Philhealth Coverage Decidedly Important

by ERNESTO T. SOLIDUM

Mr. J’Roel del Rosario-Manager, Philhealth Aklan

explaining to the tri media members the importance of Philhealth.

On February 14, 2010 or Valentine’s Day, Philhealth as a government owned and controlled corporation shall celebrate its 15th year of remarkable service to her people. Its universal health care program was conceptualized and implemented during Pres. Fidel V. Ramos’ term. It eloquently speaks of a revitalized social agenda mitigating health care cost where the government provides a minuscule 1.6 percent allocation from a huge P1.1 trillion budget. For developing economies like the Philippines, the World Health Organization (WHO) recommends a minimum of 5-10 percent to insure that people particularly the disadvantaged groups avail of critical medical services.

Weekly Kapehan guest at Smokehaus Resto and Bar on January 30, 2010 was J‘Roel del Rosario – Manager, Philhealth. He was later succeeded by Mr. Rey Langit who was in town for a speaking engagement at Aklan State University, Banga.

Mr. Del Rosario said that annual contribution of Philhealth to the national economy is worth P82 billion. It is P54 million in the local level. Her clienteles in Aklan has grown to 54,000 households. Thanks to the able support of Gov. Carlito S. Marquez and Cong. Florencio T. Miraflores who both raised P10 million seed fund. Del Rosario believes that P1.8 million is still unused and that must be released as more household are still affected by global recession.

"There are only two classes of memberships namely: individual paying member of P100-P120 per month or premiums financed by local govern-ment units (LGU’s) and life time members in the case of government retirees. An ID card entitles the bearer and any of his family dependents 20 percent discount from medication and hospital expenses. Privilege is given to all accredited hospitals throughout the country and even abroad. In the later case, reimbursement claims must be supported by proper documents upon patients’ return.

Del Rosario commended LGU Malay led by Mayor Ceciron Cawaling for passing an ordinance three years ago that requires all tourist resort/business establishments to register their employees with Philhealth. Meanwhile, Mayor Romeo M. Dalisay of Nabas and Mayor Jed Tirol, succeeded by Mayor Gene Fuentes of Tangalan both 4th and 5th class municipalities respectively through a resolution have appropriated funds from internal revenue allotment for health insurance coverage of their barangay constituents.

In order to expedite medical services and prevent clogging of hospital patients at Dr. Rafael S. Tumbokon Memorial Hospital, Philhealth provides capi-talization funds to Rural Health Units equivalent to P300 per beneficiary per year. Disposition of the fund is 80 percent for medical supplies and laboratory expenses while 20 percent is for medical personnel directly involved in the program. Referral hospital in the case of Nabas and Tangalan is the Ibajay District Hospital.

Del Rosario said that on the macro level, Philhealth has achieved 153 percent coverage of target beneficiaries. However, on the micro level, they have yet to serve municipalities of Altavas, Malinao, Madalag, and Libacao, all classified as economically depressed areas. Present thrust is geared on sustained membership collection and infor-mation/education/communication.

It would be pre-posterous to claim that 153 percent has been achieved by Philhealth at macro level when needs at micro level have not reached. Clearly, more hard work and perseverance are needed rather than to exude hot air. In the case of Aklan, the 54,000 households presently covered by Philhealth constitute 55 percent of total population as reported by Aklan Population Office in 2007. This figure may not vary significantly over a two year period since annual population growth registers only 1.29 percent.

Impressive Philhealth Service

Many would be impressed by service and reliability of Philhealth personnel in Aklan who could be rare these days. Replacement of lost ID cards could be done in two minutes.Processing of membership application or claims finished within an hour. Business transaction could be made on official days till Saturday morning. Office reliance on electronic gadgets makes it vulnerable to power outages. Hence, they installed stand by generator. Del Rosario is oftentimes on "off duty" seeing to it that hospitals and their personnel comply with rules and regulations governing accreditation. Challenging? "Yes indeed," said this energetic manager but experience is very rewarding.

Philhealth’s unassuming role in grassroots insurance coverage to people regardless of social status and nature of health problems constitute a humanitarian endeavor that should be cherished by everyone. Actually, insurance premium payments are just a pittance of potential benefits to cardholders and their families. It would be greatly appreciated if P1.8 million residual funds be released to destitute towns like Libacao and Madalag. Their physical and economic upliftment should be our corporate concern to secure peace of mind and vital financial safety net. /MP