Legarda urges PhilHealth to utilize funds for expanded benefits

Senator Loren Legarda called on PhilHealth to prioritize the use of its surplus funds to expand benefit packages and address gaps in healthcare access, ensuring the effective implementation of the Universal Health Care (UHC) Law.

Her statement came during a Senate Committee on Health hearing yesterday, December 18, 2024, where PhilHealth’s financial state and management was scrutinized following the removal of a P74-billion government subsidy in the 2025 proposed general appropriations. This move leaves PhilHealth’s 2025 operation reliant on its surplus and reserve funds.

Senator Loren Legarda called on PhilHealth to make the most of its PHP 150 billion surplus to support the goals of the Universal Health Care (UHC) Law. “With billions in reserves and surplus, PhilHealth has the resources to ensure every Filipino benefits from quality healthcare. But without proper implementation of the UHC Law, many will continue to face barriers to essential services,” the four-term Senator expressed.

During the hearing, PhilHealth Senior Vice President Renato Limsiaco Jr. reported that the corporation has a total of PHP 628.2 billion in assets as of October 2024, including PHP 281 billion in reserves and PHP 150 billion in surplus funds.

Despite the removal of the government subsidy, PhilHealth’s Corporate Operating Budget (COB) for 2025 is set at PHP 284.1 billion, marking an almost 10 percent increase from the PHP 259 billion allocated for 2024. Of the total budget, PHP 271 billion will be dedicated to benefit expenses, covering PhilHealth’s existing and expanded benefit packages. The funding will come from PHP 203 billion in direct contributions, PHP 20 billion from investments, and PHP 48 billion from the surplus fund.

PhilHealth nevertheless pointed out that the remainder of the surplus amount can be augmented should the PhP 271 Billion allotted for benefit expense in 2025 is exhausted.

Meanwhile, Legarda also emphasized the need to expand benefit packages to address the full spectrum of healthcare needs. She directed PhilHealth to identify accredited Konsulta provider centers equipped with breast screening, ultrasound, and mammogram machines and to make this information publicly accessible. “The UHC Law was enacted to ensure healthcare is accessible at the point of care,” Legarda said.

The hearing also tackled issues in healthcare accessibility. “It is unacceptable for people to queue at multiple offices seeking assistance for hospital bills while billions sit unused,” Legarda said. She called for operational reforms, faster reimbursement processes, and prioritization of vulnerable sectors.

PhilHealth assured the Senate of its stability and capacity to sustain operations. The agency highlighted recent expansions in benefit coverage—30% in February and 50% in December 2024—allowing higher reimbursements for hospital bills.

Legarda did not mince words when addressing PhilHealth’s obligation to its members, “PhilHealth is deducting from all of us while people are dying, asking for a guarantee letter, and going through a long process. Meanwhile, you are holding hundreds of billions in cash. The people must understand where their money is going.”

She also underscored the importance of universal healthcare as a right, not a privilege. “The UHC Law was enacted to provide equitable healthcare for all Filipinos. PhilHealth must rise to the challenge and fulfill this promise. No Filipino should be left behind when it comes to healthcare.”

Legarda’s call to action reflects the Senate’s commitment to holding PhilHealth accountable for the equitable and efficient use of its funds, ensuring that every Filipino has access to quality healthcare.(30)

—–

PhilHealth, gamitin ang pondo para sa mas pinalawak na benepisyo—Legarda

Hinimok ni Senator Loren Legarda ang PhilHealth na gamitin ang kanilang surplus funds upang palawakin ang mga benepisyo at tiyakin ang maayos na implementasyon ng Universal Health Care (UHC) Law.

Sa isang pagdinig ng Senate Committee on Health noong Disyembre 18, 2024, sinuri ng mga senador ang pondo at pamamahala ng PhilHealth matapos silang tanggalan ng P74-billion na subsidiya sa panukalang general appropriations para sa 2025. Bunsod nito, aasahan ng PhilHealth ang kanilang surplus at reserve funds para pondohan ang operasyon sa susunod na taon.

Ayon kay Legarda, dapat gamitin ng PhilHealth ang PHP 150 billion surplus nito para matiyak na ang bawat Pilipino ay may access sa dekalidad na serbisyong pangkalusugan. “May bilyon-bilyong pondo kayo, pero kung hindi maayos ang implementasyon ng UHC Law, maraming Pilipino pa rin ang hindi makakakuha ng serbisyong kailangan nila,” ani Legarda.

Iniulat naman ni PhilHealth Senior Vice President Renato Limsiaco Jr. na ang ahensya ay may kabuuang assets na PHP 628.2 bilyon noong Oktubre 2024, kabilang ang PHP 281 billion reserve at PHP 150 billion surplus funds.

Bagama’t tinanggalan ng subsidiya, naglaan ang PhilHealth ng PHP 284.1 billon para sa Corporate Operating Budget nito sa 2025. Ito ay mas mataas ng halos 10 porsyento mula sa PHP 259 billion noong 2024. Sa naturang pondo, PHP 271 bilyon ang ilalaan para sa mga benepisyo ng mga miyembro ng PhilHealth kasama na dito ang dinagdag na serbisyo at benipisyo ng korporasyon.

Ngunit, binigyang-diin ni Legarda ang pangangailangang palawakin pa ang mga benepisyo upang tugunan ang lahat ng pangangailangang medikal ng mga Pilipino. Isa sa mga iminungkahi ni Legarda ang pagtukoy sa mga Konsulta provider center na may kagamitan para sa breast screening, ultrasound, at mammogram. Dapat umano itong ipaalam ng PhilHealth sa publiko sa pamamagitan ng social media at iba pang paraan. “Ang Universal Health Care Law ay isinabatas upang matiyak na ang serbisyong pangkalusugan ay maabot sa mismong punto ng pangangailangan,” pahayag ni Legarda.

Isa rin sa mga isyung tinalakay ay ang hirap sa pag-access ng tulong medikal. “Hindi katanggap-tanggap na paikot-ikot ang mga tao sa iba’t ibang opisina para makakuha ng tulong habang bilyon-bilyong piso ang hindi nagagamit,” ani Legarda.

Ikinatuwa naman ng senador ang mga hakbang ng PhilHealth, gaya ng 30% at 50% increase sa benepisyo noong Pebrero at Disyembre 2024. Gayunpaman, kinakailangan pa din umano ng reporma sa operasyon ng PhilHealth upang mas mapabilis ang proseso ng reimbursement, at pagsuporta sa mga mahihirap at nangangailangang sektor.

“Huwag niyo nang patagalin. Ang mga Pilipino ang nagbibigay ng pondo ng PhilHealth, pero bakit napakahirap makuha ang benepisyo? Hawak niyo ang bilyon-bilyong pisong pondo, habang may mga namamatay na tao, nagmamakaawa pa para mabayaran ang mga gastusin nila sa ospital,” mariing pahayag ni Legarda.

Ipinaalala rin niya na ang Universal Health Care ay isang karapatan, hindi pribilehiyo. “Ginawa ang UHC Law para masigurong pantay-pantay ang serbisyong pangkalusugan para sa lahat ng Pilipino. Kailangang gampanan ng PhilHealth ang kanilang tungkulin. Walang Pilipinong dapat maiwan pagdating sa kalusugan.”(30)