Dagdag na PhilHealth benefits, sapat ba? | The Mangahas Interviews
Tumaas man ng hanggang 30% ang coverage rate ng ilang benefits package ng PhilHealth, tataas din ang premium contributions sa 5% mula sa dating 4%. Pero ayon sa Malacañang, pinag-aaralan pa raw ni Pangulong Bongbong Marcos kung makatutulong ba sa mga miyembro ng PhilHealth ang pagtaas ng premium contributions.
Ayon sa PhilHealth, lahat ay maaaring makinabang sa ipinatupad na dagdag benepisyo sa ilalim ng Universal Health Care Act. Sapat din daw ang pondo para tustusan ang mga benefit enhancement ng PhilHealth.
Ang mga benepisyong sakop ng 30% increase at iba pang usapin sa PhilHealth, sasagutin ni Acting Vice President for Corporate Affairs Group Rey Baleña sa The Mangahas Interviews.
Ayon sa PhilHealth, lahat ay maaaring makinabang sa ipinatupad na dagdag benepisyo sa ilalim ng Universal Health Care Act. Sapat din daw ang pondo para tustusan ang mga benefit enhancement ng PhilHealth.
Ang mga benepisyong sakop ng 30% increase at iba pang usapin sa PhilHealth, sasagutin ni Acting Vice President for Corporate Affairs Group Rey Baleña sa The Mangahas Interviews.
Transcript
00:00 [Music]
00:05 Good day to all of you. You are now watching Damangahas Interviews.
00:09 We will talk about PhilHealth Benefits.
00:13 There are additional benefits but there are also additional contributions.
00:18 Joining us now to talk about these things is Mr. Ray Balenya.
00:24 He is the Acting Vice President of the Corporate Affairs Group of the Philippine Health Insurance Corporation.
00:30 Good day, Mr. Ray.
00:32 Good day, Ma'am Malu and of course, to all of our viewers.
00:37 We would like to thank you in advance, Ma'am Malu, for being a part of our program.
00:43 Okay. PhilHealth was very young during the early days, in the 1990s.
00:48 He was a graduate of the Polytechnic University of the Philippines where he was a senior.
00:56 Tell us, what are the additional benefits of PhilHealth that are top of the town now but we are just level off.
01:03 What are the benefits?
01:05 Well, Ma'am Malu, since last year, we have enhanced, expanded, and improved PhilHealth benefits.
01:14 If we can remember, last year, the implementation of the premium adjustment was suspended.
01:23 It should have been 4.5% and we were left with 4% of our monthly income.
01:30 So despite that, Ma'am Malu, PhilHealth was able to expand and enhance our primary benefits.
01:41 We started with our coverage for dialysis patients.
01:46 Before, Ma'am Malu, PhilHealth answered 90 sessions per year for patients with chronic kidney disease stage 5.
01:55 But our PhilHealth Board approved it to make it 156 sessions.
02:02 The 156 sessions is the total requirement of a patient for dialysis for a whole year.
02:12 So before, patients were saving their 90 sessions.
02:18 Now, they cannot complete their dialysis treatment because everything is covered by PhilHealth.
02:28 Mr. Ray, you have already made adjustments to your benefits,
02:33 aside from the dialysis treatment, the sessions are already complete, up to 150+ treatment sessions.
02:40 What other benefits have you added in the past?
02:45 Well, before, we did not have an outpatient mental health package, Ma'am Malu.
02:50 But now, we have it.
02:52 We launched it in October in tandem with the Department of Health.
02:57 We know that many of our countrymen are in need of it, especially those who have been affected by the pandemic.
03:06 So we have two packages there, depending on the services that the patient will require.
03:14 There are 9,000 pesos and 16,000 pesos.
03:19 The 16,000 pesos is for specialist care.
03:24 Before, we did not have that and the PhilHealth Board approved it.
03:30 Aside from that, there are some conditions that have a very severe effect on patients.
03:39 This is what is called the burden of disease.
03:43 We have three conditions that were enhanced last year.
03:50 The high-risk pneumonia, Ma'am Malu, was previously 32,000 pesos.
03:55 That was increased to 90,100.
03:59 The increase in high-risk pneumonia was almost triple, Ma'am Malu.
04:04 There are two kinds of stroke.
04:07 There is ischemic stroke and hemorrhagic stroke.
04:10 The hemorrhagic stroke was previously 38,000 pesos, but now it is 80,000 pesos, more than double.
04:18 And the ischemic stroke was previously 28,000, but now it is 76,000, so more than double.
04:26 So these are the main accomplishments we accomplished last year.
04:32 Aside from that, we also improved our Z-benefit packages.
