“Dapat masanay kang tumulong sa mahihirap,” Senate Committee on Health Chairperson Senator Bong Go said as he urged Philippine Health Insurance Corporation (PhilHealth) CEO and President Emmanuel Ledesma, Jr., to scrap its single period of confinement policy.
A single period of confinement, according to PhilHealth Circular No. 0035, series of 2013, means admissions and readmissions due to the same illness or procedure within a 90-calendar day period shall only be compensated with one case rate benefit.
During the Senate Committee on Health Public Hearing recently which Go presided on as Chairperson of the said committee, Ledesma gave his commitment that PhilHealth will thoroughly study the revision and the possible removal of the abovementioned policy, saying there has been a flaw in the Circular.
The legislator, in his opening statement, raised the policy of single period of confinement, “Bakit ganyan ang polisiya? Kunyari nagka-kumplikasyon ka sa panganganak pag nagka-bleeding, makaka-claim ka base sa case rate. Pero sa susunod na linggo, pag mag-bleed ka ulit, hindi ka na makakaclaim.”
“Mapipigilan mo ba ang diarrhea? Mapipigilan mo ba ang bleeding o pneumonia?”
“Kung ma-confine ang isang tao dahil sa diarrhea at nagamit na niya ang PhilHealth nya, hindi na sya pwedeng magka-diarrhea within 90 days dahil hindi na niya maa-avail ang PhilHealth benefits for the same illness. Mapipigilan mo ba ang diarrhea? Mapipigilan mo ba ang bleeding o pneumonia? Pwede ba nating sabihin, sorry po pero hindi ka na pwedeng magka-diarrhea within the next 90 days,” the lawmaker added.
By not covering the same illness, the senator noted, some doctors are forced to give a different diagnosis to help patients to be able to avail of their PhilHealth benefits.
In the same hearing, he called the attention of PhilHealth to increase their benefits in light of the recent spikes of illnesses, including leptospirosis, dengue, and the most recent, monkeypox.
Go underscored that health equates with the life of every Filipino, recalling a patient from Ozamis who wanted to remove oxygen support to avoid further hospital costs.
“Katumbas ng kalusugan ang buhay po ng bawat Pilipino,” he stressed.
Related to this, Go mentioned the out of pocket health expenses of Filipinos, citing a 2024 Philippine Institute for Development Studies (PIDS) research, which showed that out of the total expenses of Filipinos for their health, 48% was paid from their own pockets, 25% came from government share, such as PhilHealth, while the rest came from voluntary and compulsory health care payment schemes.
In the middle of all this, he reiterated his deep concern and opposition to the transfer of billions of funds from PhilHealth to the national treasury.
As stated by executive officials during the last hearing, the funds for health will be used instead to fund other programs and projects of the government.
“Hindi ito katanggap-tanggap para sa akin lalo na dahil maraming pasyente pa po hanggang ngayon ang naghihingalo at hindi makalabas sa hospital dahil wala pong pambayad. Lalung-lalo na po yung mahihirap nating kababayan,” Go said.
“Imagine P500 billion reserve fund, ilang pasyente pa ang mabubuhay imbes mamatay kung magagamit po itong pondo na ito?”
“Seryosong usapin po ito dahil buhay po ang nakataya dito… Natutulog po yung pondo dyan, kaya nga po nawawalis ng ating mga finance officials ng gobyerno dahil bilyon-bilyong piso ang nakatengga na dapat sana magamit para sa mga pasyente. Imagine P500 billion reserve fund, ilang pasyente pa ang mabubuhay imbes mamatay kung magagamit po itong pondo na ito? Bakit, bangko na ba ang PhilHealth na kailangan nitong mag-accumulate ng liquid assets?” he lamented further.
Part of the discussion on the August 20 Senate public hearing is the excess funds of PhilHealth, the review of the implementation of the Universal Health Coverage Act, the utilization of medical assistance programs, the implementation of the Health Facilities Enhancement Program, and the release of Health Emergency Allowances still due to qualified health workers, among others.
