Health advocate Dr. Tony Leachon has called for the immediate removal of PhilHealth’s 24-hour confinement requirement following the case of a longtime contributor who was reportedly denied benefits after dying less than a day after being admitted to a hospital.
The case of Marvin Sulit, who had reportedly paid PhilHealth contributions for 25 years, sparked public outrage after his widow disclosed that they were unable to claim benefits because his confinement lasted only 19 hours before his death.
Speaking on DAILY TRIBUNE’s Hot Patatas, Leachon described the policy as an outdated regulation that fails to address the realities faced by patients in emergency situations.
“At your darkest moments, you should be receiving help. The fact that a patient is brought to the emergency room already means he or she needs urgent medical assistance,” Leachon said.
He stressed that the issue was not the fault of the hospital but stemmed from a longstanding PhilHealth policy that he had questioned even during his tenure as a PhilHealth director from 2016 to 2019.
According to Leachon, Sulit’s family was left with a hospital bill of around P200,000 after the patient succumbed to a brain hematoma before reaching the required 24-hour confinement period.
Complex rules
“The painful part is that someone contributes for 25 years, and yet nothing can be deducted from the hospital bill because of a technical rule,” he said.
Leachon argued that benefit eligibility should not depend on the number of hours a patient remains confined, especially in life-threatening cases such as stroke, heart attack, severe pneumonia and other medical emergencies.
“There should be no time period attached to illness. Emergency cases are often the most critical and costly. If someone is admitted through the emergency room, that person should automatically qualify for assistance,” he said.
The health advocate also questioned the practicality of expecting ordinary members to understand the complexities of PhilHealth’s benefit packages and circulars.
“People do not study PhilHealth packages. What they understand is simple: They paid their contributions and expect help when they need it most,” he said.
Leachon noted that while PhilHealth officials have pointed to existing packages for emergency and deceased patients, the controversy highlights the need to review both the agency’s policies and the implementation of its benefit programs.
Increased funding
Beyond the 24-hour rule, Leachon urged lawmakers and PhilHealth’s board to revisit benefit packages for major illnesses, particularly those among the country’s leading causes of death.
He cited stroke, heart disease, cancer, kidney disease and severe pneumonia as conditions that often leave families facing catastrophic healthcare expenses despite PhilHealth coverage.
