PhilHealth office. INQUIRER FILE PHOTO
MANILA, Philippines — Why should PhilHealth give its funds when many things should be fixed? Maybe because we were not consulted in the first place.
The Philippine Health Insurance Corp. (PhilHealth) labor union has joined the opposition against the transfer of the state health insurer’s supposedly unused funds of nearly P90 billion to the national government and called for expanding health benefits using that money to lessen the out-of-pocket expenses of Filipinos needing medical care.
In an open letter dated Aug. 13, PhilHealth-WHITE (Workers for Hope, Integrity, Transparency and Empowerment), also called out the management for claiming it had “surplus” funds but couldn’t implement benefits for the marginalized sectors, including persons with disabilities and solo parents.
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“There have been many discussions and studies on the controversy that we are [again] facing—the remittance of P89.9 billion of PhilHealth to the national government. The law is clear with it: it is prohibited, it cannot happen and it should not happen,” PhilHealth-WHITE president Maria Fe Francisco said in the letter.
Shared position
The union held the same position of budget watchdogs and members of medical professional organizations that remitting the unutilized government subsidies of PhilHealth back to the treasury was also in violation of Section 11 of Republic Act No. 11223, or the Universal Health Care (UHC) Act of 2019.
The UHC Act states that “no portion of the reserve fund or income thereof shall accrue to the general fund of the national government or to any of its agencies or instrumentalities, including government-owned and -controlled corporations (GOCCs).”
According to Francisco, the law also directs PhilHealth to use any excess reserve fund “to increase the program’s benefits and to decrease the amount of members’ contribution.”
The Department of Finance (DOF), citing the 2024 budget law, issued Department Circular No. 003-2024 directing PhilHealth and other GOCCs to remit their unutilized subsidies from 2021 to 2023 to the national treasury to fund the government’s unprogrammed appropriations.
PhilHealth already gave P20 billion back to the general fund on May 10. Three more transfers are set: P10 billion on Aug. 21, P30 billion on Oct. 16, and P30 billion on May 26, 2025.
Return P20 billion
The DOF and the Department of Health (DOH) said the P20 billion was used to fund the P27.4 billion in unpaid health emergency allowance for healthcare workers who served during the pandemic. The DOH was supposed to request P27.4 billion for its 2025 budget for the same purpose.
PhilHealth-WHITE called on the DOF to return the P20 billion to improve PhilHealth programs.
“Why should PhilHealth give its funds when there are many things that should be fixed? Maybe because we were not consulted in the first place,” the union said.
Supreme Court petition
Sen. Aquilino Pimentel III, doctors and public health advocates filed a petition in the Supreme Court on Aug. 2 to stop the transfer of the PhilHealth funds to the national treasury.
Speaker Martin Romualdez, Senate President Francis Escudero, Finance Secretary Ralph Recto, Executive Secretary Lucas Bersamin and PhilHealth president Emmanuel Ledesma Jr. were named as respondents.
On Aug. 13, the court gave the respondents 10 days to comment on the temporary restraining order being sought by the petitioners, according to the tribunal’s spokesperson Camille Ting.
The petitioners also asked the Supreme Court to return any funds that had been transferred following the DOF circular back to PhilHealth.
By taking away the unused funds, which are part of pooled PhilHealth member’s contributions, the government “deprived the Filipino people access to quality and affordable health care goods and services,” they said.
“Without challenging the act of Congress and the Executive of siphoning public funds intended by law and public policy for health, a dangerous precedent will be set that shall be inimical to the public welfare and the citizens’ right to accessible and affordable health and medical services,” their petition read in part.
DOF defends move
The DOF has defended its decision to transfer funds, asserting that it was acting within the authority granted by Congress.
It also reassured the public that reclaiming the “idle funds” would not hinder the state insurer’s capacity to deliver services.
Recto maintained that even if PhilHealth transferred P90 billion, it would still be awash in cash of about P546 billion and stay afloat for three more years at least.
But the union members were not seeing the supposed surplus as more than half of the PhilHealth workforce were still casual and job order employees, and regular posts have not been updated for the past 17 years. The state health insurance corporation was established in 1995.
“We are facing all the harsh criticisms of the public because they thought we are living in luxury inside our offices. This is not true. Many of our members have left PhilHealth in search for better opportunities,” the union said.
Puzzling recommendation
It said that despite the “long list of deficiencies” in PhilHealth’s operations, it was puzzling for PhilHealth president Ledesma to recommend to President Marcos a reduction of its members’ premium contribution.
“We understand that it would be a big help to members if the premium was lowered. But on how it would be done, or what is the legal basis, we also do not know,” the union said. Health Secretary Teodoro Herbosa, who is the ex officio chair of the PhilHealth board, also questioned Ledesma’s recommendation.
The current 5 percent premium paid for by PhilHealth direct contributors is in compliance with RA 11223. PhilHealth is mandated to gradually raise members’ contributions from 2.75 percent in 2019 year after year. The scheduled increases will end in 2025 when it reaches the second year of the 5-percent cap.
Since the UHC law was enacted in 2019, the premiums have not been reduced, but the scheduled raise for contributions has been suspended twice—in 2021 and 2023, during the pandemic.
Increased benefit package
PhilHealth in February this year implemented a 30-percent increase in the benefit package in almost all of its 9,000 case rates—the first across-the-board hike since 2013.
But Herbosa noted that these were “not additional benefits, but corrective benefits” to account for the inflation in the past decade.
Since last year, PhilHealth has significantly increased the benefit packages for some “catastrophic diseases,” including cancers. The aim is to lessen the out-of-pocket hospital expenses of members, if not to completely eliminate them.
It also expanded outpatient benefits, including outpatient therapeutic care for severe acute malnutrition for children 60 months and below (from P7,500 to P15,000 per year) and outpatient mental health package (from P9,000 to P16,000 per year). —WITH A REPORT FROM JANE BAUTISTA