Disturbing, if not worrisome, is the recent finding of the government think-tank Philippine Institute for Development Studies that five provinces have only 52 percent or lower PhilHealth coverage.
These provinces are Maguindanao, Lanao del Sur, Basilan, Sulu, and Tawi-Tawi. These provinces, by the way, are populated mostly by Filipinos who live below the poverty line.
Compare that with Greater Manila – composed of Metro Manila, Central Luzon, and Calabarzon – which has 98.9 percent, Luzon 90.7 percent, and the Visayas 90.5 percent.
The National Health Insurance Program seeks to achieve universal population coverage in the country.
But the 52 percent coverage in the five provinces is way below the target 100 percent of the healthcare coverage guaranteed by the Universal Healthcare Act.
RA 11223 provides that all Filipinos are automatically enrolled under the NHIP. Hence, PhilHealth coverage should be 100 percent.
But after looking into PhilHealth’s registered beneficiaries data from 2018 to 2021, the PIDS researchers found geographic discrepancies in the population coverage across provinces.
The study showed that Mindanao has the largest share of indirect contributors, mostly indigent or sponsored, at 57 percent.
Needless to say, it is the indigents and beneficiaries of government programs like the Pantawid Pamilya Pilipino Program who are at higher risk of contracting diseases.
The most poverty-stricken provinces also have low population coverage, with only senior citizens, indigents, or sponsored beneficiaries as members.
What should be done?
The government think-tank urged PhilHealth and the Department of Health to focus on improving healthcare coverage in the poorest provinces, especially in priority areas like Mindanao.
The PIDS research emphasized using standardized equity measures, like poverty incidence, in national allocation and prioritization frameworks of projects and activities for equity and efficiency across health programs.
The government think-tank also proposed that PhilHealth, in collaboration with other government agencies, must ensure the accuracy, validity, and consistency of data on indigents at both national and subnational levels to improve healthcare equity throughout the country.
The 1987 Constitution directs the government to “protect and promote the right to health of the people” and to “adopt an integrated and comprehensive approach to health development which shall endeavor to make essential goods, health and other social services available to all the people at affordable cost.” The administration should take decisive steps to ensure that this particular constitutional provision is fully carried out.