The Philippine Health Insurance Corp. (PhilHealth) is seeking additional government funding to sustain its programs and support the continued implementation of the Universal Health Care (UHC) Law, its top official said Thursday.

Speaking during a health forum at Healthway Cancer Care Hospital, PhilHealth president and CEO Dr. Edwin Mercado said the state insurer needs a predictable and consistent budget to maintain its benefit programs and operations.

“We need a predictable and consistent budget because it’s hard if we are not consistent and predictable. So it looks like the response of our budget officers is positive,” Mercado said in an ambush interview.

Mercado said PhilHealth’s projected actuarial requirements indicate that the agency would need nearly P285 billion in 2027 to cover benefits and operating costs.

“The cost of giving the benefit and our operating cost can be covered, and the break-even that we can live with is almost P285 billion for 2027. That is based on our projected actuarial,” he said.

The forum, attended by representatives from PhilHealth, the Philippine Institute for Development Studies and the Private Sector Advisory Council (PSAC), focused on the implementation of the UHC Law and the challenges facing the healthcare sector.

Participants cited the need for sustainable financing, prudent fiscal management and continued investments in healthcare infrastructure and workforce development to maintain gains under the UHC program.

Sustainability

Mercado also underscored the role of the private sector in expanding healthcare access.

“In most cases, our private sector has more capacity. In areas such as cardiac procedures, stenting, open-heart surgeries and orthopedic implants, most of the capability is in private hospitals. So we should really engage private hospitals,” he said.

PIDS Senior Research Fellow Dr. Valerie Gilbert Ulep said expanding healthcare access must be supported by sound fiscal planning and evidence-based policymaking to ensure long-term sustainability.

Meanwhile, PSAC Health Sector Lead Paolo Borromeo said sustained collaboration between government and the private sector remains critical in strengthening the country’s healthcare system.

Borromeo noted that one of PSAC’s priorities since 2022 has been supporting the implementation of universal healthcare and PhilHealth’s continuing reforms.

He cited efforts to strengthen primary care, expand benefit packages and improve operational efficiency as among the initiatives being pursued to make healthcare more accessible and affordable for Filipinos.