04:39 And recently, Ma'am Malu, February 14, took effect, the Valentine's Day and the anniversary of PhilHealth,
04:48 all those who were admitted to our accredited facilities on February 14, their benefits increased by 30%.
05:01 So our case rate packages were increased by 30%, so it's a big increase.
05:11 And of course, we were able to catch up with the effect of medical inflation.
05:18 So aside from the select conditions that are really high burden for patients and will require a big increase,
05:28 the rest of the case rate packages, the decision was made to make an inflation adjustment rate, and that is 30%.
05:41 Before we dive into the numbers, let's explain.
05:45 The full package can be given to the patient, including the medicine, laboratory, hospital room and board.
06:01 It means that it is not like a one-time amount that will be given. It should be included in the list and received services, right?
06:13 If you are in the hospital.
06:16 Ma'am Malu, our packages increased by 30%.
06:22 The coverage is all the items that you mentioned, from room and board, medicine, laboratory, and there is a component for professional fees.
06:35 So the doctor's fee is also covered by our packages that we increased by 30%.
06:43 But in reality, Mr. Ray, if you are in the hospital, aside from the dialysis treatment sessions,
06:51 but if you are in the hospital, for example, ischemic heart disease, hemorrhagic heart disease,
06:57 you will spend P100,000 in just a few days.
07:02 Especially if the fill health, as they say, can cover up to 20% of the coverage.
07:11 If your bill is up to half a million, fill health will cover 20% and within the package ceiling. Is that right?
07:20 Yes. Because what we will be paid in the hospital is the set amount of the package.
07:29 But there are medicines and services that other hospitals say, because we also have a family member who is in the hospital,
07:38 is not covered by fill health or does not have approved medicines that will cover fill health insurance. Is that right?
07:46 Yes, that's right, Ma'am Malu, because our limitation is what is set in the law,
07:54 that the only medicines that we can pay are the medicines that are in the Philippine National Formulary.
08:04 So that is one limitation and fill health cannot be done because it is set in the law.
08:11 The development is an issue that is really right that the fill health management is studying
08:20 because we are always talking to our partners and that is one of the reasons why we went out to our stakeholder meetings this January.
08:30 So that is an item that I think is really in the priority of fill health.
08:37 And if they need amendments to the law, that's right.
08:41 There is a call from Speaker Romualdez to review the charter of fill health.
08:47 That is one of the items that can be discussed and can be one of the amendments.
08:54 So that we can address the limitations that you mentioned, Ma'am Malu.
08:59 So if this is a welcome development, what about the benefits packages?
09:05 But in reality, you also increased the premium payments from 4 to 4.5 and now it's 5%.
09:13 Let's be clear, the minimum is P10,000 per month.
09:18 The pay is 5%, P500 for the fill health contribution.
09:23 If you are paying P80,000, P190,000 per month, your monthly contribution to fill health will reach P4,000.
09:36 In reality, in one year, the lowest rate is you will pay P6,000 per year.
09:46 So if you have a high salary, you will pay P48,000 per year.
09:53 Is that fair? Because if you are not hospitalized, you will not benefit from fill health.
09:58 Well Ma'am Malu, I will answer your last question.
10:02 If we are not going to get sick, we will not be able to use this.
10:07 Well, in reality, we are a health insurance, Ma'am Malu, that we are really paying because we know that even if we don't want to get sick,
10:16 we have a strong belief that even if we don't want to, but someone gets sick in the family, we have fill health benefits that we can use.
10:26 Instead of us going bankrupt, borrowing, or having a child who is not studying.
10:34 So that is the importance of fill health for every Filipino family.
10:39 So we are calling it health insurance and in reality, we really don't want to use it because we don't want to get sick.
10:47 But if someone really gets sick, we have something to use as a benefit.
10:52 Now, that is the importance of our health insurance, Ma'am Malu.
10:59 And just to clarify, your paying members will reach 36 million Filipinos but if their dependents are added, their beneficiaries,
11:14 it will reach 50 million Filipinos in all, the children.
11:19 But your non-paying or non-premium clients, your supporters, senior citizens, PWD, the four-piece, it will reach 23 million Filipinos.
11:37 So it means that 1 is to 1.5 is the one who is paying and the non-paying is the 23 million.
11:45 This is from the budget that is allocated to fill health by the taxpayers every year. Is that right?
11:52 Yes, Ma'am Malu. Because the direct contributors are the ones who are paying the contribution because there is a possibility to pay.
12:18 So the bulk of that, Ma'am Malu, are those who are employed or formal economy.
12:24 So the bulk of that, around 21 million, are private and public employees.
