DOH eyeing expansion of Zero Balance Billing program
MANILA, Philippines—The Department of Health (DOH) is seeking to expand the implementation of its zero balance billing program as it seeks to address the inadequate number of beds and provincial government hospitals in the country.
“The DOH is proposing for a new line item in the GAA (General Appropriations Act), which we will call ‘Zero Balance Billing support for Level 2 and Level 3 LGU (local government unit) hospitals,’” Health Secretary Teodoro Herbosa said on Wednesday.
Herbosa said during the hearing of the Senate committee on finance regarding the 2026 proposed budget of the DOH that he had sent a letter to finance committee chair Sen. Sherwin Gatchalian regarding the proposal.
“This is so [the zero balance billing policy] will not just be for DOH hospitals. It would be very helpful if this is funded,” Herbosa explained.
According to him, the fund will be used to support local government units that currently have no DOH hospital in their area, as well as lower-class municipalities that may not have a lot of budget to implement the zero balance billing policy.
He also explained that the DOH is focusing on Level 2 and Level 3 LGU hospitals as these handle more serious cases compared to Level 1 facilities.
READ: Long lines? Marcos wants ‘zero balance billing’ in DOH hospitals improved
Under the zero balance billing policy of the government, patients no longer have to pay any fees when admitted to the basic or ward accommodation of the 83 DOH-run hospitals in the country.
Herbosa, however, said in the same hearing that these DOH hospitals are currently located in only 42 provinces, with 40 others lacking such a facility.
This means that some Filipinos would have to travel to another city or municipality just to avail of the zero balance billing.
Herbosa also pointed out in an earlier hearing that the country’s bed-to-population ratio as of 2024 was at 1.005 beds per population of 1,000, which was lower than the ideal 1.5 per 1,000.
Gatchalian noted during the hearing on Wednesday that “because of the zero balance billing, we have had unintended consequences, one of which is the bed occupancy rate.”
In his presentation, Gatchalian pointed out that based on 2024 data from the DOH, the average annual bed occupancy rate of hospitals in Metro Manila was at 96.83 percent, while for regional hospitals and other health facilities, the bed occupancy rate was at 151.29 percent.
This was higher than the recorded rates in 2023, which was 78.47 percent for Metro Manila hospitals and 115.68 percent for regional hospitals and other health facilities.
READ: DOH says lack of hospitals, beds hinder access to Zero Balance Billing
“We can see that we have a lot of hospitals that are overcapacity. The same with regional hospitals,” Gatchalian said.
“In other words, with the zero balance billing, we will see this type of scenario moving forward.”
Based on his presentation, several Metro Manila hospitals had an average bed occupancy rate higher than 100 percent in 2024.
This includes Dr. Jose Fabella Memorial Hospital in Santa Cruz, Manila, which was at 169.74 percent; Quirino Memorial Medical Center in Quezon City, with 150.17 percent; and Jose Reyes Memorial Medical Center, also in Santa Cruz, with 120.34 percent.
For regional hospitals and other health facilities, Gatchalian noted that the San Lorenzo Ruiz General Hospital in Malabon City had an average occupancy rate of 374.75 percent; Siargao Island Medical Center in Dapa, Surigao del Norte, was at 312 percent; while Joni Villanueva General Hospital in Bocaue, Bulacan, was at 242.32 percent. /gsg
