Philhealth issues statement on 18 percent coverage

THE Philippine Health Insurance Corp. (PhilHealth) continues to be committed in its mandate to deliver Universal Health Care for every Filipino. The latest Philippine National Health Account (2023) reports that 44.4 percent of the country's Current Health Expenditure (CHE) was paid through out-of-pocket (OOP) means.

UPLIFTING HEALTH Philhealth assures the Filipino people that it will continue its service to uplift health and well-being in the nation. IMAGE FROM PHILHEALTH

Meanwhile, the government — which not only includes PhilHealth services but as well as other health financing government initiatives such as the Medical Assistance for Indigent Patients — contributes 42.6 percent.

Although this is an aggregated figure, we are cognizant of PhilHealth's significant role in alleviating the still-heavy financial burdens that Filipinos face when accessing health services.

Hence, we have set out to reduce the OOP expenditure to around 25-35 percent over the next three years, which would entail a series of regular reviews and refinement of our processes.

For PhilHealth alone, this translates to an increase of the current CHE share to around 25-35 percent by 2028 — which necessitates focusing our benefit releases to prioritize high burden, and high cost diseases that commonly affect Filipinos, as evidenced by data.

This calls for alignment with our health care providers — professionals and institutions alike — to ensure preparedness for the implementation of benefits, allowing our members to promptly access care and financial risk protection.

Benefits have been and will be expanded, but we need the health care supply-side to match these efforts.

However, we clarify that PhilHealth's contribution to CHE (or the country's health expenditure) is different from the support value or the amount that PhilHealth covers for each hospitalization or visit of our members.

However, reducing the OOP expenditure requires concerted, multisectoral efforts in strengthening the health system's financing strategies. PhilHealth continues to cooperate with different government agencies such as the Department of Health (DOH), National Economic and Development Authority (NEDA), and Local Government Units (LGUs). Only through synchronized efforts among government agencies could we successfully achieve health financial risk protection for every Filipino. PhilHealth is also supporting Senator Pia Cayetano's advocacy of lessening the amount that Filipinos spend on medicines out of their pocket. Philhealth is directly coordinating with her office to improve its services.