Health reform advocate Dr. Tony Leachon has called for the abolition of guarantee letters (GLs) and urged the government to shift fully to automatic payments through the Philippine Health Insurance Corporation (PhilHealth).

“For too long, indigent Filipino patients have been forced to beg, queue, and wait for discretionary guarantee letters — tokens of assistance that depend not on need, but on access, influence, and political favor,” Leachon said. 

“This system has trapped our most vulnerable in cycles of uncertainty, humiliation, and delayed care,” Leachon added, saying that automatic PhilHealth payments would correct what he described as a long-standing healthcare injustice.

“By abolishing guarantee letters and consolidating aid under automatic PhilHealth payments, we move from a fragmented, politicized system to one grounded in transparency, accountability, and fairness,” he said.

He added that under the Universal Health Care law, PhilHealth must provide standardized, predictable support “free from discretion, free from politics, and free from the inequities that have long plagued medical assistance programs.”

In July, the Department of Health said it preferred channeling medical aid through PhilHealth rather than via GLs. 

This followed complaints from private hospitals that they would no longer honor GLs issued by government officials unless the state settled more than P500 million in unpaid claims under the Medical Assistance for Indigent and Financially Incapacitated Patients program.

At the time, Palace press officer Claire Castro said the DoH had enough funds to settle the claims.

As this developed, Senator Loren Legarda vowed Friday to file a bill mandating the automatic appropriation and automatic release of PhilHealth’s annual funding.

“This reform is essential to ensure that the PhilHealth can meet its statutory obligations, protect its reserve fund, and sustain the financial risk protection that millions of Filipinos depend on,” Legarda told members of the Healthcare Professionals Alliance Against Covid-19.

She also called for the return of PhilHealth’s P60-billion fund after the Supreme Court unanimously ordered the return of funds previously transferred to the National Treasury.

“[HPAAC] reiterated that PhilHealth deserves far more robust funding,” she added, noting the agency must allocate at least P147 billion in 2026 to subsidize premiums for 24.5 million indirect members.