PhilHealth 鈥榲ery healthy鈥� with P150B surplus, P490B investment funds
MANILA, Philippines — The Philippine Health Insurance Corporation (PhilHealth) is in a healthy state despite fears from different sectors over the proposed zero government subsidy for 2025, its president and chief executive officer Emmanuel Ledesma said on Tuesday.
Ledesma made this assurance during PhilHealth’s briefing before the House of Representatives committee on good government and public accountability, amid questions about whether the state-run insurer would be financially viable for 2025 even without the over P70 billion allocation in the General Appropriations Bill (GAB).
“As the leader of PhilHealth, I must acknowledge the challenges that persistently affected us as well as the progress we have made. Let me begin with a clear and candid statement: despite areas that need significant work, PhilHealth is still a very healthy corporation at the moment,” he said.
According to Ledesma, PhilHealth’s surplus funds are at P150 billion, its reserve funds at P280 billion, and its investment fund at P490 billion.
Ledesma did not provide a total, but his figures indicated PhilHealth has P920 billion. However, the reserve fund is not usually used to pay off benefits, which means that it has P640 billion to spend for 2025.
“As of October 2024, PhilHealth holds a surplus of P150 billion, and a total reserve of P280 billion, complemented by an investment fund nearing P490 billion as of November 2024. These figures clearly demonstrate that PhilHealth is financially robust, well-positioned to sustain operations, and fully capable of addressing the healthcare needs of our P115 million members,” he said.
Article continues after this advertisement“And we are steadily progressing with our objectives. In fact, we are about to implement another 50 percent increase in coverage for most of our case rate packages. That means that this year, we will have implemented a total of 80 percent increase, across-the-board, for almost all of the case rate packages,” he added.
Article continues after this advertisementThe PhilHealth chief also acknowledged issues with PhilHealth’s management of healthcare packages, promising that President Ferdinand Marcos Jr.’s administration seeks to address these issues.
“Let me speak with candor, your Honors. I am conscious that the PhilHealth institution has become a source of frustration for our colleagues in the government, particularly the legislators who are anxious for the well-being of your constituents. PhilHealth has faced intense scrutiny, and many of its shortcomings were exposed,” Ledesma said.
“These challenges brought us to a critical juncture, a need for comprehensive reforms at the corporation, to rebuild both the institution and public confidence in it. It was in this context that I was appointed under the leadership of our beloved President Ferdinand Marcos. The vision for Bagong Pilipinas has given a clear mandate to bring about a renewed PhilHealth,” he added.
Criticism
However, Ledesma’s appeal for patience regarding the changes regarding the higher case rate packages and the smoother facilitation of benefits payments was met with criticism.
Agri party-list Rep. Wilbert Lee, for example, asked what the cause of PhilHealth’s inefficiency was as delays may mean patients would die.
“Hindi ko matanggap na wala tayong paraan na bilisan ito, sinasabi mo dito […] that yes we’re on the road to increase and by next year we can see increased benefits, we can see ganito. Pero ‘di ko matanggap pa rin na bakit hindi natin ito kayang gawin bilisan lahat. Kulang ba ang team? Nagiging delayed ba ang meeting sa benefits committee?” Lee asked.
(I can’t accept that we have no way to speed this up. You’re saying that we’re on the path to improvement and that by next year we’ll see increased benefits, we’ll see progress like this. But I still can’t understand why we can’t make all of this happen faster. Is the team lacking? Are meetings with the benefits committee being delayed.)
“‘Yon ang hindi ko matanggap, Mr. Chair, na kailangan mag-antay, a little more patience, ano’ng katumbas? Maraming pasyente, more patients are dying,” he added.
(That’s what I can’t accept, Mr. Chair—that we’re being asked to wait and have a little more patience. At what cost? Many patients, more patients, are dying.)
“We hear you loud and clear; we are working as fast as we can. Maybe to add, Mr. Chair, we are also about to undergo a major reorganization in PhilHealth because we will be increasing our manpower. We are trying as fast as we can to increase our accredited facilities, I’d like to think Mr. Chair, I understand all of the impatience and everyone wants to get things resolved,” Ledesma replied.
Over social media, several individuals expressed concerns with PhilHealth, as it was given zero government subsidy for 2025 — with some fearing that the insurer would not be able to assist them if they get sick.
However, House lawmakers — Tingog party-list Rep. Jude Acidre and La Union 1st District Rep. Paolo Ortega V said that claims that PhilHealth would not have any funds for 2025 were fake news, as it still has around P600 billion in reserve funds.
Acidre also noted that providing assistance for PhilHealth members and beneficiaries would not stop, as the state-run insurer’s funds can last up to two years.
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