The Philippine Health Insurance Corp. (PhilHealth) assured its members that the agency has not been remiss in improving its services and benefits and said it is ready to comply with whatever the Supreme Court would decide on the controversial transfer of P89.9-billion of its excess funds.
Dr. Israel Francis Pargas, PhilHealth senior vice president for Health Finance Policy and concurrent spokesperson, said in the Sept. 3 episode of VERA Files’ Tres from Tress podcast that the corporation recognizes the criticisms and opinions of civil society groups and its members opposed to the return of funds to the government, adding it was only following the law with regards to the transfer.
“Kami naman po ay susunod din kung ano man ang maging desisyon ng ating korte,” he said. (We will comply with whatever the court decides.)
The supposed idle funds, accumulated over several years, prompted Finance Secretary Ralph Recto to order its transfer to the national treasury to cover unprogrammed allocations in the General Appropriations Act (GAA) for infrastructure and social service projects.
A petition challenging the constitutionality of the transfer was filed on Aug. 2 before the High Court by the Philippine Medical Association, Sen. Koko Pimentel, and former Finance undersecretary Cielo Magno, among others.
The first tranche of P20 billion was returned to the Bureau of Treasury last May, and another P10 billion in August. Two other tranches of P30 billion and P29.9 billion are set to be transferred in October and November, respectively, unless the SC issues a temporary restraining order (TRO) before then.
Not all subsidized premium used
Explaining the accumulation of surplus funds, Pargas said not all of the government subsidies provided under the GAA for premium contributions of lifetime members (senior citizens) and those without the capacity to contribute such as indigents and persons with disabilities, end up being utilized.
“‘Yun binibigay sa aming pera ng gobyerno ay merong kaakibat na bawat pangalan kung kaninong premium siya papasok … Hindi naman lahat ay nagkakasakit, so maaaring ‘yung premium na ibinabayad sa atin ay hindi lahat nayu-utilize,” the spokesperson said.
(The subsidy provided by the government goes to specific people whose premiums are subsidized … Not everyone gets sick, so it is possible that the premiums [PhilHealth gets] through subsidies are not utilized entirely.)
Health reform advocates such as Dr. Anthony Leachon, who strongly opposed the transfer, had criticized PhilHealth for letting its unused funds stagnate.
“Kahit meron kang reserve funds, dapat zero sum. Ibig sabihin, gagamitin ho ‘yon. At hindi savings bank ang PhilHealth kasi ginagasta ‘yan para sa kalusugan,” Leachon said during the Aug. 14 episode of the podcast.
(Even if you have reserve funds, it should be zero sum. That means it should be used. PhilHealth is not a savings bank because the funds are meant to be spent on health.)
Pargas reiterated that before the order to transfer funds, PhilHealth has been working to expand its benefits and improve services to better serve its members.
Despite the suspension of increase in contribution rates in 2023 (to 4%), the state insurer has been progressively coming out with and expanding its benefit packages since the previous year. Last April, coverage across all packages was increased by 30% and applied retroactively on eligible hospital admissions from Feb. 14.
The PhilHealth spokesperson shared that further expansion of coverage is expected before the end of the year, including another possible increase of 30% on all packages. This was echoed by chief executive officer Emmanuel Ledesma during the Senate hearing on the agency’s proposed budget for 2025.
Pargas also announced other projects in the pipeline including the digitalization of member records and the PhilHealth Plus program. (Read Rising hospital costs cancel out expanded PhilHealth benefits)
