Group wants PhilHealth to account for fradulent schemes

MANILA, Philippines — An alliance of doctors, nurses, and other health workers and professionals raise serious doubts about the “predominantly commercial insurance-based Universal Health Care Law” in the wake of mid corruption allegations hounding the Philippine Health Insurance Corp. (PhilHealth).

In a statement, the Health Alliance for Democracy (HEAD) demanded PhilHealth to account for all the unresolved fraudulent schemes, including the cases of “ghost dialysis” patients at WellMed Dialysis Center, a PhilHealth-accredited private facility in Novaliches, Quezon City.

According to Edwin Roberto, a former WellMed employee, the center has been filing benefit claims of deceased or nonexistent PhilHealth members.

HEAD said there were also fraudulent claims reported on cataract operations and pneumonia.

Without resolving these cases, the alliance said questions would arise about the multi-billion government allocation to PhilHealth for the implementation of the UHC.

PhilHealth will handle the implementation of the UHC with premium contributions of its members, funds allocated under the General Appropriations Act, shares from Philippine Gaming and Amusement Corp., and shares from collected sin taxes.

According to a three-part report in the Philippine Daily Inquirer, an estimated P154 billion from government coffers were lost from 2013 to 2018 due to PhilHealth overpayments and other fraudulent schemes.

The group also expressed concern over the reported “mafia” operators in the state health insurance company, “which over the years have been managing not less than P60B worth of people’s money on top of the billions worth of members’ premium contribution.”

“For health care to be really universal, the government should go beyond a health insurance program. It should strive to achieve the people’s aspiration for a free, comprehensive and progressive health care system,” said HEAD.

“Government funds which came from people’s money should be allocated directly to strengthen the public health care system,” it added.

(Editor: Alexander T. Magno)