Health advocate and former PhilHealth senior adviser Dr. Tony Leachon has called for the immediate abolition of PhilHealth's 24-hour confinement requirement, saying the policy unfairly deprives emergency patients and their families of much-needed financial assistance.
Speaking on DAILY TRIBUNE's Hot Patatas, Leachon cited the case of Marvin Sulit, a PhilHealth contributor for 25 years whose family was reportedly denied benefits after he died just 19 hours after being admitted to a hospital.
“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He stressed that the issue lies not with hospitals but with an outdated PhilHealth policy that he had questioned during his tenure as a PhilHealth director from 2016 to 2019.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 he succumbed to a brain hematoma before meeting the 24-hour confinement requirement.
“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 length of confinement, particularly 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.
He also questioned the practicality of expecting ordinary members to understand the complexities of PhilHealth 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.
While PhilHealth officials have pointed to existing packages for emergency cases and patients who die within 24 hours, Leachon said the controversy underscores the need to review both agency policies and their implementation.
Beyond the 24-hour rule, he urged lawmakers and the PhilHealth board to reassess benefit packages for major illnesses, including stroke, heart disease, cancer, kidney disease and severe pneumonia, which often leave families with catastrophic healthcare expenses.
“Many middle-class families are only one serious illness away from financial hardship. Healthcare costs can easily reach hundreds of thousands or even millions of pesos. PhilHealth benefits must keep pace with those realities,” he said.
Leachon also renewed his call for increased government funding for PhilHealth. While the agency's proposed 2027 budget stands at around P300 billion based on actuarial projections, he said the allocation should be raised to as much as P400 billion to expand coverage, strengthen benefits and reduce out-of-pocket costs for patients.
“This case shows why outdated rules need to be reviewed. PhilHealth exists to help people during their most difficult moments. Policies should reflect compassion and the realities faced by Filipino patients and their families,” he said.