HOUSE members on Wednesday called on officials of the Philippine Health Insurance Corporation (PhilHealth) and the Department of Health (DOH) to settle their differences and align themselves to better serve the people.
Lawmakers made the call during the meeting of the House Committee on Good Government and Public Accountability chaired by Manila Rep. Joel Chua convened to discuss PhilHealth’s zero subsidy in the 2025 national budget.
Former DOH secretary and Iloilo Rep. Janette Garin noted the apparent internal conflict between the PhilHealth and the DOH regarding case rates or prescribed costs for treatments for covered ailments or diseases, and the implausibility that the PhilHealth Board of Directors, which the DOH secretary chairs, discusses step-by-step or one-by-one the case rates during its meetings.
“Hindi na kaya ng secretary of Health yan. Huwag nating lagyan ng icing na hindi kapani-paniwala ang mga pangyayari. The immediate solution here is first, to stop the internal fighting between PhilHealth and DOH. Kasi kaming mga pasyente at yung mga tao ang nagiging kawawa sa walang hintong bangayan ng DOH at PhilHealth. Let’s call that situation a fact. Kasi doon sa Board meeting ninyo nagkakaroon ng awayan ang Chairman, Secretary ng DOH at President ng PhilHealth. And I think that is an injustice to the Filipino people,” Garin said.
She said the Board should not be involved in the issue of case rates.
“Let’s put back the career officials who were supposed to examine the case rates. First question, why was that collapsed? Second question, yung case rates na yan na palpak ang pagpagawa, dalawang tao ang umupo sa mesa at nag drawing. Kaya nga ginawan yan ng amendments, and I did issue an order to invite all representatives from patients, stakeholders, hospitals, and medical professionals and specialists. Pero sa dami-dami ng mga meeting nasaan ang output?” Garin asked.
Antipolo City Rep. Romeo Acop sought to confirm Garin’s observations.
PhilHealth President and Chief Executive Officer Emmanuel Ledesma Jr. admitted that there are debates and differences between in PhilHealth and DOH policies, but these have not deterred them from performing well, emphasizing that both PhilHealth and the DOH are working for the Filipino people.
“The fact that we are able to increase the case rates by 95 percent (and) enhance the benefit packages, we’ve been able to increase the payment claims to hospitals, we’ve been able to move forward in our digitalization process. We’ve done so many positive things so there are always two sides to a coin po, pwede nating tignan yung hindi masyadong maganda pero marami din po tayong magandang accomplishments,” Ledesma said.
DOH Assistant Secretary Albert Francis Domingo said he witnessed the healthy debates in PhilHealth Board meetings.
Chua encouraged the PhilHealth and the DOH to align.
“Could you imagine what you could accomplish kung naka-align kayong dalawa. Mayroon pa kayong konting differences and yet you are telling us marami kayong nagiging accomplishment (What more) pag aligned kayo,” he said.
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