Wednesday, February 23, 2011

Poverty and Health Insurance Coverage


by ERNESTO T. SOLIDUM


"Philhealth: Tapat sa serbisyo, sapat na benepisyo, lahat panalo", is the theme of the 16th year anniversary celebration of the nation’s leading health insurance provider. The guest at the weekly Kapihan on February 19, 2011 at Smokehauz Resto & Bar is Mr. O’J Roel del Rosario, manager Philhealth, Aklan.

Dr. Ambrosio R. Villorente underscored the importance of good health to personal happiness. According to World Health Organization, health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmities.

Mr. del Rosario said the legal basis of National Health Insurance program is RA 7875 and its celebration institutionalized by Pres. Procl. No. 1400 issued in 2007. Today, Aklan has 44,437 Philhealth cardholders covering an estimated 60 percent of total families.

Del Rosario expressed strong optimism over upswing of individual paying members who are professionals, part time employees, fully employed household helpers, overseas contract workers and lifetime members. Actually, we have exceeded our planned targets. Record show Aklan bested other provinces in Region 6 as to the total cardholders and collection for the past year, revealed Del Rosario.

Philhealth subscribers had minimum monthly payment of P100, P200 for professional, and P350 for higher level income. The last two groups have their payment revaluated recently because of sky-rocketing cost of operation and on principle that those more fortunate in life subsidize those with less.

The policy insures that all Filipinos are given the financial access to quality health care. Normally 20 percent of all hospital bills (room and board, doctors’ fees, medical drugs) are deducted from the patients’ billing account. If patient happens to be a senior citizen, another deduction of 20 percent is effected. A total of 29 public health facilities in Aklan are accredited with Philhealth.

Access to socialized health insurance by poor segment of society has been made possible through financial assistance of Gov. Carlito S. Marquez and Cong. Florencio T. Miraflores, and Municipal Mayors of Nabas, Tangalan, and Kalibo. Malay LGU has approved an ordinance requiring all business establishments to register all their employees with Philhealth before issuance of business permits.

However, subsidies taken from Internal Revenue Allotment need constant updating since they are effective only for one year. Exception are lifetime members who have completed 110 monthly payments or retired from the service, said Del Rosario.

Direct benefit of a Philhealth cardholder and his beneficiaries is hospital confinement for 45 days per year. Beneficiaries include legitimate spouse, dependents, adopted child not more than 21 years old, parents 60 years old and above and congenitally defective children.

Undoubtedly, health is one of three primary concerns beside agriculture and education that needs to be given serious consideration by the Aquino Administration. Despite the presence of 134 doctors per 100,000 population, Dr. Jose Tiongko, MMG Federation Pres. said that 68 percent of Filipinos die annually without seeing a doctor. This is attributed to grinding poverty and unemployment. Majority lives in rural areas where medical services are not available.

This is supported by report of National Statistical Coordination Survey that only 2 out of 100 Filipino families were lifted out of poverty between 2008 and 2009. One family per 100 was lifted out of food poverty between 2000 and 2009.

Dr. James D. Welfensohn, Pres. of World Bank cited that high incidence of poverty in developing countries is due to rampant corruption in government. In addition, three fourth of 10 leading causes of mortality is directly traced to poverty.

With poverty incidence in Aklan recorded at 41.6 percent in 2010, there could be no guarantee that those living on one dollar per day could ever gain access to universal health care. High cost of hospitalization combined with expensive medical drugs cause frustration and confusion. Even if accommodated in a charity ward, a patient must buy almost all his medical supplies from drugstores rather than the hospital pharmacy. The result is insolvency and prolonged hospital confinement.

Inflation for the past 10 years effectively shrunk our peso to 60 centavos in purchasing power. This means quality services of Philhealth could be jeopardize if revenues are not adjusted to harsh economic realities.

Considering that an average hospital confinement cost P6000, the P100 monthly premium payment by cardholders is not really commensurate. Reckoned from past 16 years of inflation most likely this must be increased to P200. If this seem farfetched by indigent families, LGUs can fill the void through legislation otherwise they can be pushed to leftist organizations.

A month long celebration of Philhealth appears dull and uninteresting. It is best that once in a year, its employees engage in a civic tree planting program, medical mission or be involved in environmental sanitation.

By the way what are our plans with that huge P180 billion investment question could be addressed to Pres. and CEO Dr. Dey Aquino.

Philhealth indeed offers generous benefits to cardholders but has limited impact. Certainly, the 20 percent financial coverage could hardly be accepted as socialized scheme when half of the population are struggling for economic and physical survival. The minimum target must be doubled with appropriate counterpart funding from LGUs and the countryside development fund of Cong. Florencio T. Miraflores.

It appears the vitality of our nation is sapped by circumstances that are preventable. Truly, life is precious but without good health, life can be an image of death. Presently, we are simply hoping for the best response from our elected officials. /MP

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