The dismal performance of the Philippine Health Insurance Corp. (PhilHealth) and the failure of its officials to stem systemic fraud warrant the privatization of the government鈥檚 medical insurance company, Sen. Sherwin 鈥淲in鈥� Gatchalian said on Wednesday.
Gatchalian, Senate economic affairs committee vice chair, said PhilHealth was among dozens of government-owned and -controlled corporations (GOCCs) that had consistently failed in the performance evaluation standard of the Governance Commission for GOCCs (GCG) for the past several years.
He said the 鈥渂iggest scandal in recent memory鈥� happened in PhilHealth, referring to allegations of massive corruption that had led to criminal charges against former PhilHealth president Ricardo Morales and some other officials of the state-run health insurer.
鈥淲e are all dismayed that even during the COVID-19 [pandemic], many unscrupulous PhilHealth officials callously pocketed (public funds),鈥� Gatchalian said during the Senate hearing on the GCG鈥檚 proposed budget of P198 million for 2021.
鈥淗ow come PhilHealth was (allowed) to operate this way? Now we鈥檙e dealing with the consequences of poor management and corruption inside,鈥� he said.
In wrong people鈥檚 hands
鈥淭his creates a very good ground for a possibility to privatize PhilHealth. Personally, my own analysis is that its operations can be privatized,鈥� he maintained.
Gatchalian, a scion of a business clan from Valenzuela City, said a company he had worked for when he was still in the private sector had paid a private health insurance provider for the medical benefits of its employees.
鈥淲e all know right now that (PhilHealth鈥檚) operation is prone to corruption in the hands of the wrong people,鈥� said Gatchalian, who presided over the hearing.
鈥淏ut since this operation can be performed by the private sector, why not just give it to the private sector and the government will just pay premium?鈥� the senator said.
GCG Chair Samuel Dagpin Jr. said privatization of PhilHealth was 鈥渙ne of the options鈥� his agency had considered to eradicate various rackets allegedly perpetrated by some of its corrupt officials, but only Congress could decide on that.
Dagpin said the GCG has been pushing for institutional reforms to improve the state-run insurance company鈥檚 performance since 2017 when it recommended the transfer of PhilHealth鈥檚 administrative supervision from the Department of Health to the Department of Finance.
Senate President Vicente Sotto III, who had exposed the allegedly irregular distribution of P14.9 billion in PhilHealth鈥檚 COVID-19 response funds, had already filed a proposed measure to replace the health secretary as PhilHealth board chair with the finance secretary.
鈥淭he problem is really in the claims and benefits portion of our health-care system 鈥� I think there must be a reformation,鈥� Dagpin said.
鈥淲e also have to define what are the basic essential health services to be (covered) by the UHC (universal healthcare) law. That should be properly studied,鈥� he said.
Hope for reform
Asked by Gatchalian whether PhilHealth鈥檚 problematic system, which has been blamed for the unabated corruption in the state insurer, could still be rectified, the GCG head said: 鈥淭here is hope for reform, really.鈥�
鈥淚 already mentioned that the claims and benefits portion of the health-care system is the one having problems,鈥� he added.
Dagpin also disclosed that PhilHealth scored less than 50 percent under the GCG鈥檚 performance management system in 2019, failing the mandated 90 percent passing rate.
The GCG official said they had submitted their own recommendations to Malaca帽ang and the Department of Justice, which had been directed by President Duterte to lead the investigation into the multibillion-peso corruption scandal that supposedly pushed PhilHealth to the brink of financial collapse.
Last week, the National Bureau of Investigation brought criminal charges against Morales and eight of his subordinates in the Office of the Ombudsman for the alleged misuse of P14.9 billion in interim reimbursement mechanism funds.
The funds specifically allotted for hospitals treating patients infected with the new coronavirus were allegedly given to dozens of health-care facilities that did not even handle a single case of COVID-19.