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Legarda says PhilHealth must deliver on implementation of hiked case rates

Published Jan 4, 2025 09:00 am

At A Glance

  • Senator Loren Legarda is holding her breath as far as the Philippine Health Insurance Corporation's (PhilHealth) implementation of its recent increases in benefit package is concerned.

Loren Legarda.jpgSenator Loren Legarda (Senate PRIB)

Senator Loren Legarda is holding her breath as far as the Philippine Health Insurance Corporation's (PhilHealth) implementation of its recent increases in benefit package is concerned.

“Although these reforms are welcome, we still need to see how PhilHealth will implement them effectively,” Legarda said in a statement Saturday, Jan. 4.

“For instance, while there’s a 50 percent increase in select case rates, PhilHealth has not clarified which cases will be covered and how much will be allocated. This uncertainty only contributes to the lack of trust among PhilHealth members, who often delay seeking medical treatment until emergency situations arise," she said.

Legarda called for the strict and transparent implementation of these increases by the state health insurer.

The lady senator pointed out that despite having PhilHealth coverage, many ordinary Filipinos feel insecure about going to the hospital.

“An ordinary Filipino, despite being covered by PhilHealth, feels insecure to go to the hospital because the amount PhilHealth will cover is often unidentified and, when provided, is often low,” she noted.

“As a result, their out-of-pocket expenses consume a substantial part of the bill. Poor patients, despite universal healthcare coverage, are forced to seek assistance from other government programs, such as guarantee letters (GLs), or resort to loans just to cover the remaining healthcare costs,” she explained.

Legarda said that PhilHealth’s success should be measured by the confidence of patients in seeking treatment, and in knowing that it will meet their needs.

“True universal healthcare cannot exist if the coverage remains insufficient and uncertain,” she said.

Legarda also addressed the broader issue of PhilHealth’s priorities. She reminded the government corporation that its core mission should focus on providing accessible healthcare for all Filipinos, not on making financial investments.

“PhilHealth must reassess its organizational values and invest in our most valuable asset—our people’s health and trust,” she said.

“Up to the extent allowed by law and prudent corporate health, every centavo should go towards healthcare services for Filipinos. Investments can be secondary and incidental, used to generate returns on unused funds, but the priority must always be spending on services that directly benefit the people," she further said.

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