Pro-Poor Philhealth Social Insurance

Pro-Poor Philhealth 

Social Insurance

by Ernesto T. Solidum

The Weekly Kapihan last week discussed the topic, “Philhealth and Kapotodcco Services” held at NVC Carmen Hotel. The guests are Aimy M. Derequito, Social Insurance Officer III and Reynaldo A. Agcawili, Pres. Kalibo Poblacion Tricycle Operators and Drivers Credit Cooperative. (KAPOTODCCO).

Ms. Desaporado said that the mandate of Philhealth is based on RA 10606 or Universal Health Care Law. As such, all Filipino families irregardless of economic, political or religious creed are given free access to primary health care provided by accredited hospitals and Rural Health Units (RHU).

The point of Care (POC) program addresses non-Philhealth members belonging to indigent families who seek emergency medical relief in government hospitals. Routine procedure includes checking ID’s such as 4P’s beneficiary, senior citizen for validation. Interviews are done by trained Social Workers and upon evaluation recommend patient as beneficiary of the program. The privileges include physical check-up, supply of medical drugs and in-house confinement from first day until his hospital discharge. There is no billing balance policy making it the best pro-poor program of the government, Ms. Desaporado averred.

RHU’s Primary Care Package is based on National Household Targetting System (NHTS) administered by Provincial Health Office (PHO). Under this program, the bonafide families seeking medical assistance are given free services namely: physical check-up, BP, diagnostic exam of urine, blood, sputum, visual among others. These privileges are extended to OFW’s, DepEd personnel and accredited organized groups such as Grace International Church in the Philippines and Catholic Diocese of Aklan. These services if done in private hospitals or clinics may cost P1,500 but with Philhealth it is gratis et amore.

In order to keep abreast with modern medical trends, Philhealth coordinates with LGU’s to provide periodic in-service trainings. The desired lifestyle is admonished such as repudiation of vices like drinking, smoking and gambling but to engage in physical exercise.

Mr. Agcawili maintained his composure listening to a litany of complaints against undisciplined and erring tricycle drivers. Charges are legitimate and reasonable such as driving without license, non-wearing of uniform, overcharging passengers, no signal light, non-conveyance of passengers, colorum or no license to operate, dishonesty among others.

Well, it is urgently requested that complaints be formally filed with the Secretary to the Sanggunian Bayan of Kalibo. Important information are body number of tricycle, time and date of incident and/or personal effects that may have been lost. Cases will be promptly acted upon to settle them based on incontrovertible facts and levying of fines or penalty to guilty party. “We want to impose discipline and rid our ranks of undesirable individuals,” Agcawili disclosed.

The problem of undiscipline tricycle drivers has been with us since the 1960’s. Despite countless seminars conducted by LTO, LGU and NGO’s the problem has not abated. This is due to the road holding capacity for tricycles in Poblacion, Kalibo which is limited to 1,500 units only while there are 3,000 actively competing for limited passengers and cargo, a cut throat competition leading to traffic violation and even violence.

One way to solve traffic mess is to limit the number of  tricycle units to operate in Poblacion, Kalibo. Operators and drivers may shift to multicab or light passenger jeepneys. The franchise routes may be given by LGU’s to operators servicing semi-urban barangays bringing passengers and their baggage (fruits, vegetables) to their destination. This will provide safe, secure and comfortable ride never before experienced by commuters.

Kalibo is a tourism hub and gateway to Boracay. One notable complaint of foreigners is the variable fares in public transport. Another is the untrained tricycle drivers to extend help to tourists. In countries like Thailand, Malaysia, and Singapore, there is standard operating procedure that draws praises from tourists. LGU, DOT, LTO and NGO’s can train transport sector operators from Kalibo, Malay, Tangalan, Ibajay, Nabas, Buruanga and Libacao on Personality Development, Traffic Rules and Regulations and Tourism Site/Objectives.

On Universal Health Care program, it is commendable that Philhealth has finally reached 100 percent of its target households. Philhealth Aklan has reinvented itself under Alexander Padilla, Pres. and CEO. However, there is overwhelming request to peg the annual premium payment at its previous rate of P1,200. This will allow poor families to avail of social benefits of Philhealth at affordable cost.

DOH in the 2015 national budget is allocated P102 billion, P32 billion for Philhealth and P1.8 billion contributed by European Union for Philippine Health Reform. It is unfortunate that according to former DOH Sec. Esperanza Cabral, DOH is seriously undermanned at a ratio of 2.3 health service provider (doctor, nurse, midwife) per 10,000 population. The optimum ratio recommended by WHO is 24 per 10,000 population.

Moreover, there is additional funding of P32 billion from the Sin Tax Reform Law. It is humbly suggested that ratio be increased from 2.3 to 6.0 per 10,000 populations. This could be attained by deploying doctors, nurses and midwives in rural areas making their services accessible to poor families.

The data from National Statistic Authority (NSA) show that the country has 221,000 registered jobless nurses. The Philippines is number one exporter of nurses in the world while our licensed doctors are second only to India. Disproportionate or skewed ratio of medical personnel to the population results in death of seven (7) Pinoys without seeing a doctor. A Mona Lisa song states it all: “They just lie there and they die there.”

Indeed Philhealth stands out as a model of social insurance reaching out to its less privileged sector. /MP