PHIC accounts for only 11% of the total Health Expenditure despite billions of funds

Media Release

07 September 2016

Does the Duterte Administration want to provide free health services?

If yes, then PhilHealth is NOT the way to go.

After calling out the Philippine Health Insurance Corporation (PhilHealth) for failing to be relevant to the poor during the presidential debates and expressing exasperation for the lack of access to health services, President Rodrigo Duterte seems to be backtracking.  

Despite its exclusion from the budget of the Department of Health, subsidy for PhilHealth to cover for indigent patients is increased by 6.9 billion pesos, from 43.8 billion pesos in 2016 to 50.2 billion pesos in 2017.  

For Health Alliance for Democracy (HEAD), PhilHealth is not the way to provide free health services.

“Free health service means no payment at the point of service.” said Dr. Joseph Carabeo, HEAD secretary-general. “This does not happen with PhilHealth.”

First, PhilHealth benefits are enjoyed mainly by in-patients. Those who need out-patient care or those who are not admitted to a healthcare facility have very little to benefit from PhilHealth.

Second, diseases or medical conditions that do not fall within the PhilHealth list of case rates have even less benefits, even for in-patients.

Third, PhilHealth subsidies are mainly eaten up by private health institutions since fees and rates are unregulated, and costs of health care remain prohibitively high.  

Most importantly, PhilHealth is only as good as the existing healthcare delivery system. In most parts of the country, government-run health facilities are either absent or under-resourced, forcing patients to shell out their own money.

“History and government data have proven this.” Dr. Carabeo added. “Despite billions poured into PhilHealth, it accounts for only 11% of total health expenditure. On the other hand, out-of-pocket spending is still high at 60%.”

HEAD is proposing direct subsidy to state-run facilities rather than coursing funds through PhilHealth.

With better funding, health facilities can have better and more complete medical supplies and equipment. Barangay and rural health centers can provide free and quality out-patient services, while bigger facilities like hospitals will have better and more complete diagnostic and therapeutic capabilities.

“For years, PhilHealth has eaten up the biggest chunk of the national budget for health. For years, quality health services have remained inaccessible. If change is to come, the Duterte government’s reliance on PhilHealth must change.” Carabeo said. ###