The Philippine Health Insurance Corporation (PhilHealth) together with the Office of the Presidential Adviser on the Peace Process (OPAPP) recently assessed the implementation of the PAyapa at MAsaganang PamayaNAn (PAMANA) and Sajahatra Bangsamoro health insurance program in the former’s Head Office in Pasig City.
The assessment was undertaken to apprise both parties on the issues in the regions where implementation of the program on the ground level is concerned.
Attended by PhilHealth officers, OPAPP program coordinators and representatives from various regions, the one-day activity assessed the efficiency, accessibility, and sustainability of the program in coming up with action plans and recommendations to better serve its goal of providing social health insurance coverage to former combatants as identified by OPAPP under PhilHealth’s Sponsored Program.
Among the concerns raised during the meeting were the identification and targeting of the number of beneficiaries, awareness level on the program among beneficiaries, and the utilization of budget provided by the national government.
According to Dr. Narisa Portia J. Sugay, PhilHealth’s OIC-Vice President, Member Management Group, PhilHealth does not usually meet the 100 percent enrolment target provided by OPAPP because some of the beneficiaries included in the list are already existing members and are part of the other membership programs of the social health insurer.
Sugay also mentioned that the availment of services under the Primary Care Benefit package has declined for almost four years since the partnership began in 2013 wherein most of the beneficiaries failed to enlist themselves in the program. “This is something PhilHealth and OPAPP should look into (percentage of availment), and I hope that the beneficiaries could visit the health care institutions so they can be profiled (health profile),” Sugay added.
PhilHealth recorded a slight decrease in benefit availment rate among the PAMANA and Sajahatra program beneficiaries in 2017 but claims are still in process. “Maybe we could have the figures before this quarter ends, since we have a 60-day filing rule with our accredited facilities,” Sugay explained.
On the other hand, John Michael G. Ojano, OPAPP Social Protection Program National Coordinator, said that they are trying to devise certain parameters in selecting the beneficiaries to avoid political implications that might arise in the process, particularly in the enrolment.
Ojano revealed that as much as they wanted to inform the beneficiaries of their entitlement as PhilHealth members, most of the beneficiaries are hesitant because they do not want to be identified as former rebels.
The PAMANA is the peace and development convergence program of the national government in support of the six-point peace and development agenda. It covers former combatants such as the New People’s Army (NPA), Moro National Liberation Front (MNLF), Revolutionary Proletarian Army (RPA), and Cordillera People’s Liberation Army (CPLA) and communities coming from areas affected by conflicts while Sajahatra Bangsamoro covers the Moro Islamic Liberation Front (MILF) communities and their decommissioned combatants.
When the PAMANA Project was first implemented in 2013, PhilHealth was able to enrol 723 beneficiaries or 11.12 percent of the total 6,500 target enrolees. The figure increased to 3,306 or 50.86 percent in 2014. It further climbed to 11,405 or 57.31 percent of the targeted 19,901 beneficiaries in 2015; then to 14,514 or 65.04 percent of the 22,319 target in 2016, and to 17,425 or 68.30 percent out of the 25,512 target in 2017.
Likewise, the actual enrolment of Sajahatra Bangsamoro reached 3,679 in 2013, 11,238 in 2014, 22,710 in 2015, and 20,300 in 2017.
Ojano assured PhilHealth that the program will still continue despite the stall in negotiations with rebel groups. “The implication of “no talks” with the NPAs will not affect PhilHealth, it’s just that the thrust of PAMANA now is more focused on areas/communities and not on personalities since it is not only the combatants that are affected by the conflict but the whole community as well,” Ojano said.
This year, the national government has appropriated P54 million for PAMANA program and P54.5 million for Sajahatra Bangsamoro program for the health insurance benefits of about 22,514 and 22,709 beneficiaries, respectively. (END) (By Michelle S. Nisperos; Photos by Jose Mari Sanvicente)
(Reference: Dr. Israel Francis A. Pargas, Head Executive Assistant and Concurrent OIC-Vice President for Corporate Affairs Group, Cel No. 0917-8089399)