News Archive 2003
PhilHealth: Celebrating 8 Years of Quality Health Care - February 14, 2003
THE Philippine Health Insurance Corporation (PhilHealth) today celebrates its eighth year as a government owned and controlled corporation spearheading the implementation of the country’s premiere social health insurance program. Since it first took over the reins of administering the former Medicare program for government and private sector employees in 1997, PhilHealth has come a long way in providing convenience to its members availing themselves of hospitalization benefits.
Membership
From a fully-centralized organization, PhilHealth now has 16 regional offices and 74 service offices located in key cities and provinces in the country. These branches provide quality public service to almost 40 million PhilHealth members nationwide. “It is definitely not an easy task to be catering to the needs of our members, but this is what we are committed to do,” PhilHealth President and CEO Dr. Francisco T. Duque III said. “With a membership base that is much larger than that of the GSIS and SSS combined, we certainly have a bigger responsibility.”
Today, PhilHealth serves four major membership sectors: employed, individually paying, non- paying and sponsored sectors. These membership categories eventually evolved as PhilHealth’s services and benefits expanded.
To the employed sector belong the 1.4 million government employees and five million private sector employees. The individually paying sector counts the self-employed and voluntary members who opted to continue enjoying PhilHealth coverage. The non-paying sector is comprised of retirees and pensioners who are 60 years old and above and who have made at least 120 monthly contributions during their active years in service. Finally, the sponsored sector is where society’s poorest of the poor belong to.
Benefits development
In terms of benefits development, PhilHealth has been able to increase the support value of the program from a measly five percent to as much as 70 to 80 percent, with average value paid per claim of P5,536.00. For Year 2002 alone, PhilHealth paid a total of P8.8 billion in benefit claims of PhilHealth members nationwide, from a low of P4B in 1999.
Early on, PhilHealth started out with three different benefit packages for three different sectors. These packages were eventually equalized in the spirit of social solidarity, with preferential bias for the less privileged sector of society.
“Our priority thrusts are attuned to the poverty alleviation program of President Gloria Macapagal-Arroyo,” Duque said. In fact, it is the NHIP’s relevance to the current administration’s programs that prompted President Arroyo herself to showcase the benefits that the ordinary Filipino can gain from being enrolled with the program. “Napaka-importante ng PhilHealth. Pag may PhilHealth, sagot ng gobyerno malaking bahagi ng kanilang gastos. Nagiging mura ang serbisyo ng paggamot,” she said.
Soon, at least two new benefits will be introduced to address the needs of PhilHealth members, particularly those battling tuberculosis and those about to give birth to their second child.
Partners in service delivery
Over the years, PhilHealth’s network of partners has also expanded. From only 1,341 partner-hospitals and 15,118 physicians, the list of PhilHealth-accredited health care providers has grown to include 1,511 hospitals, 17,724 doctors and 349 rural health units as of yearend-2002.
Some 36 banks, composed of private and government depositories, have also tied up with PhilHealth to make premium remittance a breeze. With over 3,000 branches nationwide, these accredited banks have certainly helped boost collection efforts through their accessibility.
Targets for the year
As PhilHealth turns eight today, it continues to focus on membership registration, hoping to enrol at least 1.6 million families more into each of the Sponsored Program (for indigents) and Individually Paying Program (for self-employed and voluntary).
It will continue to bank on the full support of local government units to help ensure their needy constituents and make health care services accessible.
As far as its infrastructures are concerned, PhilHealth will work on the legacy systems, particularly its information technology plans to make its services even more convenient, not only for its members, but also for its partner-hospitals and doctors.
PhilHealth also sees more service offices opening in various parts of the country, even as it strengthens its information dissemination efforts through tri-media to cascade the latest program developments to the farthest regions in the archipelago.
“We need to reconfigure our systems as the challenge of universal coverage is heard louder,” Duque said. “We will continue to synergize our efforts, roll out the lasting quick wins defined by process audits in our organization to ensure that we are able to give our publics the quality public service that they deserve.”