Lawmaker to defer DOH’s 2025 budget if PhilHealth fails to improve benefits, coverage

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Lawmaker to defer DOH’s 2025 budget if PhilHealth fails to improve benefits, coverage

Katrina Domingo,

ABS-CBN News

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MANILA — Approval of the Department of Health’s (DOH) proposed 2025 budget will be deferred if the Philippine Health Insurance Corp (PhilHealth) fails to increase the coverage of its benefits package before plenary deliberations, a House lawmaker said on Wednesday.

PhilHealth should implement another “30-percent increase in all its benefit packages” and include diagnostic scans in its covered services, AGRI Party-list Rep. Wilbert Lee said during the DOH’s budget deliberations in the House of Representatives.

“Kapag hindi ito nangyari (If that does not happen), I will move for the deferment of the budget of the PhilHealth at the proper time,” the lawmaker said.

He said the state health insurer should use its excess funds to expand its services and lower member premiums.

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Lee presented a P470,000 hospital bill showing that, of the total amount, PhilHealth only covered P24,000, which he said seemed like pocket change.

He added processing PhilHealth needs to move faster on improving its services.

“Hindi na po katanggap-tanggap na pagmi-meetingan na naman ng BenComm (Benefits Committee) ito at i-dri-dribble na naman tayo,” he said.

(It is no longer acceptable to say that the the Benefits Commitee will meet on it, and they will pass the buck again)

The Department of Finance (DOF) earlier said that the state insurer could end 2024 with about P546 billion in funds even if it utilizes P90 billion to cover the allowances of healthcare workers during the pandemic.

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PHILHEALTH: COVERAGE ALREADY INCREASED, ANOTHER HIKE EYED

The state insurer has “implemented a 30-percent increase” in February, PhilHealth president Emmanuel Ledesma told the House Committee on Appropriations.

“We are in the process of studying another round across the board. It will happen on or before Christmas Day,” he said.

“So we will have an almost 60-percent increase across the board,” he added.

Ledesma vowed to check if the state health insurer could cover Lee’s request.

“We are currently looking at all of these. We are asking for more patience,” the PhilHealth president said.

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“There are close to 10,000 case rates in PhilHealth. We are really trying to cover all,” he said.

Health Secretary Teodoro Herbosa said “they will review as requested all these packages,” noting that the current 30-percent support value of the state insurer in every hospital bill is “low.”

“The progress of PhilHealth has also been very slow. We should jump up our provision of health care to as much as 80 percent of costs,” the health secretary said.

“We will comply and make sure that appropriate action will be taken by PhilHealth,” he said.

Earlier this year, PhilHealth said they will sustain the increase in premium contributions to 5 percent from 4 percent of a worker's monthly salary.

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