PhilHealth: Still one of the worst agencies  

The purpose of the government is to serve and protect the people. But there are agencies that are more of liabilities rather than assets. They should be abolished. Top of the list is PhilHealth.

Although I am in the USA right now, I get a lot of messages about the notoriously miserable PhilHealth services. I need to comment and seek others' views too. I met many Pinoys here in Washington DC whose close relatives are PhilHealth members. All I can hear from them are gripes.

PhilHealth is a burden. It’s no longer performing its mission. It should be abolished. If we conduct a survey today, provided the results aren’t counted by the Comelec's vote counting machines, PhilHealth will most probably emerge as the worst government agency, for being notoriously inefficient, anti-people, and with too many overpaid incompetent officials.

PhilHealth has forgotten that the prime duty of the government is to serve and protect the people. The way PhilHealth is performing is the complete opposite of what is intended.

It’s charging members too much, and is increasing the rates to make up for millions lost due to incompetence or corruption. And its services are below minimum expectations. Membership should be voluntary. We should recall that House investigation of PhilHealth officials. Congressman Marcoleta’s persistent questions revealed PhilHealth's many questionable decisions.

There were too many controversies, but instead of solving the problems, DOH Secretary Francisco Duque, PhilHealth chairman, hasn’t done anything. I have been a member of PhilHealth since its creation in 1995 but in all my hospitalization experiences, all I can recall are serious anxieties, wounded feelings, and extreme disappointments. PhilHealth makes my blood pressure rise. I regret awarding Duque in 2014 when I was the national president of PMAP.

Allegedly, one of the biggest anomalies lawmakers spotted was the use of the so-called Interim Reimbursement Mechanism, a system of giving hospitals and clinics cash to use during fortuitous events. And they included the pandemic as a fortuitous event. That’s why during the height of the health crisis, many hospitals and corrupt PhilHealth officials allegedly stole millions from PhilHealth funds. While members like me get headaches just to avail of services we paid for, they were stealing money I contributed.

Based on the findings of the Senate and the House, since PhilHealth is incapable of promptly computing how much exactly it owes hospitals and clinics, given the many disputed claims that are supposedly fictitious and fraudulent, PhilHealth officials decided to advance cash to medical institutions by estimating average claims for the last three months. Herein lies the chances for anomalies. Many hospitals were investigated and found guilty of conspiring with PhilHealth officials. But these institutions couldn’t be suspended, much less closed during the pandemic. I want to see heads roll and officials jailed, but I have seen none at all.

PhilHealth also failed to withhold taxes on advances given to hospitals and clinics, thus depriving government of much-needed revenues. PhilHealth is also being charged by some hospitals as exercising discrimination and abuses in discretion in reimbursement and advances of funds. They allegedly favored friendly hospitals and clinics and made the others wait, pushing some medical institutions to the brink of economic and financial collapse. I haven’t heard many positive comments about PhilHealth. All I hear are gripes and complaints, despite all the PR and ads.

If the government wants to fulfill its constitutional mandate to serve and protect the people, PhilHealth should be abolished or overhauled, its officials, systems and procedures revamped and reformed, and PhilHealth membership made voluntary. PhilHealth services are expensive. The people should be allowed to choose their own HMO. As a member of PhilHealth, I cannot remember any single positive thing I got for the money I contributed for decades. PhilHealth is a burden. It must be abolished.