12:31 So that's right, Ma'am Malu. Those are the main sources of funding, the social health insurance contributions,
12:39 the direct subsidies for the non-paying or vulnerable sectors that are affected by special laws.
12:50 All right. Your funding, your report last year, your premium collections increased to 32 billion pesos.
13:01 But your budget requested by the government is 101 billion pesos. So 1 is to 2, 1 is to 3. What's the difference?
13:11 So it means that you need to sustain yourselves continuously because if not, fill health will be in danger.
13:18 You will be out of the picture and you, your acting president, said that if you don't help the PACOR and PCSO,
13:26 fill health will be in danger until 2027. Please clarify that.
13:31 So your collection is around 32 billion, government budget subsidy is 101 billion pesos.
13:37 How can fill health be really financially viable?
13:40 Well, you know Ma'am Malu, first, our national government is committed.
13:45 Every year, the government is giving subsidy because we have a lot of indirect contributors that the government will really fund by law.
13:56 However, for 2024, if you heard, our 100 billion was reduced by 40 billion. So last minute, there was a reduction.
14:09 But the truth is Ma'am Malu, our fund will not be depleted because as we speak now, we have a solid financial position.
14:22 They said in the past, we have surplus funds and our reserve fund is solid.
14:30 This is what we see that will really help in many benefit enhancements that fill health is doing since last year, this year and in the next two years.
14:43 You know, in enhancing these packages and raising awareness among our countrymen that fill health benefit is big,
14:53 those who are hesitating to go to the hospital for treatment will decide to go to the hospital for treatment.
15:01 Therefore, utilization will increase. So before we know which, our surplus funds, we can maximize that in the benefit of patients.
15:13 What do you mean by surplus funds? Does it mean you have savings? How much is the total?
15:22 If there's an excess budget, it should be reverted to the treasury every year. Are you the one who is losing surplus funds?
15:31 Based on the statement of our President and CEO, Sir Mandy Ledesma, more or less we have 500 billion reserve fund.
15:46 It's solid and big. It looks big now because the enhancements we did last year are kicking in.
15:59 I said that if we expand our benefit packages and raise awareness of our members, the utilization will naturally increase and we can maximize it.
16:15 So that is the strategy of fill health according to the law. It's better to increase the benefit packages.
16:23 It's good that we have extra funds. We increased it so that when the member utilizes it, their fill health coverage is substantial.
16:39 That's a good news. You're saying that you have a surplus of 500 billion pesos. Where did that come from?
16:45 It was only in 2021 and 2022. The DOH said that you need to be supported because if not, the income or the revenue position of fill health will be in deficit.
16:58 Where did the 500 billion pesos come from?
17:00 First, it's bad for the efficiency of our collection. Not only for the efficiency of our collection, but it's also the direct support and remit of the employers,
17:12 the payment of our members. So there is a direct support of our members for their fill health.
17:23 Second, as they say, not everyone gets sick. Not everyone requires confinement. That's why there are extra or surplus funds.
17:41 But with this enhancement, we can see that the benefit availment of our members is improving.
17:50 Please explain it sir because it seems like there is a checkered history of fill health.
17:56 It's funny that your member database was hacked. But they said that you fixed it. Please explain how it was fixed.
18:05 And in the recent 3 years, fill health has been on the news because you have to give bonuses, allowances, and performance benefits packages to your top executives.
18:19 Please explain the first issue, the hacking. Is your database fixed?
18:24 Isn't it problematic that your members might have a phishing or identity capture from the hackers?
18:33 We want to clarify that our databases were not hacked. They were kept safe and they were not hacked.
18:43 Therefore, no one copied or got anything from our databases. So they remained intact.
18:49 What was hacked were workstations, actual computers that our members use where they download data for research, for computing benefits and others.
19:11 So these are what we got. Fortunately, Ma'am Malu, that was the situation and we were able to do what we should do to avoid this happening again.
19:25 We have sufficient anti-virus software and our cybersecurity posture is being established. We are not letting go of our coordination with the DICT and the National Privacy Commission.
19:47 We are not letting go of our internal systems and processes. There is no solution for this.
20:01 Our members are hopeful that we are doing everything we can to avoid this happening again. No one can say 100% that we will not be allowed to enter.
20:13 It's a matter of fortifying and not to be complacent in this regard.
20:20 We have set up our information campaign so that our members can be protected from possible phishing and scam calls.
20:33 We are happy because we are not receiving any reports related to that. So when it comes to that, we are happy.
20:43 Second, on the issue of...
20:45 Disallowances. You are giving a lot of bonuses.
20:51 You know, Ma'am Malu, our compensation structure is based on what is in Executive Order 150, the Compensation and Position Classification System.
