Bong Go Urges PhilHealth to Prioritize Reforms, Reduce Costs

Senator Criticizes Disparity Between PhilHealth’s Reserve and Public Healthcare Struggles

THE PHILIPPINES: In a recent interview, Senator Christopher “Bong” Go has called on the Philippine Health Insurance Corporation (PhilHealth) to take immediate action in addressing the country’s healthcare challenges, particularly the burden of high medical costs on ordinary Filipinos. Go, who chairs the Senate Committee on Health, emphasized the pressing need for reforms in the country’s healthcare system.

“Many of our countrymen are still dying without payment for their hospitalization,” Go said, highlighting the plight of many Filipinos who avoid hospital treatment due to financial constraints. He pointed to the “unfair” situation of PhilHealth holding a PHP 500 billion reserve fund while citizens continue to struggle with their medical bills.

Expanding PhilHealth’s Benefit Packages

During Senate hearings, PhilHealth made several commitments aimed at improving its services. Among these was the expansion of its benefit packages, which Go sees as crucial to reducing healthcare costs for Filipinos. The senator advocated for more preventive care services, including dental consultations and emergency coverage, to be part of these expanded packages.

“There are many benefit packages that they should expand. For example, dental benefit package… it’s called prevention, so the disease doesn’t get worse,” Go explained. He added that improving preventive care would not only help citizens but also potentially reduce overall costs for PhilHealth in the long run.

In February 2024, PhilHealth raised its case rates by 30%, and the agency has committed to a further 50% increase by the end of the year. Go stressed that such increases are necessary to ensure that healthcare services are adequately funded and accessible.

Removal of Controversial Policies

One of the key victories in the recent Senate hearings was the abolishment of PhilHealth’s Single Period of Confinement policy, which had been in place since 2013. This policy had restricted coverage for patients who required multiple hospitalizations within a set timeframe, leaving many without financial assistance for necessary readmissions.

“They removed it effective September 30, approved by the board,” Go confirmed, crediting the Senate’s persistent efforts in achieving this change. The removal of this policy is expected to provide more continuous coverage for patients, especially those with chronic conditions requiring multiple treatments.

Additionally, Go has been vocal about PhilHealth’s 24-hour confinement rule, which required patients to be hospitalized for at least 24 hours before they could claim insurance benefits. He criticized the rule as impractical, particularly for patients who needed urgent care but did not require overnight hospitalization.

In response to Go’s concerns, PhilHealth pledged to remove the 24-hour rule by the end of the year. “We will keep an eye on it,” Go said, assuring the public that he will closely monitor the agency’s progress on this front.

Reducing Premium Contributions and Out-of-Pocket Expenses

Go has also championed the reduction of premium contributions for PhilHealth members. Currently, contributions are set at 5% of income, but Go has co-authored legislation that aims to lower this to 3.25% by 2025. He emphasized that reducing these contributions is crucial, given PhilHealth’s substantial financial reserves.

“This is the salary of the people, we worked hard for it. The premium contribution should be reduced,” he argued, underscoring the need to alleviate the financial burden on Filipino workers while ensuring that PhilHealth continues to provide essential services.

Another major focus for Go is reducing the out-of-pocket expenses Filipinos face when seeking medical care. “Please prioritize this to reduce the out-of-pocket expenditures of our fellow Filipinos,” he urged PhilHealth, emphasizing that no Filipino should be forced to forgo medical treatment due to the fear of financial ruin.

Addressing Critical Health Concerns

Go also pressed PhilHealth to prioritize coverage for diseases that are among the leading causes of death in the Philippines, including pneumonia, dengue, and chronic kidney disease. He asked whether the promised expansion of benefit packages would include these conditions, to which PhilHealth responded affirmatively.

“Yes. There are many heart diseases, cardiovascular diseases, pneumonia, diabetes, respiratory diseases,” Go explained, noting that these illnesses often lead to costly hospitalizations that many Filipinos struggle to afford. He stressed that these conditions must be addressed in PhilHealth’s future benefit expansions.

Looking Ahead: Monitoring and Accountability

As PhilHealth continues to implement reforms, Go vowed to remain vigilant in ensuring that the agency fulfills its commitments. He reiterated that promises such as the removal of restrictive policies, the expansion of benefit packages, and the reduction of premiums and out-of-pocket expenses must be fully realized for the benefit of all Filipinos.

“We will keep an eye on their promises,” Go repeated, promising continued oversight to ensure that PhilHealth delivers on its commitments to the public.

The senator concluded by urging PhilHealth to use its funds responsibly to alleviate the financial struggles of ordinary Filipinos. “I will repeat, your money is too much while the lives of our countrymen who cannot leave the hospital are dying,” he said, stressing the need for immediate reforms to return the benefits of the public’s contributions to those who need them most.