PhilHealth coverage vs savings hit
SOME congressmen scored the Philippine Health Insurance Corporation (PhilHealth) for reporting an accumulated reserve fund totalling P463.7 billion in 2023, which they said could have otherwise been used to expand its benefits coverage of members.
“If there’s an excess, we should either lower the premium (charge) or increase the benefits coverage (for members),” Party-list Rep. Ray T. Reyes said at Tuesday’s House panel hearing.
He said the state health insurer is somewhat being “unfair” as the total in contributions it collects from its members appear lower than the value of the health benefit being provided to them.
PhilHealth started hiking its monthly contribution rate incrementally in 2019 so that it may be able to sustain the benefits being provided to its members.
The contribution rate this year stands at 5% from 2.75% five years ago.
“We’re concerned not only in increasing the benefits of PhilHealth but also on the sustainability of the program,” PhilHealth Executive Vice President Eli Dindo D. Santos told the House panel when he was asked why the state insurer is still asking for government funding despite accumulating almost half-a-trillion in excess fund.
Mr. Reyes said PhilHealth violates its charter stating that the reserve fund should not exceed two years’ worth of projected program expenditures as the agency has a total operating budget of P142.6 billion annually.
The PhilHealth is in the process of expanding its benefit packages to follow its charter, Mr. Santos said. However, the state health insurer cannot reduce its monthly contribution rate on its own as it needs to be amended by Congress.
Commenting on PhilHealth’s membership charges, Marikina Rep. Stella Luz A. Quimbo said: “With the amount you charge to (your members), how come you’re providing so little to the people?”
She alleged PhilHealth is being unfair to its members as the value of the benefits it provides to its members is lower than what they collect.
Philhealth spent P75.8 billion for its benefit pay-outs last year, almost half of the amount paid by state insurer in 2022 at P143 billion and P140 billion in 2021, Mr. Santos told the panel.
“How come (PhilHealth) spent so little in benefit spending in 2023?” Ms. Quimbo asked.
Mr. Santos said PhilHealth’s uptick in benefits spending in 2021 and 2022 is due to COVID-19 claims. — Kenneth Christiane L. Basilio