21:12 It is being implemented and overseen by the Governance Commission for GOCC.
21:19 As we speak, we don't have any incentives or allowances that are being given.
21:29 You can see it. We don't have any because the GCD is under our control and we need to comply with it.
21:37 That's just now because in the past years, bonuses have become very expensive.
21:44 What about the former PhilHealth Board?
21:48 Well Ma'am Malu, those packages and incentives that were given in the past, we are defending those above board.
22:00 For example, when we got the attention of the Commission on Audit, we discontinued it.
22:08 Of course, we are responding to their recommendations.
22:15 So we can say that our countrymen should not be worried about the salary of PhilHealth employees.
22:23 It is being followed by the system and regulations, which is also being followed by the rest of the GOCC.
22:32 So that PhilHealth employees will not be disadvantaged.
22:37 Because you are a government-owned and controlled corporation with your own charter.
22:43 You should have your own decision on your position, classification and benefits.
22:51 But you still have P7.8 billion in notice of disallowances and the last 15 years, you are counting it.
23:02 What will be the settlement of this total?
23:05 What will be the head office, regional offices in Central Luzon and Cordillera, including the notice of disallowances?
23:15 Well, we are responding to the notice of disallowances and we are saying that we are defending it.
23:22 It has a sufficient basis in our charter because PhilHealth has authority to set the compensation.
23:31 Now, we are being guided by Executive Order 150 and of course, we are being guided by GCG.
23:38 Now, you said that there are many long-term things because the process is also long.
23:44 It is going back and forth. We will respond after the court studies it.
23:49 For example, after the court studies it, there will be another set of recommendations.
23:57 Of course, it is long. We are fighting for the past because it will not be a good thing if there is no sufficient basis in the law.
24:16 That is our position. All of that was accepted, not only by the officials, but all of the employees were accepted.
24:29 All right. Mr. Ray, please explain to us.
24:33 The record of payment to private hospitals or government hospitals,
24:39 your partners in delivering your services were covered. They should be paid for 60 days.
24:48 But sometimes, you cannot pay for 75 days.
24:53 There is also an issue in the field of PhilHealth.
24:57 When you go back, PhilHealth reports that 90 cases out of 100 will be paid and will be settled properly.
25:06 Three to four will be rejected.
25:09 There are 28 cases that are returned to the hospital or health facility because you have additional documentation that is needed.
25:17 So in the field of hospitals, you should pay properly.
25:21 In the field of PhilHealth, they say that hospitals are being upgraded or over-claimed.
25:31 What is the truth? In your field, why should you pay properly?
25:35 Well, first of all, this is wrong. Payment is fast when it comes to good claims.
25:44 If the claim is good and complete, it is fast.
25:47 If I'm not mistaken, we ended the year with an average turnaround time across all regions of maybe 33 days.
26:01 It used to be 27 but now our national average is 33.
26:06 But those 33 days are still fast to be hammocked in the 60 days that the law has set.
26:14 Because the law says that the claim should be processed and paid within 60 days.
26:19 So that's the truth. And the truth is, before the claim goes to PhilHealth, there are 60 days for the hospitals to file a claim against us.
26:31 So let's not forget that it's also two months.
26:34 If they reduced the 60 days, that's already two months that the claim was heard.
26:43 After that, when it comes to us, we have another 60 days.
26:47 But I am saying that on average, we have already paid for 33 days.
26:52 So that's when it comes to good claims.
26:55 Now, there are claims that are returned and this is also a big percentage if we look at it.
27:04 But why are we returning it? Because it's really not fit for payment.
27:09 Because if we don't file the claim one by one, we just pay for it, even you will get angry at us because you are paying for it.
27:20 If the claim is defective, there are for compliance, there are unsigned, or documents that are not enough, we are returning those.
27:29 That's one of the sources of discrepancy. Why is PhilHealth's record different from the hospitals' record?
27:42 Because if we return it to the hospital, we will no longer consider it payables.
27:49 In our book, it will be released. But in the hospitals' part, they should not consider it receivables because for compliance, it was returned to them.
28:02 So that's the reality there. There is a discrepancy there.
28:07 There are also some that are denied. So there are claims that are denied because there are some that are not complied with or were late in filing.
28:20 There are also many that are denied. So our talk to the hospitals is to fix it and make sure that the claim is correct.
28:31 We will not be delayed in returning it if it is payable or not.
28:37 We can avoid the return to hospital claims and the denied claims.
28:42 So if the process is fast, the good claims, you said two months, two months, hospital two months, you two months, let's say one month,
28:53 two months is the fastest processing of the PhilHealth payment to the hospitals.
