The Department of Finance (DOF) lauded President Ferdinand R. Marcos, Jr.’s decision to restore to the Philippine Health Insurance Corporation (PhilHealth) its unutilized funds of PHP 60 billion that were remitted to the National Treasury pursuant to a provision of the General Appropriations Act of 2024.
The DOF confirms that it had communicated to the President a solicited opinion that since PhilHealth had improved its revenue performance, it supports a fund augmentation to boost the expansion of benefit and services, and that it fully recommends the restoration of the reverted PHP 60 billion.
Another factor is the creation of fiscal space created by the termination and suspension of flood control projects.
Specifically, the restoration of the money will allow PhilHealth to meet its Zero Balance Billing program obligations, the agency explained.
“The expansion of services requires the infusion of funds, and we in the revenue sector will do our job so that such an important public service will be financed,” the DOF said.
The DOF is happy that wasteful expenditures will now be rechanneled to hospital wards.
Under the 2024 GAA, the DOF was ordered by Congress to sweep the idle and unused fund balance of government-owned and controlled corporations (GOCCs) to fund key priority projects of the government.
Prior to the sweep, the Office of the Solicitor General (OSG), the Office of the Government Corporate Counsel (OGCC), the Governance Commission for GOCCs (GCG), and the Commission on Audit (COA) gave DOF the green light to do so.
Of the PHP 60 billion remitted by PhilHealth, the bulk, or PHP 27.45 billion, was used to pay for the Health Emergency Allowances of COVID-19 frontliners.
Other critical programs funded were the Medical Assistance to Indigent and Financially Incapacitated Patients (PHP 10 billion); the procurement of various medical equipment for the Department of Health (DOH) and local government units (LGU) hospitals, and primary care facilities (PHP 4.10 billion). It also funded three DOH health facilities (PHP 3.37 billion) and the Health Facilities Enhancement Program (PHP 1.69 billion).
The rest, or about PHP 13.00 billion, was used to fund government counterpart financing for foreign-assisted infrastructure and “social determinants for health” projects. These will accelerate the delivery of healthcare services to remote areas and enhance the health and well-being of Filipinos by ensuring food security.
If there is upside in the DOF’s compliance with a law passed by Congress, is it that it triggered an upward readjustment of PhilHealth benefits.
A combination of management change and system overhaul led to significant improvements in PhilHealth services to its members.
For example, package rate for breast cancer patients rose from PHP 100,000 to PHP 1.4 million, or a 1,300% increase.
Dialysis sessions and medications were made free for an entire year.
The peritoneal dialysis treatment ceiling of PHP 270,000 was raised almost four times, to PHP 1,269,000.
Kidney transplant expenses are now reimbursable up to PHP 2,100,000 from PHP 600,000.
For post-kidney transplant care of child patients, benefits have been increased to up to PHP 1,765,130 for the first year and up to PHP 810,732 for the succeeding year.
Severe dengue hospitalization costs have been raised from PHP 16,000 to PHP 47,000, while benefits for cataract patients have been increased by up to 826.238% or from PHP 20,200 to PHP 187,100.
Therapy and rehabilitation sessions and assistive mobility devices for persons with disability are also now covered by the state health insurer up to PHP 40,000.
To address poor eyesight and malnutrition, the optometric services for children up to 15 years old (PHP 2,500), as well as therapeutic care for severe acute malnutrition for children 60 months old and below (PHP 7,500 to PHP 17,000), are now covered by PhilHealth.
Other benefits expanded under PhilHealth include open-heart surgeries. The benefits for ventricular septal defect went up to PHP 614,000 (from PHP 250,000), as well as total correction of tetralogy of fallot (PHP 614,000 from PHP 320,000) and coronary artery bypass graft surgery (up to PHP 960,000 from PHP 550,000).
Heart Valve Repair and/or Replacement for Valvular Heart Diseases for pedia and adults have also increased up to PHP 816,500 and PHP 825,000.
Inpatient benefits were also increased for neonatal sepsis (PHP 25,793 from PHP 11,700), bronchial asthma (PHP 22,488 from PHP 9,000), ischemic heart disease (PHP 523,853 from PHP 21,900), and COVID-19 (PHP 55,000 from PHP 43,997).
Preventive oral care health services in primary care are now covered by PhilHealth with benefits ranging from PHP 200 to PHP 1,500 on a per tooth or visit basis.
