PhilHealth benefits should be transferable, include consultation

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opinion

LAST December 16, 2017, the Philippine Health Insurance Corporation’s Regional Office X Office signed with six Cagayan de Oro City-based PhilHealth-accredited hospitals a memorandum of agreement to adhere to the “No Hospital Deposit Policy”. The agreement makes its clear and reminds hospitals of the policy, which is actually a law that they should comply.

Last August, President Rodrigo Duterte signed into law Republic Act No. 10932, otherwise known as the Anti-Hospital Deposit Law. It provides that “in emergency or serious cases, it shall be unlawful for any hospital or medical clinic to request, solicit, demand or accept any deposit or any other form of advance payment as prerequisite for administering basic emergency care, for confinement or medical treatment, or to refuse to administer medical treatment and support any patient.

Under the MOA, the PhilHealth accredited hospital shall not impose a deposit requirement for eligible PhilHealth members and their dependents who come to the facility for confinement or admission. But what about patients who are not PhilHealth members and those who are members but were unable to contribute for a time due to financial constraints? Does this mean that they should be denied medical services if they can’t make a downpayment? Will Philhealth shoulder such patient’s medical bill? And what about the hospital, how would it protect itself from potential huge cost of accommodating the influx of cashless indigent patients? Or how can the hospital recover the cost asap.

Philhealth can solve these problems and relieve both patient and hospital by being flexible with its restrictions to contributors or members. Currently, member’s dependents, whose hospitalization can be covered by Philhealth, are limited to children and parents. Philhealth should allow a member’s Philhealth contribution to be used for covering the medical bill of a non-relative who is not enrolled with the health insurer or lack contributions.

If good samaritans can let their health insurance help others with Philhealth’s approval, many patient would be given needed medical services and hospitals can recover the cost by collecting the bill from Philhealth. Philhealth funds will not be depleted because not all members are availing of insurance at the same time. And the person who shared his or her Philhealth benefits to a non-relative may forfeit using the insurance for himself/herself or his/her dependents until the used contributions are replenished to be fair.

Such flexibility, the transferability of Philhealth insurance to a non-relative member, is in line with Philhealth’s mandate of providing universal health. It is in line with the no-deposit law and with President Duterte’s thrust of inclusive health. Just imagine how many with medical conditions would be helped by others willing to share their Philhealth benefits with the hospital having a fair opportunity to recover cost.

Meanwhile, the use of Philhealth benefits is only applicable when the beneficiary is confined or hospitalized. Not all medical conditions or injury require hospitalization and confinement. In fact, this is more expensive than simply providing patients with a medical check-up or doctor consultation service and lab tests. So Philhealth benefits should cover consultation.

When the Dengvaxia controversy erupted, Philhealth was quick to offer coverage to all children who may suffer complication from the dengue vaccine. I believe with this move, Philhealth recognizes its duty and obligation to helping ensure public health, especially that of children. It is a very touching gesture to volunteer such help even before it becomes necessary. If it can do this, it is open-minded enough to now consider making its benefits transferable and cover not just medical confinement but also medical check-up.

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