28:59 But if it's a bad claim, how long is it? For example, two months, two months and you will return the papers,
29:06 the hospital will present documentation for the claim. How long is the bad claim?
29:13 That's another 60 days to refile.
29:16 Six months already?
29:17 Yes, six months. After that, we have another 60 days to process again.
29:25 If it's fixed, we will pay. If it's not fixed, we will be denied.
29:34 How much is the total of the denied claims overall, for all hospitals? You said you have 12,000 health facilities.
29:45 Sorry ma'am, I don't have data to hold on to. But if I'm not mistaken, the denied claims, at any given time, it also goes up to 3 to 4 percent.
29:58 So 3 to 4 percent is small, but of course, it's big in terms of peso value.
30:05 So I might not have the figures right now, but the message here really is that there is a way to avoid denying the claim.
30:15 There is a way to avoid the return of the claim and the turnaround time will not be long.
30:21 All right. Now regarding the denied claims, are some health workers included?
30:28 Some health workers, patients, sometimes they over-claim or they say that even if it's just a small case,
30:38 they will do pneumonia or do a significant health case just to claim a bigger amount in the field.
30:49 Because that's what they say, that some hospitals and health workers over-claim to get a bigger benefit or claim money in the field. Is that right?
31:02 Well the technical term for that is up-casing. Unfortunately, ma'am Malu, that's a thing.
31:11 In the past, there was that. And if there are claims that we think are biased, let's say that's the case,
31:25 the claim can be subject to further review.
31:31 So it can be investigated and if there's no evidence after investigation to doubt the claim, it will return to the process.
31:44 There is such a process. Of course, we are individually filing all the claims.
31:51 All right. Just to clarify, what is the effect on your member if the claim is false or a bad claim, will they not be able to claim their field health benefits?
32:04 Well, no. There is no effect on them because the hospital claims are their reimbursement for field health.
32:12 That means the member has been granted or enjoyed his benefits.
32:19 This time, the hospital is the one who is claiming.
32:22 So if there are such issues, of course, it will be reduced.
32:26 Even if it's just one claim, it will be reduced in the hospital because they already removed it, ma'am Malu.
32:33 So they are the one who is paying the cost.
32:35 So they can be compensated? Is that so?
32:38 Yes, they can be compensated. But what we are saying here is, why are some people submitting a good claim and they are being paid immediately?
32:51 So we are not removing the possibility that there are so many toxic things being done by the billing clerks, the procession to the hospitals.
33:02 We understand that. That's why we have an intervention, our regional offices, that they work closely with the hospitals.
33:11 They are doing seminars with the billing and the procession to the hospitals.
33:16 So now, the errors are being avoided. The oversight is being avoided.
33:22 So if that is avoided, the incidence will be reduced.
33:25 If it is not wiped out, of course, we are all happy. We are happy and the hospital is happy.
33:30 Okay. How many outstanding claims do you have to be settled? Do you have at least that figure?
33:36 Because you said you have 500 billion reserve or surplus.
33:41 But do you have contingent liabilities that you should pay if you are to be settled?
33:48 We were able to settle 50 billion in our partner hospitals by December end.
33:57 If you remember, Ma'am Malu, in September, we were able to declare 27 billion pending claims.
34:07 This is what we committed that in 90 days, that is until the end of 2023, we should be settled.
34:18 So we went beyond that Ma'am Malu because we paid a total of 50 billion.
34:24 Because we backtracked and we still have some claims that we have earned.
34:29 So we paid 50 billion in claims that we reported to the Congress last year.
34:35 From January 1 to February 17, we were able to pay 20 billion to the hospitals.
34:43 So if we compare it to the figures of the last year for the same period, there is a huge difference.
34:51 We are able to pay a lot, meaning the process of paying claims is continuing and fast.
35:01 Is health, pill health in particular, a political issue?
35:06 Because we know that there are congressmen or members of the executive branch who are also doctors and owners of hospitals.
35:15 Do you favor them because there are reports during COVID that the reimbursement package for certain hospitals in Davao City and other places is advanced?
35:29 Do you also consider the political connections of pill health and the hospitals that are your partners?
35:37 Well, we can say Ma'am Malu that our treatment is equal to all of our partner providers.
35:45 We can say that if the claim is good, there is no reason for it to last longer in pill health.
35:50 If it's good, we can say that after the year 2023, on average, we will pay the claim for 33 days.
36:00 So I think if it's a bad claim, it will last longer. We cannot do anything when it comes to bad claims.
36:08 If it's a bad claim, we cannot do anything. It will last longer.
