Proposal to Suspend Premium Payments for PhilHealth Members in Need

Marika 2nd District Rep. Stella Luz Quimbo. Photo from House of Representatives of the Philippines
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(UPDATE) Marikina 2nd District Rep. Stella Quimbo has recently filed a proposed House resolution that calls for the suspension of premium contributions for minimum wage earners, whether they are employed or self-employed, urging PhilHealth to take immediate action. The resolution seeks to suspend these contributions while a thorough review of the expansion of PhilHealth member benefits is conducted.

According to Quimbo, the unspent premium funds of PhilHealth can adequately cover the premium contributions of minimum wage earners for at least a year. In 2022 alone, the premium contributions of minimum wage earners amounted to P19.6 billion. The proposed resolution highlights that PhilHealth’s reserve fund is projected to grow by 68 percent, reaching P463.7 billion by the end of 2023 from P275.8 billion in 2022.

In addition, the resolution suggests that the unspent appropriations for premium subsidies in 2022, amounting to P24 billion, can be utilized to subsidize the employee share in premium contributions of minimum wage earners and the premium contributions of self-employed individuals earning minimum wage in 2024. By suspending the employee share in PhilHealth premium contributions for minimum wage earners, an average monthly wage increase of approximately P400 can be expected for non-agricultural workers in the National Capital Region (NCR) or Metro Manila.

It is important to note that the suspension being sought will not exceed one year. Quimbo emphasizes that this temporary suspension aims not only to provide short-term economic relief but also to initiate a comprehensive review of PhilHealth’s benefits and contribution structure. The ultimate goal is to expand health benefits for all members and potentially reform the contribution structure, or even eliminate premiums for minimum wage earners and self-employed individuals earning the equivalent of minimum wages.

In 2022, Congress allocated P80 billion as a subsidy for the premiums of indigent families, senior citizens, and persons with disabilities. However, benefit claims for this sector only amounted to P56 billion, resulting in a net flow of P24 billion. Quimbo stresses that the review being proposed aims to design benefit packages that focus on illness prevention and provide greater support during hospitalization. Ultimately, preventing illnesses is more cost-effective than curing them.

Furthermore, Quimbo believes that with sufficient support from PhilHealth, Filipinos will no longer delay seeking medical attention until their conditions worsen. This shift towards proactive healthcare will lead to more rational spending on healthcare, which will, in turn, result in more reasonable PhilHealth contributions from workers and annual appropriations from Congress.

In line with these efforts, Speaker Ferdinand Martin Romualdez has ordered the House Committee on Health to review PhilHealth’s charter on February 13, 2024. The objective of this review is to expand patients’ benefits and ensure that PhilHealth fulfills its prime mandate of increasing benefit packages. PhilHealth President and Chief Executive Officer, Emmanuel Ledesma Jr., affirms that increasing benefit packages is crucial to make healthcare more accessible and affordable for the people. By reducing out-of-pocket expenses, the overall health system of the country can be enhanced.

Ledesma also highlights recent enhancements made by PhilHealth, such as the increased coverage for high-risk pneumonia to P90,100 from P32,000, and the enhancement of the Z Benefits package for breast, colon, and rectal cancers. Additionally, the package rate for select orthopedic implants has been increased.

In conclusion, the proposed House resolution seeks to provide immediate relief to minimum wage earners by suspending their premium contributions to PhilHealth. This move aims to not only alleviate their financial burden but also initiate a comprehensive review of PhilHealth’s benefits and contribution structure. By expanding health benefits for all members and potentially reforming the contribution system, the goal is to create a more equitable and accessible healthcare system for all.

Source: The Manila Times

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