Who’s watching the claims?

While most Filipinos are trying their best not to catch COVID-19 and stay out of hospitals, some patients or their family members have been raising the red flag to warn media and the authorities that hospitals need to be strictly monitored and investigated when it comes to claims for compensation for the treatment of COVID-19 cases. This is in the light of unusually high hospital charges or billings, or the possibility of certain illnesses being passed off as “COVID-19”.

Many of us know that in the early days of PhilHealth hundreds if not thousands of false claims were made by criminal minded physicians who would prescribe unnecessary cataract surgeries, D&C or Dilation and Curettage for women and a host of other minor procedures that were often unnecessary or elective and then collect a bundle from the government. The same scenario may already be playing out since the PhilHealth has released advanced amounts of cash to hospitals to cover COVID-19 cases and claims. To its credit, PhilHealth took the precautionary measure of placing limits or case rates so that the coverage or claims does not hit past the million peso charges like it did in the early days of ECQ.

However, the opportunity to make false claims or to pad the charges is still there. Given how paranoid we have all become, it would be so easy to enter a case of common flu, severe asthma, or coughing as suspected or symptomatic COVID-19, throw in all the X-rays, CT scan, blood tests etc. and the PhilHealth ends up paying for a false claim. Independent testing of patients must be done and there should be two separate samples to insure that one set is checked by the government. Better to be safe than sorry.

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Hold on to your horses in case you’re already making vacation plans right after May 15. In the best case scenario which would be Metro Manila shifting to GCQ or General Community Quarantine, only essential travels will be allowed and not leisure road trips or vacations. The bad news is, there is a high probability that the current ECQ status will remain or shall go into a second extension, thus the title: “Double Overtime”. Yes I am speculating but it is all based on the curious series of events beginning with Presidential spokesperson Harry Roque sharing with the Malacañang Press corps that seven LGU executives have advised the IATF that they want to extend the ECQ in their respective localities. That in turn was followed by the current chairman of the Metro Manila Commission expressing support for the call of LGU members to extend the ECQ or risk a serious secondary wave of infections that could be worse than the first one.

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While we are all wondering about what happens after May 15, it is clear that the IATF is failing in communicating to the people under Enhanced Community Quarantine what the difference or little difference there will be between ECQ to GCQ. Little is said and done to prepare people and manage their expectations. Even if there is a back to work “order”, we have already been told it would be for limited businesses and sectors primarily those capable of providing rapid testing or swab tests for COVID-19, imposing social distancing measures, housing and or having nearby medical facilities. The question is, does the IATF actually have the guidelines, template or an actual “business model” for a full scale GCQ that everyone can refer to?  

Unlike in the time of Karlo Nograles, the IATF briefings nowadays are beginning to sound and look like a “typhoon damage” or “weather incident report” instead of real briefings that explains the developments and progress in containing COVID-19. Explaining the incidence of lockdowns, explaining the facts and figures of new cases, deaths and recoveries, as well as equipping the public on what to expect and what they need to do or can do within a particular time frame or calendar. The common observation is that the current presentations make it appear that the government’s response is on a day to day basis, containment has sunk to the level of Mayors and Governors having to deal with the problem on the ground with whatever resources they can find, and the national government merely barking but not realizing how complicated matters are down at the barangay level.

This is what happens when people try so hard to control things that they try to fix “ “what ain’t broken”. For some unexplained reason, the highly effective, professional and responsive Karlo Nograles was removed as the spokesman for the IATF and was replaced by Presidential spokesperson Harry Roque who now holds two jobs. Alongside that change came a “memo” reportedly from the office of the Executive Secretary that henceforth no one is allowed to speak or communicate IATF matters except Mr. Roque. In an ideal world or the corporate world, that may work. But in the middle of a global pandemic and a government that is struggling to keep its head above the water, that memorandum is like the self-destruct mechanism on the set of a Mission Impossible sequel. Sorry, Harry Roque is not “that” good, he is not omnipresent and truth be told, he is very human and he has a list of people he does not like and won’t give the time of day, me included. But when a memorandum prevents other government officials from filling in the void or the need for public information, you are no longer communicating, you are endangering the public and making enemies at a time when you need all the help you can get.

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