The proposal to enhance PhilHealth benefits for members who regularly pay premiums deserves serious scrutiny and deliberation. After all, workers, professionals, entrepreneurs, and other contributing members rightfully expect that the benefits they receive should reflect the sacrifices they make through years of contributions.

Yet as this discussion unfolds, it is equally important to remember that expanding benefits for contributors should never come at the expense of the dignity of those who are unable to contribute.

Recent remarks comparing paying members with indigent beneficiaries have reignited an old debate: Who deserves more from the government? The answer should be clear. Every Filipino deserves healthcare, although the manner by which coverage is financed may differ.

The fundamental principle behind social health insurance is the constitutional mandate to promote the right to health for all Filipinos. Those who are able to contribute help sustain a system that protects everyone, especially those who are most vulnerable to illness, poverty, disability, and old age. This is not charity. It is social justice put into action by the government.

The indigent who receives PhilHealth benefits is not receiving a favor. The senior citizen who enjoys health coverage is not freeloading on the system. Their inclusion is the result of deliberate policy choices embodied in law and rooted in the Constitution's commitment to promote social justice and protect the welfare of the people.

Indeed, it is inaccurate to suggest that indigent members contribute nothing and should not enjoy the same benefits as paying members. While they do not directly pay premiums from their own pockets, their coverage is funded through public resources, including allocations from revenues generated by excise taxes on tobacco and alcohol products, commonly known as “sin taxes.” Congress specifically designed this funding mechanism to ensure that the poor would not be denied healthcare simply because they could not afford insurance contributions.

Likewise, the enrollment of senior citizens into PhilHealth was not accidental. It was a recognition that their advancing age often brings greater healthcare needs while reducing earning capacity. The Expanded Senior Citizens Act of 2010 (Republic Act No. 9994) and the Mandatory PhilHealth Coverage for Senior Citizens Act of 2014 (Republic Act No. 10645) sought to ensure that old age would not become a sentence to medical neglect. These measures were later reinforced by the Universal Health Care Act (Republic Act No. 11223), which expanded the vision of healthcare as a right rather than a privilege.

This principle was eloquently captured by the late president Ramon Magsaysay, who famously said, “He who has less in life should have more in law.” The statement remains one of the most enduring expressions of Philippine social justice. It recognizes that equality does not always mean treating everyone identically. Sometimes fairness requires extending greater protection to those who have fewer resources and fewer opportunities.

Acknowledging the rights of indigents and senior citizens does not diminish the legitimate concerns of contributing members. Many workers and professionals have long asked why their PhilHealth benefits often seem disconnected from the premiums they faithfully pay. They deserve answers. They deserve better services.

This is why the debate should not be framed as a contest between contributors and non-contributors. It is a false choice. The Philippines can pursue both objectives simultaneously: stronger benefits for paying members and continued protection for vulnerable sectors.

The challenge now is how PhilHealth can improve efficiency, reduce waste, strengthen benefit packages, and ensure that every peso entrusted to it translates into better healthcare outcomes for all members.

Contributors deserve more benefits. That is a reasonable and worthy objective.

But the poor deserve dignity. Senior citizens deserve respect. And healthcare must remain a shared national commitment for both the able and the poor.