Lawmaker suspects PhilHealth feigning losses to get more funds
Unscrupulous officials of Philippine Health Insurance Corp. (PhilHealth) seem to be trying to portray the company as losing financially to get more funds from the government, a member of the House of Representatives said on Thursday.
During a joint hearing held by the House committees on good government and on public accounts, Marikina Rep. Stella Luz Quimbo expressed disgust that PhilHealth was projecting a deficit of at least P96 billion for next year but was expecting to achieve only 5 percent of its expected collection from paying members.
P15B in losses
“Why is that this early, PhilHealth seems to have gone lazy in collecting premiums from its members? Is that not part of their mandate? They are [an] insurance program, they are supposed to collect from whom they are supposed to collect,” Quimbo said.
The House committees are investigating alleged irregularities in PhilHealth, and have sought the help of the National Bureau of Investigation in trying to unmask the people behind the scams that allegedly have led to losses of at least P15 billion for the company.
Quimbo also questioned why PhilHealth had been “raising alarm bells” over losses of up to P86 billion to be caused by the “Konsulta Package,” a new program the company was planning to launch next year.
“So this early, they (PhilHealth officials) are already expecting to fail. Why are they raising alarm bells? I think that’s their way of trying to ask for more money from the government,” she said.
In the proposed 2021 National Expenditure Program that is undergoing scrutiny by the House, PhilHealth is seeking a budget of P71 billion, the same amount it was allotted in the 2020 budget.
Cavite Rep. Elpidio Barzaga Jr. echoed the concern of citizens that they might not be able to get PhilHealth services due to the insurer’s dwindling finances, as shown in previous House hearings.
Expected shortfall
PhilHealth’s new president, Dante Gierran, told House members that for 2021, the company was expecting to get P158 billion in funds. It is projecting to spend an estimated P254 billion in benefit claim payments, in addition to P50 billion that it aims to allot for COVID-19 cases.
“There is some kind of [an expected] shortfall. Where will we get the deficit? It may possibly be from our investments, but then again, these are reserved. This is why we are asking for more [funds],” he said.
House members have raised concern about pouring P71 billion into PhilHealth despite massive fraud in the various aspects of its operations.
But according to Quimbo, the company should work hard to collect from its members under the individually paying program, mainly consisting of self-employed members.
A health economist, the Marikina lawmaker wondered why PhilHealth was bent on pushing the Konsulta Package when it was aware that it would cause further losses to the company.
Under the new program, PhilHealth would give free medical checkup for Filipinos and would spend about P68 billion, Quimbo said, citing documents she had obtained from the company.
Quimbo expressed doubt that the state insurer was ready to implement the program. A simple analysis, she said, would show that Konsulta Package would serve only around 24 million Filipinos, with the benefit pegged at P625 for each citizen.
“Even with the 46,000 accredited doctors being required to render two to three hours for free checkups, at 22 days per month, they will not be able to spend P68 billion,” she said.
PhilHealth should conduct actuarial studies before it introduces new packages, she said.
Quimbo said she had relayed to Speaker Alan Peter Cayetano and Health Secretary Francisco Duque III her findings on the two cited reasons for PhilHealth’s expected losses.
