Iloilo 1st district Rep. Janette Garin (Facebook)

Iloilo 1st district Rep. Janette Garin has underscored the need for a clear division of functions between the Department of Health (DOH) and the Philippine Health Insurance Corporation (PhilHealth).

Garin, a former DOH secretary, said doing so would help avoid duplication of efforts and unnecessary delays in the bureaucracy. 

“DOH is for promotive and preventive healthcare, while PhilHealth should focus on curative healthcare and catastrophic illnesses,” she said.

During a recent hearing of the House Committee on Good Government and Public Accountability, Garin pressed attending PhilHealth officials on the longstanding gaps in their coordination with DOH, which have resulted in inefficiencies that impact healthcare access and financial sustainability.

“In other words, hindi kaya ng PhilHealth na lahat ng problema sa kalusugan ay siyang sumalo. Hindi rin naman kaya ng DOH na yung mga gastusin sa loob ng hospital ay sa DOH,” Garin said.

(PhilHealth cannot address all problems concerning health. On the other hand, DOH cannot shoulder all hospital costs.)

Officials of the state health insurer led by its president, Emmanuel Ledesma acknowledged the issues and admitted that there were overlaps in the functions between their agency and DepEd.

Ledesma said that these need to be addressed to improve service delivery. He also agreed to conduct an internal review of past enrollment practices to identify discrepancies.

The Iloilo congresswoman cited specific instances where overlapping roles resulted in inefficiencies, such as the procurement of medical supplies.

“Ang binibili ng DOH hindi dapat nire-refund ng PhilHealth. Ang packages ng PhilHealth ay hindi nagdodoble sa packages ng DOH,” she said.

(Medicines purchased by DOH must not be refunded by PhilHealth. PhilHealth benefit packages must not be mirrored by DOH packages.

PhilHealth Vice President Lemuel Untalan also confirmed that the agency continues to refine its enrollment lists to eliminate redundancies and remove ineligible beneficiaries.