36:14 We don't have special treatment even if it's a big or small hospital.
36:20 If the claim is good, we can pay it quickly.
36:26 I have one concern for migrant workers. Your OFW population is big, especially for self-employed and paying members.
36:38 What is the situation? How will they compute their benefits?
36:44 Of course, if the workplace salary is big, $500 or let's say up to $800 per month, our OFWs will really get a lot of benefits.
37:00 What about the benefits if they have HMOs outside the country?
37:05 Your concern is what do you want to do with the OFWs?
37:11 Well, it is in the UNHCR that OFWs are considered as direct contributors.
37:19 They are considered as self-paying members because they don't have a local employer,
37:27 except for the C-based employers. But in the land-based OFWs, they are paid 100%.
37:44 So they are considered as direct contributors and they are subject to our conditions for contribution.
37:55 For example, this year it's 5% of our monthly income.
38:01 Our salary floor is 10,000 pesos and the maximum ceiling for this year is 100,000 pesos.
38:09 So our OFW members are subject to that.
38:16 How will they compute their payment? Is it directly to the PhilHealth?
38:26 Because it will be a problem if it is delayed or if you have a penalty.
38:31 It should be within certain days after the first three months, they will be able to pay.
38:38 Their problem is what is the availment of membership, payment, and if they have benefits that they need to claim.
38:52 What will happen? They are here in the Philippines, should they be hospitalized?
38:57 Well, not necessarily, ma'am Malu.
38:59 Actually, we have flexibilities when it comes to OFW members.
39:04 As far as I know, they can pay 2,400 pesos if they want before they depart.
39:14 And the balance can be paid gradually within the calendar year.
39:20 So that's one of the flexibility that we have given to OFW members and I know that until now, that flexibility is still enforced.
39:29 Second, they are entitled to the full benefits even if they are confined abroad.
39:39 In fact, not only OFWs can claim even if they are confined abroad.
39:45 Even if we are all, even if we are not OFWs, as long as we are confined abroad, we can file it here in PhilHealth.
39:53 And we have a long filing period that we have given instead of 60 days, 180 days.
40:02 And what we need among others is the statement of account, the abstract, the diagnosis, and the receipt.
40:13 So that's what we need to reimburse you, equivalent to the case rates that are set there.
40:22 So even if they have HMOs, because some OFWs are saying that their coverage is superior, they are lucky.
40:35 But you know, not all OFWs have that.
40:39 So how about the OFWs who don't have that?
40:44 So we have PhilHealth.
40:46 Now, another good thing about this, Ma'am Malu, is that their qualified dependents here in the Philippines will also benefit from their PhilHealth coverage.
40:58 So that's what some of our countrymen forget.
41:01 They have relatives here who are utilizing that.
41:05 So for me, our OFWs, for sure, many of them are healthy and almost sick.
41:13 The relatives here are the ones who truly benefit.
41:18 But if we add to that, their contribution will reach a higher level if for example, they are able to pay $200.
41:27 So it means that 100% of our land-based OFWs will be able to pay that.
41:33 It seems like they have a little bit of a weakness.
41:36 Yes. Actually, as a last point, Ma'am Malu, we want to share.
41:41 We are a social health insurance program and we operate under the principle of social solidarity.
41:49 That's right, but they seem to be pitiful because actually, if you compare, their salary is higher because of foreign currency.
41:59 But their family's socioeconomic conditions are the same.
42:04 We are a social health insurance program and we operate under the principle of social solidarity.
42:11 Where there are people with abilities, they are the ones who assist our countrymen who are without abilities.
42:22 Because our payments are in assurance of our abilities.
42:28 This is combined, big or small, into one pool of funds.
42:34 And this is what we are leveraging to provide temporary benefits to the members who are sick.
42:43 So you know, yes, you can think that we are paying a lot, but that is the principle.
42:51 Because we are the ones with abilities, we are the ones who are being paid.
42:58 It's like we have a big house and we are all being paid for it.
43:03 Of course, those who are strong, they are the ones who are being paid.
43:09 Those who are weak, they still want to help, they are still being paid.
43:14 But of course, they are just commensurate with their abilities.
43:18 Basically that way, they are being paid.
43:21 Now, we know that there are suggestions from the Congress to review the Universal Health Care Law in the light of many issues and concerns.
43:36 For example, by the OFWs.
43:38 So we believe that this discussion will be more focused on this issue.
43:46 And we at PhilHealth, what is the wisdom of the Congress about this?
43:51 That is what PhilHealth is doing.
43:53 There is no shortage, no lack.
43:55 Okay. There is just a minor item.
43:57 I don't know if it's a minor or a major item.
