Viral PhilHealth case exposes insurance system flaws – party-list

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June 15, 2026 | 5:25pm

MANILA, Philippines — A viral case involving a woman who said her husband died after failing to get a lifesaving operation for brain hematoma shows the failures of the country's health care system, a progressive women's group said Monday, June 15.

Gabriela Women's Party said the case reflected systemic problems in Philippine health care, including what it described as the national government's insufficient funding for public hospitals, which it said affects ordinary citizens the most.

"Mahigit 25 na taong kinaltasan ang sahod, tapos hindi rin pala magagamit sa panahon ng pangangailangan... Hindi sana umaabot sa ganitong trahedya kung direktang pinapalakas at pinopondohan ng gobyerno ang ating mga pampublikong ospital," House Assistant Minority Leader and Gabriela Women's Party Rep. Sarah Elago said.

(Their salaries were deducted for more than 25 years, only for the benefits to be unavailable when they needed them. This tragedy would not have happened if the government directly strengthened and funded our public hospitals.)

Elago was referring to the viral Facebook post of Maria Lourdes Sulit, whose husband Marvin died of brain hematoma after the family could not afford a surgery that she said would have cost P2 million to P4 million.

Sulit also said their appeal for PhilHealth assistance to reduce their P200,000 hospital bill was denied because Marvin had been hospitalized for less than 24 hours.

"My husband had just died. How could he not be eligible?" Sulit said.

PhilHealth explains 24-hour rule

PhilHealth Senior Vice President Israel Paragas said there are available packages for members who die in less than 24 hours, appearing to point to how the hospital processed the claim.

"Kung halimbawa mamatay in less than 24 hours, meron din tayo in less than two days or after, meron mga pakete na naka-assign. Siguro hindi lamang gaano napansin o nakita o hindi ganoon na-familiarize ang mga ospital o ang ospital kung kaya hindi nila nabigyan ng benepisyo," Paragas told dzMM on Monday.

(For example, if someone dies in less than 24 hours, or in less than two days or after, there are assigned packages for that. Maybe the hospital was not able to notice them or was not familiar with them, which is why the benefits were not applied.)

Paragas said Sulit and her husband could have received P73,000 to P108,000 in PhilHealth assistance had the surgery been performed.

He said, however, that the insurer could not shoulder the P200,000 hospital bill.

Insurance system insufficient. Elago said the case showed that the insurance-based system under the Philippine Health Insurance Corp. is not enough to ensure accessible and quality health care.

"Kailangan ng isang sistemang pangkalusugan na tunay na nakabatay sa pampublikong serbisyo at sapat na pondong pampubliko," Elago said.

(What we need is a health care system that is genuinely based on public service and supported by sufficient public funding.)