THIS REFERS to Mr. Ike Señeres’ column “Reinventing universal healthcare” which came out in Panay News on Jan. 18, 2019. Allow us to address the key points raised.
- On the contention that “In other words, the real bottom line here is how much the patient still has to pay after deducting what PhilHealth has to pay in terms of the coverage that is due to their members.”
We agree that the real bottom line here is how much the patient still has to pay after deducting what PhilHealth has to pay in terms of coverage that is due to the members. May we inform you that this is basically one of the promises of the Universal Health Care bill if signed into law, i.e., to impose no co-payment for services rendered in basic or ward accommodation, and that co-payments and co-insurance for amenities in public hospitals shall be regulated by the Department of Health and PhilHealth. We truly believe that with this provision, Filipinos will be able to feel the relevance of UHC.
- “… having access to private hospitals and clinics is not part of the equation, because in those places, the private patients could presumably pay for every service or procedure, regardless of whether these are covered by medical insurance or not.”
While patients seeking treatment in private facilities can be presumed to be financially capable, we should also consider the fact that prohibitive medical costs especially for catastrophic cases can potentially lead one, even the rich, to impoverishment.
There have been numerous cases in the past wherein families, even those who are well-off and enjoying the good life, were eventually stripped of their life’s savings or forced to borrow only to be buried later on in debt. We even heard of families getting their children out of school or seeing those hard-earned possessions sold away just to pay for the costs of recovering from financially draining health conditions.
As no one can really guarantee a life that is free from illness or injury despite strong determination to reduce their likelihood, it will always be a wise decision to make the necessary investment in health not only through healthy and fit living, but also through health insurance.
More importantly, those who cannot afford to pay should have equal access to social health insurance in keeping with the program’s principle of social solidarity which dictates that healthy pays for the sick, those who can afford pays for those who cannot afford, and the young subsidizing the old.
- “Again in this context, what should be in the equation are those patients who have no other choice but to go to the public hospitals and clinics, where in theory everything should be free such that having medical insurance has no direct bearing at all.”
We believe that a meaningful health insurance should more than adequately provide for the financial protection for a citizen’s hospitalization expenses. We have been looking at ways by which we can help reduce out-of-pocket expenditures especially for the poor and the marginalized. One of the ways by which we realize this objective is through the No Balance Billing (NBB) policy or Walang Dagdag Bayad. Under the NBB, no other fees will be charged against entitled members including their dependents beyond what PhilHealth pays for when they are admitted in government hospitals. Currently, the NBB covers indigent and sponsored members, and most recently the household helpers (kasambahay) as well.
We appreciate your concern over the feasibility of universal healthcare’s aim of providing all Filipinos with free quality healthcare. We are especially conscious of this pronouncement that puts the PhilHealth program at the center of our present administration’s health agenda. We believe we have consistently adhered to the 3As that are needed to help make health insurance meaningful, namely, adequacy, availability and affordability.
While we understand that medical expenses are often huge, unplanned and may create financial stress at a time when our member’s primary concern is their health rather than financial issues, allow us to assure the public that we are continuously on our toes for the benefit of our members. – SHIRLEY B. DOMINGO, M.D., vice president for corporate affairs, group/official spokesperson, Philippine Health Insurance Corp.
