Continue full coverage for treatment of COVID-19 patients, Philhealth told

MANILA, Philippines — Several lawmakers called on the state-owned Philippine Health Insurance Corp. (Philhealth) to reconsider its decision to limit financial coverage for coronavirus disease (COVID-19) patients.

Bagong Henerasyon Partylist Rep. Bernadette Herrera-Dy said that now is not the time for Philhealth “to impose health care financial burdens on our already suffering citizens.”

“It must continue full coverage of all COVID-19 confirmed, probable, and suspect patients. Every single one. No exceptions, no loopholes, and no excuses,” Dy said in a statement.

Philhealth, Dy said, should let the Department of Finance look for the funds to shoulder the financial costs of hospitalization, outpatient care, and medicines.

Quezon City Rep. Precious Castelo, meanwhile, said that Philhealth can seek additional funding from the national government should its funds not suffice to provide full coverage for COVID-19 patients.

“It is the poor and senior citizens who will not be able to pay for the excess cost of treatment,” Castelo said.

Likewise, Castelo said that PhilHealth president Ricardo Morales and Philhealth executive vice president for corporate affairs Shirley Domingo should not expect many infections to develop into coronavirus disease “since based on official projections, less than five percent of the cases would be severe and critical, while at least 80 percent would be mild and moderate.”

Anakalusugan Partylist Rep. Mike Defensor argued that Philhealth “has the resources and backing of the national government to absorb the entire cost of treating COVID-19 patients.”

“For this year, Philhealth expects to collect more than P104 billion in contributions from members. In addition to that, it is receiving a budgetary subsidy of P71.3 billion. This means that it has at least P175 billion, excluding income from investments,” Defensor said.

Defensor said that Philhealth also collected P118 billion in contributions and posted a net profit of P8 billion in 2018.

Thus, the move to stop its no cost limit for treating coronavirus COVID-19 patients “will prejudice poor patients who might shy away from seeking medical care due to the huge cost involved,” Defensor said.

“That is the last thing President Duterte and we in Congress want in passing the Bayanihan to Heal As One Law. We will not heal as one in fighting this pandemic if we leave out the poor,” he added.

Morales earlier announced that Philhealth will shoulder the hospital expenses of all COVID-19 patients in the country.

But in early April, Morales said that while PhilHealth has sufficient funds, a new case rate package for COVID-19 patients is needed to ensure sustainability.

A case rate package sets the maximum amount that PhilHealth will shoulder for a patient for a certain ailment. This means that if the total expenses exceed the set rate, the patient has to shoulder the excess amount.

The new package divides patients into four categories, depending on the gravity of their condition.

Coverage for mild pneumonia is set at P43,997, moderate pneumonia at P143,267, severe pneumonia at P333,519, and critical pneumonia at P786,384.

EDV