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THE Philippine Health Insurance Corp. (PhilHealth) defended the increase in its contributions, saying it will allow the state health insurer to provide primary care to its members.
The increase, which was implemented for the first time in 2020, spans five years according to the provisions of the Republic Law 11223 or the “Universal Health Care Law.”
By 2021, PhilHealth will increase its premium rate to 3.5 percent per month from 3 percent in 2020. This means that those who earn P10,000.01 to P69,999 will pay a premium rate ranging from P350 to P2449.99. Those earning P10,000 and less will pay P350 per month, while those with an income of P 70,000 will pay P 2,450.
In 2022, PhilHealth’s premium rate will increase to 4 percent per month for those who earn up to P80,000; 4.5 percent in 2023 for those earning up to P90,000; and 5 percent in 2024 for those who earn up to P100,000.
The higher premiums prompted reactions from the public and legislators as they would be implemented amid the coronavirus pandemic and corruption allegations against the state insurer.
Representative for Anakalusugan’s party list, Michael Defensor, joined calls on Saturday to defer the increase.
“Millions of taxpayers are daily wage earners and other workers reeling from the Covid-19 pandemic, like most of our people. PhilHealth should not increase its financial burden at this time, ”said Defender.
Defender proposes delaying the increase by at least six months to give Congress time to pass an amendment bill and other measures to increase its revenue through reforms that will make PhilHealth more efficient and effective and reduce corruption, which has resulting in losses worth billions of pesos each year.
The legislator said PhilHealth could implement the adjustment later this year and would still comply with the law.
Defender said that even with the delayed increase in contributions, PhilHealth will not run out of funds as it is slated to receive P71 billion from taxpayers under the 2021 national budget. He added that PhilHealth can also use the proceeds from its investments.
Defender also urged the new leadership of the state insurer to recover “illegal” advances related to Covid-19 for private hospitals or health care institutions (HCI) under the interim reimbursement mechanism (IRM), which amounts to 15,000 million of pesos, including 1,500 million pesos released to health establishments with cases of fraud. These funds purportedly allow HCIs to provide assistance to victims of natural disasters and calamities such as the Covid-19 pandemic.
“In fact, they should get those advances back first before making any premium increases,” he said.
However, PhilHealth’s senior manager of corporate communications Rey Balena told The Manila Times in a telephone interview that they have no control over the mandatory increase.
Balena said that the increase in premiums would allow the state health insurer to maintain the current level of benefits, as well as expand it further, such as the pilot execution of the package “Konsultasyong Sulit at Tama” (affordable and adequate consultations), which allows All Filipinos enroll with a primary healthcare provider of their choice.
Filipino overseas workers, who will also pay adjusted premiums, will also benefit from the national health insurance program, as they and their families will be fully covered by PhilHealth.
He said PhilHealth was saddened by the fact that many people disagreed with the increase in the contribution amid the corruption allegations that plagued PhilHealth last year, including the P15 billion of IRM funds allegedly “stolen” by senior executives from their coffers.
The state insurer said that P13.03 billion of the P 14.97 billion, or 87 percent, of the funds have been liquidated by the recipient HCIs.
Of the 711 health facilities that have made use of the IRM fund, 353 have been completely liquidated, 273 have liquidated at least 50 percent, and 85 have managed to liquidate less than 50 percent of the funds they received under the program.
Balena reiterated that the money was not “stolen” and that there were receipts to prove his claim.
It assured the public that PhilHealth was instituting reforms, especially in fraud detection under the leadership of its new president, the former head of the National Bureau of Investigation, Dante Gierran.
The IRM funds have been the subject of a joint panel investigation that Defensor co-led as then head of the public accounts committee.
In October of last year, the joint committee passed House Bill (HB) 7832, which seeks to reform PhilHealth by “prescribing related urgent measures necessary and appropriate to address the issues and concerns” affecting the state insurer.
Defender was also the author of HB 7424, which seeks reduced premium contribution rates for millions of OFW.
With reports from DIVINA NOVA JOY DELA CRUZ
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