44:00 Why is it only 2 million that the government personnel are paying?
44:04 It seems like they are overwhelmed by private sector self-employed OFWs, the paying members.
44:12 Is it only 2 million from the government?
44:16 Actually, as of year-end of 2023, it's 2.9 million, Ma'am Malu.
44:23 Then 18.1 million are in the private sector for a total of 21 million.
44:30 So this is what is declared to us, the employees in the government sector.
44:40 So of course, there are many job orders, if there are many job order contractors.
44:47 They are not counted as employees.
44:51 They could be more, they could be that many, but they are counted in a different category, in self-paying.
44:59 But it seems like it's small because if we count the teachers, soldiers and police,
45:04 we are over 2 million public servants.
45:10 It's not believable, 2.9 million, you said.
45:14 But 2.9 million compared with 18 million in the private sector.
45:19 So they are the ones who are passing the field health problem, the private sector.
45:24 Well, we will look into it, Ma'am Malu. But now, the premium contributions of those in the public sector,
45:35 that is facilitated by our DBM.
45:42 So all the national government agencies, their social insurance contributions are fully accounted for,
45:55 that is provided by the national government.
45:59 So I guess we will have to further look into this, Ma'am Malu.
46:04 But for now, this is what is in the field health record.
46:10 I know you don't want to destroy the field health record that you are trying to improve.
46:21 But there were recent elections where the field health card or indigents were used for politics.
46:29 The GMA cares or the distribution of field health cards by our indigents voters.
46:35 What is the assurance that the field health will not be used in the upcoming election?
46:42 What are the plans of our politicians?
46:45 Well, first, our field health card is a standard field health card.
46:52 There are no other elements that are included there.
46:55 Before, there were faces and other logos.
46:59 Now, there are none.
47:01 Second, our poor countrymen are automatically field health covered and the national government is paying them.
47:12 We no longer have a sponsorship program where the local governments used to partner with them
47:20 for the enrollment of their poor constituents.
47:25 Therefore, in that process, it is possible to think that it can be included in politics.
47:33 But that's not happening anymore.
47:35 Since the syntax law was passed, the national government took the commitment of field health coverage,
47:46 field health contributions of the poor.
47:49 We have already answered that. The national government has already answered that.
47:55 We will pay that every year.
47:57 So that's one of the institutional arrangements that we have seen that will protect or shield the program from politics,
48:08 as you were mentioning, Ma'am Malu.
48:10 Senator Bong Go is a re-electionist.
48:12 He's the one-stop shop that is field health, PagCorp, PCSOS, all together will help and provide medical services.
48:21 Will he revive that? It seems like he wants to continue that program.
48:25 So maybe Senator Bong Go is not the only one, to be fair.
48:28 There are many politicians who joined that program.
48:33 What is the position of the field health board now?
48:35 Well Ma'am Malu, you must be referring to the Malasakit Center?
48:41 Yes. Actually Ma'am Malu, the Malasakit Center was established by virtue of a law.
48:49 According to the law, field health is a part of the services and agencies that the Malasakit Center will build
48:59 to help the poor patients who need help.
49:04 And therefore, by this mandate of the law, we are responsible to be a part of the Malasakit Center.
49:17 In fact, it is included in all of our arrangements.
49:20 We make sure that every Malasakit Center, we have people there.
49:24 That means that all of the agencies that will help to build the field health.
49:31 So that is our position, Ma'am Malu.
49:34 There is a law that establishes that and therefore, we are there in the establishment of the law.
49:39 I don't think the law is the problem or your co-operation.
49:43 It seems like the problem is that the politicians are visiting and joining your Malasakit Centers.
49:49 It seems like they are leading the doctors, health workers, and field health, Pancor PCSO personnel
49:56 to give aid and then take pictures and photo-op.
50:00 Will you ban them from visiting the Malasakit Centers?
50:04 Well, we don't have the power to ban our beloved servants who want to serve in the grassroots.
50:17 We are in the Malasakit Center to do our mandate and our mandate is to ensure that our fellow citizens
50:25 who will be visiting the Malasakit Centers will be given what they should be given.
50:31 In the field health, that is the health insurance benefit.
50:34 So no more, no less.
50:36 But you don't really need the politicians to be there.
50:39 They don't have a role except to take pictures.
50:42 Well, we don't want to comment but of course, we are thankful to them
50:50 because they are the instrument to pass the law.
50:55 They are the reason to fund the Malasakit operations.
51:01 So I think it's beyond us, Ma'am Malu.
51:05 We are there for a certain reason and that is to serve the patients.
51:12 As a member of the field health, it is true that what is important in field health is until retirement,
51:18 you have a benefit that you can ask for, own.
