rep. Jude Acidre said that the failure of the Duterte administration to adjust PhilHealth case rates for six consecutive years is a major factor behind the agency’s inefficiencies and inability to provide adequate healthcare services. Acidre made the remarks during a recent Committee on Good Government and Public Accountability hearing, where systemic lapses and leadership instability within PhilHealth were brought to light.
PhilHealth Executive Vice President Eli Santos admitted under questioning that the last adjustment to case rates was implemented in 2012, despite a policy requiring reviews every three years. Throughout the Duterte administration, no adjustments were made except for increasing dialysis sessions to 144 annually. “So during the entire Duterte administration, PhilHealth did not make any adjustment to the rates?” Acidre asked. Santos confirmed, “Yes, Mr. Chairperson.” Acidre pressed further, highlighting that this failure occurred as healthcare costs surged, particularly during the COVID-19 pandemic, leaving hospitals underpaid and PhilHealth members underserved. “This failure to adjust the case rates periodically as per policy—and if you count it, there should have been at least three adjustments over the past 12 years—has exacerbated PhilHealth’s inefficiencies. Members are frustrated because the premiums they pay do not reflect the benefits they receive,” Acidre said. He illustrated the impact of inflation, noting that a conservative annual rate of 3% would amount to a 36% increase over 12 years. Instead, stagnant case rates have eroded reimbursements and widened the gap between PhilHealth’s commitments and its actual services. Acidre also scrutinized the leadership instability during the Duterte administration, where PhilHealth saw six presidents in six year
PHILHEALTH HEALTHCARE DUTERTE ADMINISTRATION CASE RATES INEFFICIENCIES
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