PhilHealth: Delay implementation of UHC Act, expansion of primary health care benefits

Published June 16, 2020, 12:00 AM

by manilabulletin_admin

By Hannah Torregoza

The Philippine Health Insurance Corp. (PhilHealth) on Tuesday called for a “general delay” of the implementation of the Universal Health Care (UHC) Act and the expansion of primary health care benefits under the law.

Philhealth President, retired army general Ricardo “Dick” Morales (MARK BALMORES / MANILA BULLETIN)
Philhealth President, retired army general Ricardo “Dick” Morales (MARK BALMORES / MANILA BULLETIN)

PhilHealth President and CEO Ricardo Morales made the call during the joint congressional committee hearing on the UHC law, saying the state health insurer is now “trying to conserve its resources” as it saw a significant drop in contributions due to the COVID-19 pandemic.

Morales predicted PhilHealth could experience a budget deficit until 2024 since collections have significantly dropped because most businesses were forced to close down due to the pandemic.

“Our collection is actually, to tell you the truth, our collection is about 10 percent of last year. The collection from the direct contributions has dropped significantly because there were no businesses. None of the direct contributors are paying their premiums,” Morales said during the virtual hearing.

“Indirect contributors depend on business activity which has also suffered a downturn. We are falling or lacking on reserve. We anticipate our reserves to take a hit,” he said.

“That’s why the recommendation is to delay first or postpone the implementation of the program under the UHC Act, including the primary health care services like (medical) check-ups and basic laboratory tests,” he said.

According to Morales, PhilHealth’s response to the COVID-19 pandemic, from February 2020 to January 2021, will cost them P40.7-billion. That is why, he said, the agency has to take a “very prudent approach” in rolling out new packages under the Act.

However, lawmakers disagreed with Morales and reiterated the need to improve primary health care benefits amid the pandemic.

“With the realization that the COVID-19 pandemic has already happened…don’t we need to provide primary care packages or services now more than ever?” Rep. Angelina “Helen” Tan, chair of the House health committee, pointed out.

“I understand the concern in the income or collection of PhilHealth but for consideration, I hope we can focus on the health of the people outside the hospital, which is the primary care,” she said, adding that this will actually help them lessen their expenses.

Sen. Risa Hontiveros, who is also part of the joint congressional committee, agreed with Tan: “I think President Morales knows the rule of thumb when it comes to health insurance and health financing institutions, that for every $1 spent on primary care, a country can save an equivalent to $3 to $4 on the opposite end of the spectrum in tertiary care, including hospitalization,” she said.

Johnry Castillo, from the Department of Budget and Management’s (DBM) Budget and Management Bureau, assured the congressional committee that state economic managers will give PhilHealth preferential attention, “but subject to available fiscal space for 2021.”

“The national budget memorandum provides an initial P71-billion but we cannot say if it will be increased because it will still be evaluated by the economic managers,” Castillo said.

“But this situation by PhilHealth will be given due consideration. But based on rules set by economic managers, there is an initial P71-billion,” he said.

Morales had also pointed out during the hearing that PhilHealth only received a P71.3-billion subsidy under the 2020 General Appropriations Act (GAA).

“Our (2020 GAA) proposal was for a subsidy of P153-billion, but what Philhealth received for this year was P71.3-billion. In effect, this was not enough to fund the premium of all indirect contributors, thus, affecting Philhealth’s capacity to cover all benefits,” he said.

As of April 30, 2020, Morales said PhilHealth was only able to collect a total premium income of P46.5-billion, which is below the benefit expense of P52.5-billion.

“We have a benefit expense of P52.5-billion and we have collected a total premium income of P46.5-billion. In other words, we are spending 13 centavos more per peso than we collect as premium collection,” the PhilHealth chief said.

Because of this, Morales said PhilHealth is prepared to propose a subsidy of P138-billion for 2021 if the level of government subsidy remains unchanged.