Editorial

by Ernesto T. Solidum

PhilHealth Must Open Municipal Offices

“Universal Coverage of PhilHealth”, the topic discussed at Kapihan forum at Payag Street Lounge on February 16, 2013. The guests are Mr. J’Ruel del Rosario, Manager PhilHealth, Mr. Renato L. Dela Cruz – Human Resource Management Officers,  Ms. Winelia S. Geonanca – HIA II and Ms. Aimy Joy M. Desadorada – SIO III.

Atty. Ronquillo C. Tolentino cited RA 9241 that amended RA 7875 or an Act Institutionalizing National Health Insurance Program for all Filipinos and Establishing the Philippine Health Insurance Corporation for this purpose. Today, PhilHealth celebrates its 18th founding anniversary adopting the theme, “Synergy for Universal Health Care”. 

Socialized health insurance addresses the primary health needs of all Filipinos at nominal insurance premium of P1,800 per year. Considering the dismal level of poverty and unemployment existing in the countryside, it is a welcome development that PhilHealth coverage has been expanded to include 2.5 million domestic helpers and Case Type Z benefit package for catastrophic illness like kidney transplant, coronary heart disease, congenital heart defects, and others, said former Vice Governor Tolentino.

Mr. del Rosario is very optimistic that within this decade, PhilHealth can realize corporate target of 95 percent based on current accomplishment. Slogan adopted under the leadership of DOH Sec. Enrique Ona is, “Bawat Pilipino miyembro, bawa’t miyembro protektado, kalusugan natin sigurado”.

Del Rosario started with PhilHealth as an ordinary employee on February 1, 1999. All these years dedicated himself to quality service delivery since majority of the clienteles belongs to the poor. PhilHealth regular office hours is 8:00 AM but it opens at 6:30 because 80 percent of them desperately need supporting documentation record to liquidate hospital bills. To minimize congestion in the provincial office. PhilHealth opened two (2) outlets – Member Assistance Center in Boracay and PhilHealth Express Counter in Caticlan. In the planning stage are service desks in Ibajay and Altavas. Opportunity was opened to us that Gaisano Mall allows to use office space in the third floor for our permanent provincial office. We are ready to move there next week. Del Rosario is grateful that the Civil Service Commission has recognized their humble efforts in terms of compliance with the Citizen’s Charter.

Ms. Desadorado issued a call to all PhilHealth active paying members to execute individual policy contract insurance in line with new management policy. Filing as well as updating can only be done at the Provincial Office. Despite several paying options, she advised straight one year premium payment of P1,800 or at least on quarterly basis in order to get optimum benefits, said the Lady Accountant. 

To date, there are 85,760 PhilHealth cardholders in Aklan where premium payments are sponsored either by LGU’s or Priority Development Assistance Fund of Cong. Florencio T. Miraflores and Kasangga Partylist Representative Cong. Teodoro T. Haresco revealed Ms. Geonanca. In addition, the DOH under the National Household Targetting System has 32,201 beneficiaries while the provincial government under Gov. Carlito S. Marquez has 20,000. LGU Malay increased recently PhilHealth coverage by allocating P2 million as sponsorship insurance payment that could benefit 1,111 indigent households. 

The data of PhilHealth Aklan with total registered membership acquired through sponsorship of 85,760 may appear satisfactory. However, based on NSO data, total households in August 2007 is 433,219. This means only 19.7 percent is actually covered by Philhealth sponsored membership.

Even if voluntary and lifetime members are included, the highest accomplishment could be not more than 50 percent of the total households. It should be noted that some households may have two (2) or more active paying members since parents and children may be fully employed.

Considering the surprisingly low acceptance rate of health insurance of the government, there is cogent need for more effective and comprehensive info campaign for PhilHealth membership. Under the policy, members and their legal dependants – children less than 21 years old and their parents more than 60 years old are entitled to 20 percent discount of their bills in any PhilHealth accredited hospital. This is very significant especially for the less privileged in life to take advantage.

Mr. Del Rosario allayed fears that the new location of their office at Gaisano Mall could inconvenience the elderly and disabled members. Concerns and issues are working condition of elevator (subject to rotating brownouts despite standby generator), reimbursement proceeds spent because of impulse buying and clienteles subject to rules and regulation of the Mall (like business hours, security check, fire safety). A major consequence could be increased traffic congestion and smog in that stretch covering Kalibo Wet Market, ACC High School, Aklan Valley High School, Aklan State University (Kalibo Campus) and Aklan Cooperative Mission Hospital. It should be noted that parking lot of the Mall is at the back and access to both entrance and exit is very narrow.

There must be nationwide policy that medical practitioners desist from charging extra payment beyond that authorized by Philhealth. In surgical cases, they are given 30 percent as professional fee, reasonable enough and yet some of them want to raise the bar. It is heartbreaking that some physicians do not empathize with the plight of indigent patients. They are advised to “haggle” first over professional fees of surgeons and anesthesiologists before giving the thumbs down.

Perhaps, 18 years is not enough to convince the large majority of Aklanons to avail of package of benefits with a nominal sum. Consequently, the low acceptance rate poses formidable challenge to policymakers to analyze the weakest link. Perhaps, people rely so much of largesse of politicians to subsidize premium membership payments. If this is the case it smacks of patronage politics. Here we are seriously undermining the democratic process.

The decision of PhilHealth to open offices at municipal level is innovative and a giant step. This only requires synergy of all concerned. Happy anniversary PhilHealth. /MP