"The agency is no stranger to allegations of near-systemic corruption."
The media reported recently that the Philippine government would be applying to the Asian Development Bank for a $400-million loan to “support the implementation of wide-ranging police, legal, regulatory, institutional, financing, service-delivery and performance-monitoring reforms envisaged in the Universal Health Care (UHC) Act to achieve and sustain UHC.” The loan, if granted, would be implemented by the Department of Health.
At about the same time that they were reporting a Duterte administration intention to seek more financing for PhilHealth (Philippine Health Insurance Corporation), the media were reporting that the chairman of the Senate committee on health and demography, Senator Juan Edgardo Angara, is poised to hold hearings of his committee to investigate complaints lodged against PhilHealth by various health-sector institutions, including the Private Hospitals Association of the Philippines and Philippine Hospitals Association.
Senator Angara clearly appears to think that things are not going well at PhilHealth and that an investigation by the Senate is needed. “(T)he P6.3 billion in hospital claims (that has) already been released by Philhealth to 206 healthcare facilities…..is a measly amount compared to the P28 billion in unpaid claims stated by the Private Hospitals Association of the Philippines,” said Sen. Angara when announcing the holding of hearings by his committee. “(D)uring the Senate committee of the whole hearing on PhilHealth last August 2020 PHAP already raised its concerns on collectibles/ arrears amounting to P3.6 billion,” he added.
The other association of hospitals, PHA, has told Sen. Angara that its members’ receivables from PhilHealth have remained “too high”—these apparently range from P50 million to P700 million. As a result, these hospitals have been forced to obtain loans from banks and reduce their staff and bed capacities. The PHA claims that thus far, PhilHealth has settled only about 15 percent of its members’ total claims relating to COVID-19 cases.
The P28 billion worth of claims that PHAP is complaining about covers services rendered by around 700 hospitals from March to December 2020.
These are enormous sums, and to a reasonable person they suggest inefficiency and mismanagement at the very least. The two largest groups of hospitals in this country are unlikely to be both wrong.
Thus far, nothing has been said about investigating corrupt practices in PhilHealth. The nation’s universal health care is of course, no stranger to allegations of near-systemic corruption. The 2020 Senate hearings resulted in the forced resignation of PhilHealth’s president and a number of other high-level executives. Only the continued expression of support from President Rodrigo Duterte—misguided support, in the view of many knowledgeable observer—saved the day for Philhealth’s ex-oficio chairman, Secretary of Health Francisco Duque III.
Last year’s PhilHealth hearings, and the new round of hearings that the Senate is about to hold, are a very sad commentary on the state and prospects of an institution upon which this grossly health care-short nation had pinned so much hope.
On the basis of its performance, especially during this pandemic, it can no longer be business as usual. Philhealth is a failing±if not an already failed – institution.
PhilHealth needs expert help. ADB management and Senator Angara’s committee must arrange for PhilHealth to get that help. The near-term prospects of PhilHealth turning around and becoming well-managed and efficient—especially with regard to finances±are very dim.
I suggest to ADB and to Senator Angara that, as a condition for PhilHealth’s receiving any more government funds, a request be made to one of the world’s best national health care institutions for the provision of technical assistance to PhilHealth. The experts provided by the foreign health care institution would thoroughly review, and make recommendations on, all aspects of Philhealth operations, especially its relations with this country’s hospital system.
My choice for the provider of technical assistance for Philhealth is the highly regarded NHS (National Health Service) of the United Kingdom. If approached, I’m certain that the British government will be only too happy to oblige.