Stop PhilHealth raid

Health sector groups conducted a study recently that delved into the retrieval of the P89.9 billion in Philippine Health Insurance Corp. (PhilHealth) “excess funds” that were diverted to the National Treasury.

The study showed the amount was far from idle and should have been used for basic health services instead of being recycled by the national government.

Total premium subsidies provided by the government from 2010 to 2022 was P564.46 billion, of which PhilHealth paid out P553.599 billion, leaving P10.88 billion in subsidies by the end of 2022.

In 2023, the study estimated that the government contributed P61.229 billion of which PhilHealth could repay up to P58 billion, leaving it with an estimated P3 billion surplus last year.

PhilHealth would then have only P13.88 billion in excess funds compared to the Department of Finance’s (DoF) claim of P89.9 billion.

The study thus proved there was no surplus of P89.9 billion from subsidies to PhilHealth based on the comprehensive examination of the history of “subsidies” to the agency since it started in 2010.

“PhilHealth should re-examine its financial capacity to pay the entire amount demanded without resorting to raiding the surplus from the direct contributors — the formal and informal sectors which includes salaried workers, OFWs, professionals, vendors, and others,” UHC advocate Dr. Juan A. Perez III, a former undersecretary for population and development, said. UHC stands for Universal Health Care.

Perez indicated that based on industry computations, the amount that the DoF is recovering from PhilHealth is the members’ contributions and not excess money.

Any transfer beyond the estimated actual surplus of P13.88 billion would likely tap into the contributions of paying members in both the formal and informal sectors.

PhilHealth’s board must maintain transparency with its members about the origins of the claimed P89.9 billion surplus.

The consequences of the DoF’s move are far-reaching since diverting legally mandated premiums and encroaching on other PhilHealth funds could infringe on the constitutional and legal rights to health of the poor, elderly, and differently-abled communities.

“PhilHealth’s funds are the lifeblood of our nation’s healthcare, and depleting them without replenishment is akin to bleeding a body dry,” Perez warned.

Another backlash would affect the Universal Health Care Act which mandates that all Filipinos should receive basic health services.

The government should clarify the future of the National Health Insurance Program, particularly whether it will continue to cover the healthcare needs of its 22 million indirect contributors, given the precarious state of their premium funds, according to Perez.

By taking away premium payments, particularly for the poor, the social health insurance benefits of PhilHealth are affected, making the UHC law impossible to implement.

PhilHealth must provide clear evidence that it is not diverting a single centavo from direct contributors to the national government, according to Perez.

Both Finance Secretary Ralph Recto and Budget Secretary Amenah Pangandaman conveniently dismissed as fake news the assessment on the purported diversion of PhilHealth contributions in the transfer of the P89.9 billion funds to the central government.

Stakeholders in the health industry want a thorough review of the funds before all of the money is siphoned off from PhilHealth.

The DoF computed the excess in 2023 by using incomplete benefit payment data from PhilHealth since it did not account for 2023 arrears that should be paid in 2024.

The DoF also assumed that PHIC received P78.8 billion from the budget when the 2022 GAA only showed P61.229 billion, inflating the excess to P38 billion when it could be as low as P3 billion.

Also , for the second year, Congress reduced premium payments for the poor, elderly and PWDs to P40 billion in 2024, half of what is required to keep PhilHealth membership premium payments viable.

“It is appropriate for PhilHealth members to ask the board to stop its anti-poor policies, including jeopardizing the membership of the poorest and most vulnerable Filipinos. These are facts, not fake news” Perez said.

The passing of the UHC Law provided poor Filipinos a reason to rejoice, only to be spoiled by the DoF move to sweep state firms of arbitrarily branded excess funds to clear the way for Congress’ pork barrel.