The difference between sincere public service and a dole is the Universal Health Care Act (UHC) and the Department of Budget and Management (DBM) handing out P7,000 in “medical allowance” to state workers.

Budget Secretary Amenah Pangandaman even proudly proclaimed the release of the guidelines for the annual aid which she said was in line with Executive Order (EO) 64 which prescribed a salary increase for government personnel.

“This is a promise fulfilled,” Pangandaman said in a statement.

All of the perorations, however, merely highlighted the failure of the government to implement the Universal Health Care law which has been in effect the past five years.

The law provides for free hospitalization and medicines for all Filipinos and mandates the Philippine Health Insurance Corp. (PhilHealth) to look for funding sources to implement it.

The implementing rules of the law provide that every Filipino citizen shall be automatically enrolled in the National Health Insurance Program.

It says that immediate eligibility and access are granted for preventive, promotive, curative, rehabilitative and palliative care for medical, dental, mental and emergency services, delivered as population-based or individual-based health services.

It says that within two years of the effectivity of the implementing rules, PhilHealth shall implement a comprehensive outpatient benefit, including access to medicines and emergency medical services and the services of healthcare professionals, and diagnostic, laboratory, dental and other medical services.

Recently, however, the withdrawal of the P74-billion state subsidy to PhilHealth for 2025 and the recent withdrawal by the Department of Finance of P89.9 billion in PhilHealth “excess funds” betrayed the resistance to a structured health program that would do away with patronage politics and doles.

The reality, it’s very obvious, is that Filipinos are nowhere close to having a satisfactory health program as about half or more of their medical expenses must come out of their pockets.

Senator JV Ejercito said that of a P500,000 hospital bill, PhilHealth only covers P12,000, which is an insult to Filipinos and the intent of the UHC law.

The DBM medical allowance circular clearly is a dole masked as medical assistance since it gives the option to either pool funds to obtain a health maintenance organization insurance or take the cash.

The best option would be to return the PhilHealth subsidy and have the agency fulfill its mandate under the UHC.

In a recent public inquiry, the Senate Committee on Health was told that PhilHealth had P628.2 billion in assets as of October 2024, including P281 billion in reserves and P150 billion in surplus funds.

Legislators pointed to PhilHealth’s surplus funds as the reason for denying it its annual subsidy.

Yet, PhilHealth has an obligation called insurance contract liabilities of more than P1.2 trillion to its members, half of which the reserves and the surplus can’t even cover.

The priority at the moment is encouraging doles and political patronage for the poor.

Early last year, PhilHealth increased the premiums of direct contributors such as wage earners, office workers, government employees, OFWs, self-earning individuals and small business operators.

For indirect contributors or those with no capacity to pay for PhilHealth coverage, however, Congress slashed the budget for their premiums.

Health experts said the government has shirked its duty under the UHC Act to cover the PhilHealth premiums of disadvantaged Filipinos, leaving the working class to carry the burden of funding PhilHealth through contributions deducted from their monthly paychecks.

Doles or “ayuda” provide short-lived benefits but play an essential role in clinching selfish political agendas.