Senator Go illustrates PhilHealth failing with tragic case study

Senator Christopher “Bong” Go, Chairperson of the Senate Committee on Health, delivered a privilege speech on 27 August, highlighting a major gap in how the Philippine Health Insurance Corporation (PhilHealth) handles case rates. Go used the case of one "Walter," a health officer from Camarines Norte, to illustrate the issue.

Walter, a dedicated PhilHealth contributor, faced inadequate coverage from the agency despite his years of service. After he was diagnosed with pancreatic cancer and saddled with a P4 million hospital bill, he and his family found out that PhilHealth would only cover P29,120 of this.

"Lumapit sa aming opisina, lumapit po sa Malasakit Center ang kanyang pamilya para humingi ng tulong sa hospital bill. Umabot sa apat na milyon ang kanyang huling bill sa ospital. P800,000 ang PWD discount,” Go said.

He criticized PhilHealth for its insufficient coverage, noting that Walter's total contributions amounted to P200,000 over a decade and a half. He had also been hospitalized previously, leading to a P6-million bill that the national insurer only covered P27,000 of.

“Fifteen years po nagsakripisyo si Sir Walter para sa pamilya, para sa bayan. Umabot sa P200,000 ang total contributions nya sa PhilHealth bilang mamamayan. More than 10 million in hospital bills, namatay na halos P60,000 lang suma-total ang deduction ng PhilHealth sa kanyang huling dalawang confinement,” Go said.

Go pointed out that despite an increase in case rates by 30% in January 2024, with a planned additional 30% increase, this may not address long-standing deficiencies.

“Paalala ko lang po sa PhilHealth, increase your case rates,” he urged.

He also cited data from the Philippine Statistics Authority showing that an angioplasty, with a present PhilHealth case rate of P30,000 to P39,000, can cost up to P300,000.

“Kulang na kulang talaga,” Go lamented.

Go concluded by urging PhilHealth to fulfill its promises, particularly to contributors like overseas Filipino workers (OFWs).

“Bawat piso, bawat sentimo ay napakahalaga para sa ating Pilipino, lalo na po sa mga OFW na nagko-contribute po mula sa abroad. At dapat mabigyan po ng maayos na serbisyo ang ating mga kababayan. Kung ano ang kino-contribute nila, dapat po ay mapakinabangan nila,” he said.

Super Health Center visit

Later, on 30 August, Go attended the turnover ceremony for a new Super Health Center in Barangay Alegria, Davao Oriental, part of his broader initiative to establish these centers nationwide.

Go emphasized the importance of Super Health Centers in providing primary care and early disease detection.

“Patuloy po akong tutulong sa pagpaparami ng Super Health Centers sa bansa sa abot po ng aking makakaya. Sa mga itinayong Super Health Centers, nakita namin kung gaano kalaki ang naitutulong nito sa komunidad lalo na sa rural areas. ‘Yun po ang layunin ng mga Super Health Centers, ang ilapit sa mamamayan ang serbisyong medikal ng gobyerno,” Go remarked at the event.

Go's initiative, supported by legislators, the Department of Health (DOH), and local government units, aims to establish over 700 Super Health Centers across the country. These centers will offer free consultations through municipal health offices, local government units, and PhilHealth’s Konsulta program.

During a relief activity at the Brgy. Poblacion covered court, Go and his Malasakit Team distributed food packs, vitamins, and other items to 720 underprivileged individuals, with some beneficiaries receiving additional financial support from the government.

Go concluded this visit by reaffirming his commitment to service: "Ako na inyong Senator Kuya Bong Go, ay patuloy na magseserbisyo sa inyong lahat. Naniniwala po ako na ang serbisyo sa tao ay serbisyo rin po yan sa Diyos. At ito po ang aking natatanging bisyo, ang magserbisyo sa aking kapwa Pilipino sa abot ng aking makakaya."