At a Senate hearing on 10 September, Senator Christopher "Bong" Go called for PhilHealth reforms after May Dan Jalgalado testified about her late husband, Camarines Norte health officer Walter Jalgalado, who died of pancreatic carcinoma.

Despite contributing over P200,000 to PhilHealth, Walter’s P6-million hospital bill was only partially covered, with just P27,000 reimbursed—an issue Senator Go criticized.

In his opening statement, Go expressed his deep concern over PhilHealth’s insufficient case rates, which have caused patients and their families to shoulder exorbitant out-of-pocket expenses. He pointed to the case of Walter Jalgalado as a "classic example" of PhilHealth's shortcomings.

"PhilHealth must deliver on its promises to the people whose health they are mandated to protect. First, to increase its case rates, which have been insufficient in covering medical costs. Napakaliit po talaga ng inyong case rates," said Go.

During the hearing, May Dan Jalgalado, the widow of the late provincial health officer whom Governor Dong Padilla accompanied, gave a deeply emotional testimony, recounting their family's immense financial strain despite being regular contributors to PhilHealth.

May shared that despite their regular contributions to PhilHealth, Walter was only able to avail of P27,000 for his first hospital admission.

As Walter’s condition deteriorated, his second admission bill amounted to P4.5 million, but once again, PhilHealth's coverage fell far short of what the family needed. "Na-charge lang P29,000 again for the second admission," May explained. "Nakikipagtalo ako. Bakit ganun? Bakit hindi commensurate ‘yung sa bill namin with the coverage ng PhilHealth?"

The widow revealed her frustration with the case rate system, which assigned fixed amounts for specific conditions, regardless of the actual medical expenses incurred by patients.

May's poignant testimony highlighted the broader issues within PhilHealth, including its outdated policies and the rigid application of case rates that do not reflect the reality of patients' financial needs. "Parang kami pa ang nagka-utang sa PhilHealth... sobrang unfair. Parang sa dami ng hulog niya, kami pa ‘yung hindi natulungan ng PhilHealth," she said, fighting back tears.

Moved by the widow’s testimony, Go expressed his deep sympathy for the widow and frustration with PhilHealth's failure to provide sufficient support. He called on the agency to address the disparity between contributions and benefits, pointing out that the situation experienced by the Jalgalado family was not an isolated case.

"Unang-una, ako po ay nakikiramay sa pagkamatay ng iyong mister. At nakikiramay rin po ako sa iyong dinanas sa serbisyo po ng PhilHealth," Go said. He then addressed PhilHealth President Emmanuel Ledesma Jr., pressing him to explain why the case rates were so low, despite the contributions made by members like Walter.

"Bakit po hindi niyo ayusin ‘yung inyong case rates, para mabawasan naman po yung out-of-pocket expenditures ng ating mga pasyente? ‘Yun pong pakiusap ko, ‘yan ang explain ninyo sa publiko. Paano ganito kalaki ‘yung binabayad pero ganito kaliit yung binabawas?" Go asked pointedly.

Go further emphasized the need for immediate reforms, noting that families like the Jalgalados should not be left to bear the brunt of exorbitant medical costs amid excess funds in PhilHealth that should be utilized to benefit patients in need in accordance with the implementation of the Universal Healthcare Law.

"Kaya nga, huwag niyo na pong tagalan. Bilisan niyo na po. Nagkaroon na tayo ng ilang hearing dito. Wala pa kayong ginagawang pagbabago sa... PhilHealth. Puro kayo, ‘Pag-aaralan ko,'" Go said, expressing his frustration over the slow pace of reforms.

Ledesma Jr. responded to Go's pointed questions and acknowledged the shortcomings of the current system, particularly the 12-year gap during which the case rates were not updated.

"Bakit? Bakit nga maliit? Bakit nga ang sobrang liit? Kasi po, million ‘yun, tapos wala pang P30,000 ang binawas," Go said, referring to Walter’s case.

Ledesma reiterated that PhilHealth is working aggressively to address these issues, stating, "We are, we acknowledge, at PhilHealth, we acknowledge the shortcomings. We are addressing it, we are fully addressing it by being very aggressive this year po."

He assured the committee that PhilHealth had begun increasing the case rates by 30 percent, and further improvements were in the pipeline. But Go remained skeptical, emphasizing "Huwag mo nang isipin ‘yung patience ko. Isipin mo ‘yung patients, yung mga pasyente.”

As the hearing progressed, Go once again pressed PhilHealth to take immediate action, reminding them of their mandate to protect the health of the Filipino people.

"Huwag n’yo gamitin ‘yung pondo ninyo para patulugin lang. May reserve fund kayo, bakit hindi niyo gamitin?" Go asked.

He also referenced another case involving a PhilHealth employee from Capiz who faced a similarly distressing situation, with a hospital bill reaching P800,000 but only a fraction being covered by PhilHealth, her own employer.

Go emphasized the importance of putting the needs of ordinary Filipinos first, reminding PhilHealth executives to always consider the plight of the poor. "Sabi ko kanina, Mr. Ledesma, sa bawat desisyon na gagawin ninyo sa buhay ninyo, isipin n’yo ‘yung mga mahihirap, ‘yung mga pasyente," Go stated firmly.

"Ulitin ko po, ang pondo ng PhilHealth ay para po sa health gamitin. Imbes na pinapatulog ng PhilHealth ang pondong pangkalusugan na mula naman po sa taumbayan at para po sa taumbayan yan," Go said.

As the discussion concluded, Go made it clear that his committee would continue to monitor PhilHealth closely and push for substantial reforms. He emphasized that the health and well-being of Filipinos should never be compromised due to outdated or insufficient policies.

"We will continue to fight for affordable and accessible healthcare for our people and oppose anti-poor policies of PhilHealth," Go stressed, reaffirming his commitment to advocating for a healthcare system that truly serves the Filipino people.