51:22 Unlike an HMO, the health card, that once the period of coverage is over, it's gone.
51:30 What can you say, why should people trust in field health even though there are many issues,
51:37 diseases and diseases in field health?
51:39 Why should people continue to trust in field health?
51:44 Yes, because unlike the HMO, in field health, everyone is welcome.
51:49 We don't have preconditions before we give a benefit to our fellow countrymen.
51:57 We don't require a medical checkup.
52:00 And if there are pre-existing conditions, for example, our fellow countrymen,
52:04 we don't have requirements that your contribution should be greater
52:09 because you are old or you have existing illness.
52:15 That is not in the vocabulary of field health.
52:18 So we should all be together here because weak, strong, healthy, sick, young, old,
52:26 that is the principle of the program.
52:28 We should be together here.
52:30 Social solidarity, we should all help each other.
52:35 If there are issues in the past, we have overcome all of them.
52:42 We forgot about it.
52:44 Well, we are not saying that we forgot about it, but we are saying that we have overcome both.
52:51 And field health is still here.
52:53 So what can we say about that?
52:56 What we can say is that field health has become true to its mandate.
53:01 Please give a shout out to non-paying members who are qualified.
53:06 Who all, even if they don't pay, can become a field health member?
53:12 List them because they include senior citizens, PWDs, single parents.
53:17 Who else?
53:18 That's right. I forgot about that point.
53:21 We have what we call indirect contributors.
53:24 Correct.
53:25 We will be hard on our fellow countrymen, in particular those who are on the list of the Department of Social Welfare and Development.
53:35 Second, the senior citizens, persons with disabilities, those who are returning to the government.
53:46 They are included in the field health coverage.
53:51 Single parents are also included in this program.
53:57 Even the lifetime members are included.
54:03 As you mentioned earlier, a retiree is covered for the rest of their life as long as they meet the two conditions.
54:14 They meet the age of retirement, which is 60, and 120 monthly contributions in the program.
54:22 By then, we will all meet those conditions and we will not have to pay contributions and we will be covered for life.
54:31 All right. Okay.
54:33 That's a good news.
54:35 Maybe we need to clarify this so that it will be clear that they can be non-paying members of the field health, non-contributing members.
54:44 Politicians don't need to sponsor them.
54:48 Yes, that's right.
54:50 There is no need because there are laws that are approved by the field health coverage for vulnerable sectors.
55:01 There is a law, RA 10645 for senior citizens.
55:06 RA 11228 for persons with disabilities.
55:11 There is also a previous law, I think two years ago, for single parents.
55:16 There is also for households and others.
55:20 So, that's right.
55:22 The program is for everyone.
55:26 There is no special treatment.
55:30 All of them are open.
55:31 Are the indigenous peoples and persons deprived of liberty included?
55:38 You said earlier that they are returning.
55:40 Are the rebel returnees included in the IPs?
55:45 Yes, they are also included in the IPs.
55:48 In fact, maybe if we will include them in the universal health care law,
55:53 it is already declared that all Filipinos are automatic members.
55:57 We want to clarify that as long as you are a Filipino, you are a member of the field health.
56:02 We don't need to be picky.
56:04 Don't be greedy.
56:06 Don't be greedy.
56:08 As long as you are a Filipino, you are a field health member.
56:11 Our campaign, Ma'am Malu, is to register.
56:17 Because if we are registered, we have a record in the field health.
56:22 And therefore, if we will use the benefit, we are already in the hospital,
56:26 we can avoid the hassle or the burden.
56:30 We can use the benefit but of course, there is a little hassle because first,
56:36 you cannot be seen in the record.
56:41 And therefore, if you are not on the list, we have specific things to do while the patient is confined.
56:49 But of course, instead of being able to focus on the treatment,
56:56 we are still being hassled.
56:58 That is the importance that we have a record and a field health ID number
57:05 so that when we enter the hospital, the hospital will check the field health database.
57:11 If it is seen, it is okay.
57:13 It is not a problem for the patient.
57:18 Okay.
57:19 So what I mean is that the politician does not need to be on the list,
57:24 he should be a member of the field health.
57:26 Okay.
57:27 On that note, let us monitor the next steps.
57:30 It looks like the field health is really taking care of the family, life, and finances.
57:38 Thank you very much.
57:40 This is Valenia, the Vice President for Corporate Group Affairs of the Philippine Health Insurance Corporation.
57:48 Have a good day, Mr. Ray.
57:50 Thank you.
57:51 Have a good day.
57:52 Thank you very much, Ma'am Malu.
57:54 Long live to you.
57:55 [Music]