What makes the debate over the claimed surplus money of the Philippine Health Insurance Corp. (PhilHealth) shameful is the twisted appreciation of the term “excess funds.”
PhilHealth has a lot of shortfalls, not the least of which is the P6 billion in unpaid claims to private hospitals, and the inadequate health coverage if compared with the requirements of the Universal Health Care law.
The Supreme Court is evaluating petitions to stop the siphoning from PhilHealth of P89.9 billion, P60 billion of which has already been transferred to the National Treasury.
A collusion between the Executive and the Legislative branches took place to go around a Supreme Court ruling on the Disbursement Acceleration Program that restricted the cross-border transfer of savings from one branch of government to another.
In the bicameral conference committee, the body tasked to reconcile conflicting provisions in the General Appropriations bill, items in the budget and insertions for legislators’ pet projects were switched.
Thus, the pet projects received priority funding while the regular items were relegated to unprogrammed projects that needed to source money for their implementation.
The second maneuver involved another insertion — this time provisions were included in the budget law that authorized the Department of Finance to sweep the 2024 budget of excess funds intended to fund P200 billion worth of unprogrammed projects.
PhilHealth could put the excess funds in its possession to good use.
Private Hospitals Association of the Philippines Inc. (PHAPI) members said the health insurance agency still owes them P6 billion. The amount includes debts from as far back as 2020.
Senator JV Ejercito, senior deputy majority leader, is hoping that amendments to the law creating PhilHealth would prevent the diversion of PhilHealth funds.
Senate Bill 2620, authored by Ejercito, includes reforms to PhilHealth, such as adjustments to premium rates and the stricter management of its funds.
A key provision of the Ejercito bill prevents the transfer of PhilHealth funds to other agencies.
The bill also expands PhilHealth’s coverage to include dental services and mandates regular reviews of its benefit packages.
Ejercito said the Senate has completed its work on the bill and is awaiting the action of the House of Representatives.
Faster action from the House should have the amendments in place before the end of the year.
Ejercito, a prime mover of the UHC law, lamented that its objectives have been compromised as a result of the draining of PhilHealth funds.
The measure is critical for initiating the urgent reforms needed for PhilHealth to ensure it is properly funded and managed efficiently so that health services are delivered without delay.
The bill is among the priority bills identified by the Legislative-Executive Development Advisory Council (LEDAC), underscoring its significance in the Marcos administration’s commitment to enhance public health services.
Since the enactment of the UHC law, out-of-pocket expenses of public hospital patients were reduced from 70 percent to 42 percent—but there is still a long way to go.
The UHC’s goal is to free indigents, senior citizens, PWDs and other vulnerable groups from hospital fees.
More atrocious is finding that PhilHealth is run by a mafia that some senators created.
PhilHealth came into being through the National Health Insurance Act of 1995, or Republic Act 7875, signed by President Fidel V. Ramos on 14 February 1995.
During its establishment, PhilHealth’s top-level officials were mostly recruited from the Senate, some of whom were able to clinch top regional positions and who later became so influential that they overstayed their positions by 20 years.
A former official of the agency recalled at least five names on the list of mafia members cited in the Blue Ribbon report on irregularities in PhilHealth as having worked with the Senate.
Based on a Senate report, regional vice presidents of the agency who comprised the mafia practically controlled their fiefs, especially those “who have been there a long time or since PhilHealth’s inception.”
The influence of the Senate on the agency and with a former senator as head of the Department of Finance could be the reason for the ease with which PhilHealth surrendered its P89.9 billion in “sleeping” funds.