Filipinos188jili,, for whom quality health care has long been elusive, are astounded by the story that the Philippine Health Insurance Corp. has P89.9 billion in “unused” funds that will go to national coffers for unprogrammed projects. PhilHealth has yet to settle some P4 billion in claims of private hospitals as of last month.

State subsidies to PhilHealth are supposed to expand health insurance coverage to include indigents and senior citizens. Latest data, however, indicated that of the bottom 20 percent poorest households, PhilHealth covers only one percent. The P89.9 billion is taken from the subsidies that PhilHealth failed to use from 2021 to 2023. Will this inefficiency on the part of PhilHealth mean a further slowdown in the inclusion of the marginalized in its coverage?

Public health care funds are so inadequate the government has been forced to stagger over several years the implementation of Republic Act 11223, the Universal Health Care Act – and this was before the COVID pandemic stretched health care resources to breaking point. PhilHealth does not cover treatment in emergency rooms and a host of other medical services. A visit to the National Center for Mental Health in Mandaluyong will show the acute inadequacy of funding for mental health care.

PhilHealth has started remitting the P89.9 billion in tranches to the national coffers. It can then be tapped for unprogrammed projects, which are implemented only if there is financing available from excess funds. Those unprogrammed amounts keep ballooning in the annual General Appropriations Act. The usual sources of excess funds are supposed to be new or higher taxes. For this year’s GAA, however, the bicameral conference committee inserted a provision that allows excess funds to be sourced from government-owned and controlled corporations. PhilHealth, although deriving its funding mainly from public contributions, is classified as a GOCC.

In line with this bicameral insertion, which faces a legal challenge, the Department of Finance issued a circular to impound GOCC “savings.” Critics have pointed out that the DOF circular, along with the GAA insertion, effectively amends the laws creating each GOCC. The Universal Health Care Act specifically states that excess PhilHealth funds can be used only to increase the program’s benefits and to decrease the amount of members’ contributions. But despite the P89.9 billion in supposed savings, PhilHealth contributions even went up from four percent to five percent of monthly income beginning this year.

If the government cannot see any legal, ethical or moral anomaly in this issue188jili,, perhaps its view can be altered by the demand of workers to stop the increase in their PhilHealth premiums in the light of the existence of excess funds. Or if the Supreme Court strikes down the GAA insertion and the DOF circular.

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