Better times and better options

Our national leaders have been talking and talking about having the money or part of the money needed to buy COVID-19 vaccines. If they have money then why are they not buying what they can of the Covid-19 vaccines? Why wait until you have “all” of the money? Why wait for better times? Perhaps I am over simplifying things but in the words of a talking head in Malacañang when he heard that 1,000+ Chinese POGO workers had been vaccinated: “That’s 1,000 less people we need to worry about.” If the government has part of the funds, they should buy vaccines and roll out the program. That is IF they have a real COVID-19 vaccination program.

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Rather than wrestle with the general public concerning increased membership dues as mandated by the Universal Health Law, the Philippine Health Insurance Corporation or PhilHealth surely has some alternatives to increasing its funds while creating a better and more competitive environment in the health insurance industry.

Instead of simply increasing dues, PhilHealth should address a long-standing need and suggestion from thousands of small to medium companies for PhilHealth to create its own HMO or health maintenance organization for companies. Aside from creating its own HMO program, PhilHealth can provide a better option or multiple choice of coverage for members who have the capacity to pay higher premiums for better coverage.

These two “better options” are not mythical or mere ideas. I have on several occasions suggested these to several PhilHealth officials at different levels, based on the needs and suggestions of CEOs, human resource managers and many private individuals who are fed up with the highway robbery done to them by private insurance companies.

As an operations consultant, I have discovered that many small companies can barely afford to pay the cost of HMO coverage. In one instance, a company owner I knew simply deposited P2 million in the bank and used that as a revolving fund for emergency medical coverage instead of perpetually throwing money out the door to an HMO.

The idea of creating an HMO program for small to medium companies is not new. It has long been suggested to officials of PhilHealth but every time I checked up on the suggestion, all I hear is that it is still being discussed. Just so readers know, on one occasion when I revived the idea with one of my students from PhilHealth, I was informed that there was an ongoing study called “PhilHealth Plus” which meant members can get a “plus” service or option by simply paying more. The question is what happened to that study or project? That idea was at least five years ago!

Either the planners and strategists inside PhilHealth are slowpoke dimwits or there is an internal policy not to rock the boat or compete with the private sector HMOs. Why not? The government has already competed with private sector education by increasing salaries of teachers and that resulted in better quality of education once the private teachers migrated to public schools. The government has essentially poached most of the nurses in private hospitals, enticed good doctors to migrate or set up clinics in public hospitals and this has improved services in public hospitals. So why not give the private sector HMOs and insurance companies a run for their business?

A PhilHealth HMO will surely be welcomed by the private sector executives and business owners who still end up shouldering large chunks of medical costs when employees or family members get sick. The same goes for individuals who have paid private insurance companies but end up having to advance payments, justify claims and suffer the humiliation of following up on claims or arguing about what can or cannot be covered by private insurance. The private sector has a need, has the capacity to pay and is willing to pay for better options and better services instead of being robbed annually by private insurance companies and HMOs.

Instead of spending so much time and effort digging up dirt and hurling crap at the institution, our legislators, members of the executive and officials of PhilHealth should set aside some constructive time to take advantage of the situation. Many successful businesses are those that addressed a need, created the product and then made the profit. Legislated dues and taxes are not the only answers.

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Speaking of options, now that LGUs are talking about enlisting people who want to get the COVID-19 vaccine, can someone please consider putting up a different lane for people willing to get the COVID-19 as well as pay for the vaccine. Given how so many elected officials have constantly been saying they don’t have enough money to cover the cost of vaccinating everybody, why not put up a line and list for those willing to pay? While we are not all equal financially, there are still many Filipinos, millions in fact, who have the capacity to pay and would surely be willing to pay the one time cost for their vaccination rather than multiple RT-PCR swab tests that is constantly required for travel, for work, etc.

While I admire the “free vaccination” policy of both national and local governments, I wonder why it became “free for all.” We paid for our daughter’s dengue vaccine, we paid for our flu vaccine and we paid for our pneumonia vaccine. I am sure that there are still many financially able, socially responsible and patriotic Filipinos who don’t want to add to the burden of local and national government. It is simply a matter of making the call, making a lane and making a list.  Say it and they will come.

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