Lawmaker bats for systemic reforms in PhilHealth

The one-patient, one-record principle will be followed, and an independent audit of the PhilHealth shall be required. (File Photo: Philippine Health Insurance Corporation/Facebook)

MANILA – A lawmaker at the House of Representatives on Thursday filed a measure introducing reforms to the country’s national health insurance system amid the alleged anomalies hounding the Philippine Health Insurance Corporation (PhilHealth).

Albay Rep. Joey Salceda filed House Bill 7578, or the Philhealth Reform Act of 2020, which would implement an overhaul of the main segments of the national health insurer’s operations to root out corruption and ensure that universal health care will be fully funded.

The bill proposes systemic reforms in the collection system, management of the reserve fund, the distribution and verification of claims and benefits, and the governance of the agency.

Under the bill, the premium contribution scheme is made more progressive by linking the income tax rate with a premium contribution.

Salceda said this will potentially save minimum wage earners at least PHP4,800 a year in premiums by paying only PHP100 monthly in minimum contributions

This would also effectively exempt overseas Filipino workers (OFWs) from paying premium contributions since they do not earn their income in the Philippines and will not be able to use the services of the health insurer.

“We are tying the premium contribution to income and are ending the income ceiling system. Under the old scheme, the more you earn above the ceiling, the less you pay as a share of income. This is of course not progressive. We are improving the system by linking it with income,” Salceda said.

The bill also seeks to reform the PhilHealth governance structure by making the Secretary of Finance Chair of the Board.

Salceda noted that as an insurance and investment agency, PhilHealth needs the same caliber of management in the Government Service Insurance System (GSIS).

“GOCCs (government-owned and controlled corporations) under the Secretary of Finance also seem to be better governed than other GOCCs,” he said.

For reform in the reserve fund management, the bill proposes making the Bureau of Treasury the fund manager of the investment reserve fund, accumulating net income into the reserve fund, and removing the two-year ceiling in fund life.

To prevent fraud in the reporting of cases, the bill mandates the creation of the national health database of all claims and benefits requested from and granted by the PhilHealth.

The one-patient, one-record principle will be followed, and an independent audit of the PhilHealth shall be required.

The bill mandates the PhilHealth president to report to the President of the Philippines and to Congress measures taken to address adverse audit findings.

Earlier, the Senate Blue Ribbon Committee recommended the sacking of all PhilHealth regional directors following allegations that they were part of a mafia manipulating the state insurer’s financial records.

Several officials are being accused of being members of the so-called PhilHealth “mafia” that is allegedly manipulating the state insurer’s financial records.

On Monday, President Rodrigo Duterte directed the newly appointed PhilHealth president and chief executive officer Dante Gierran to implement a reshuffle at the agency.

Gierran replaced former PhilHealth chief and CEO Ricardo Morales who resigned on Aug. 26 after admitting to having been diagnosed with lymphoma or cancer of the lymph nodes.