Then Philippine Health Insurance Corp. (PhilHealth) president Emmanuel Ledesma admitted during a congressional hearing recently that policy differences between the Department of Health (DOH) and PhilHealth have caused unnecessary suffering for millions of Filipino members.
Ledesma, who was replaced by US-trained orthopedic surgeon, Dr. Edwin Mercado Feb. 4, attended the hearing last month of the House Committee on Good Government and Public Accountability, who questioned PhilHealth officials over issues of duplication, inefficiencies, and unutilized government subsidies.
Ledesma admitted that there are overlaps in the functions of DOH and PhilHealth, and that these need to be addressed to improve service delivery.
PhilHealth vice president Lemuel Untalan also confirmed that the agency continues to refine its enrollment lists to eliminate redundancies and remove ineligible beneficiaries.
“Tama po kayo,” Untalan replied when asked if the agency was updating its data to prevent unnecessary premium payments for individuals who were no longer eligible.
Untalan explained that the list provided by the Department of Social Welfare and Development (DSWD) under the National Household Targeting System (NHTS) is only updated every four years, leading to inefficiencies in allocating government subsidies.
Ledesma conceded that the issue of excess funds due to policy misalignment between DOH and PhilHealth should be reviewed, and vowed to provide Congress with a detailed report on how these funds have been utilized over the years, a House press release said.
DOH assistant secretary Albert Domingo also assured lawmakers that efforts are being made to improve coordination.
Lawmakers also raised concerns about hospitals allegedly inflating prices when patients use PhilHealth coverage.
Dr. Israel Francis Pargas of PhilHealth acknowledged these concerns and said that their legal and investigative teams are monitoring such practices. ||
