For the entire month of February, the country is observing the National Health Insurance Month. Yesterday, February 14, your PhilHealth commemorated its 28th anniversary.
This year’s anniversary theme is “Pinalawak at mga Bagong Benepisyo para sa Mamamayang Filipino”, a manifestation of our commitment to continuously expand and make the PhilHealth benefits more relevant and responsive to the medical needs of the Filipino. In line with this commitment, we will implement several enhancements this year in our benefit packages. Recognizing the yearly ordeal of our dialysis patients, we will expand our coverage for outpatient hemodialysis from 90 to 156 sessions. This increase in the number of sessions covered is based on standards for adequate dialysis which requires three 4-hour sessions every week for chronic kidney disease (CKD) stage 5 patients.
Additionally, we would like to emphasize that dialysis is not the only renal replacement therapy that we cover. PhilHealth is providing P270,000 in financial support to patients who are on peritoneal dialysis or what we call PD-First. And for those who have organ donors, PhilHealth pays P600,000 for renal patients qualified under our Z Benefits for Kidney Transplantation. We urge our kidney patients to avail of these benefits to achieve better quality of life.
PhilHealth is also moving towards rationalizing select inpatient case rates. Initially, we are looking at moderate and high risk pneumonia and acute stroke, both ischemic and hemorrhagic, among those that will be rationalized.
Patients can expect an improvement in the extent by which PhilHealth will pay for these conditions for these are the most common cases availed of by patients in recent years.
Moreover, we will also introduce enhancements in select Z benefit packages for patients who have health conditions requiring prolonged hospitalization and very expensive treatments. In the pipeline are as follows:
- Orthopedic implants
- Kidney transplantation
- Breast, cervical and prostate cancers
- Open heart surgeries for children, specifically Ventricular Septal Defect and Tetralogy of Fallot
These enhancements are made possible with the help of the Philippine Amusement and Gaming Corporation (PAGCOR) and Philippine Charity Sweepstakes Office (PCSO). As mandated in Section 37 of the Universal Health Care Law, PAGCOR will transfer 50 percent of the National Government share from their income as provided for in Presidential Decree Number 1869 as amended; while the PCSO will transfer 40 percent of their charity fund net of documentary stamp taxes and their mandatory contributions as provided for in RA 1169.
Following the signing of the Joint Circular No. 0001-2022 between the PCSO, PAGCOR, Department of Budget and Management, Department of Finance, Department of Health and PhilHealth in May last year, a total of P21 billion from these two partner agencies have already been approved for transfer to PhilHealth under the 2023 General Appropriations Act.
At this point, allow me to personally thank the PAGCOR and PCSO for their support to the PhilHealth program. Mabuhay po kayo!
Earlier this year, President Ferdinand R. Marcos, Jr. directed PhilHealth to suspend the scheduled contribution rate of 4.5 percent and salary ceiling of P90,000 “in the light of the prevailing socio-economic challenges brought about by the Covid-19 pandemic, and to provide financial relief to our countrymen amidst these difficult times”. The PhilHealth promptly responded to this directive. Our PhilHealth Board has affirmed the agency’s compliance to suspend the premium rate increase, and directed Management to proceed with the rollout of new benefit packages as planned.
Hence, we reiterate our commitment to introduce the following this year, to be funded by the regular contributions of our members as well as from the subsidies from the National Government for Indirect Contributors:
First is the outpatient benefit package for mental health. According to a study, an estimated 6 million Filipinos live with depression and/or anxiety, which the COVID-19 pandemic has exacerbated. Thus, in addition to our existing inpatient coverage for mental health conditions, we are pleased to introduce this benefit package to improve health outcomes, quality of life, and productivity of our kababayans with mental health issues.
Another benefit package due for deployment this year is the outpatient package for severe acute malnutrition (SAM) for children below 5 years old. This is in support of the Kalusugan at Nutrisyon ng Mag-Nanay Law that provides for the management of severe acute malnutrition.
PhilHealth will also rationalize the current COVID-19 benefit packages, specifically for the inpatient packages, RT-PCR and Rapid Antigen Test and isolation packages.
The COVID-19 pandemic opened our eyes to the importance of strong primary care delivery system insofar as disease prevention and early detection of illnesses are concerned. Through primary care, a member’s health risks are mitigated early on, preventing their conditions from worsening which lead to costly hospitalizations.
This is the reason why we will continue to strengthen our PhilHealth Konsulta Package to make essential services such as consultations, health screening and assessment, laboratory tests, and drugs and medicines available to all Filipinos anywhere in the country. Last year, we started a nationwide drive so that Filipinos are informed about this package, for them to register with the Konsulta provider of their choice, and avail of this benefit. As of January 31 of this year, there are already 1,512 accredited Konsulta Providers nationwide.
Dear media partners, tulungan ninyo po kami na lalo pang maipaalam ito sa lahat ng Filipino. Please help us too with our campaign for more health care providers such as rural health units, outpatient departments of government and private hospitals, and private clinics to be accredited with this program.
In closing, we would like to assure you that your PhilHealth is and remains to be in a strong position to implement these benefit enhancements. As of September 2022, we recorded our highest net income at P46 billion. Our total assets stood at P394 billion which is 13% higher than our December 2021 figures. Also, PhilHealth’s investment portfolio stands at P355 billion which consists of 83% long-term investments in government bonds and corporate bonds; and the remaining 17% are short-term investments. PhilHealth’s reserve fund also rose to P224 billion from P151 billion in September 2021, or a 48% growth due to the consistent positive results of operations.
PhilHealth’s finances remain robust and strong. And to make it more sustainable in many years to come, we appeal to our members, employers, healthcare providers, and to our government partners for their continuous support to the Program.
Kayo pong lahat, kasama na ang buong komunidad ng media practitioners, ang aming partner para patuloy na maseguro ang kalusugan ng miyun-milyong kababayan natin dito sa bansa at sa iba’t-ibang panig ng mundo.
Last, but certainly not the least, to the hardworking and dedicated staff and officers of PhilHealth — Maraming, maraming salamat sa dedikasyon at serbisyong tunay na ibinibigay nyo para ang bawa’t Filipino ay mabigyan ng nararapat na tulong pangkalusugan. Huwag po sana tayong magsawa sa pagsulong ng ating adhikain: to deliver quality healthcare service to every Juan and Juana of every corner of our country. Let us continue to work hand in hand, together with our members and stakeholders, as we bring PhilHealth to greater heights.
PhilHealth remains committed to our mandate of providing all Filipinos with equitable access to adequate, affordable and acceptable health care services, anytime and anywhere they need them.
Thank you. Mabuhay po ang PhilHealth, mabuhay po ang Filipino!