Hospitals snubbing poor patients get warning

by Ron Gagalac, ABS-CBN News

Posted at Feb 11 2014 05:11 PM | Updated as of Feb 12 2014 01:11 AM

MANILA - The Philippine Health Insurance Corp. (Philhealth) said it will sanction government hospitals that will not shoulder the hospitalization and medical expenses of its poorest members.

Philhealth said it is now implementing the "point-of-care system" for the 14 million poorest of the poor in the country.

Philhealth President Alexander Padilla said the system is designed to help those who don't have access and resources to enlist themselves as members of Philhealth.

"Ito yung mga mahihirap na hindi nakasama noon. Pag nagkasakit sila i-e-enroll na sila ng ospital at pagbayad nila ng premium, covered na sila agad," he said.

He said, however, that the individual must be included in a list predetermined by the government based on a portal created for public hospitals.

Padilla said the indigents will not have to shell out any amount during their hospitalization because they will already be included in the "No Balance Billing System."

Under this system, the indigents included in the list should not incur expenses, including medications.

"Pag pinabili nila ng gamot sa labas ng ospital, ang gagawin namin, babayaran namin ang myembro. Pagkatapos, sisingilin namin ang ospital ng tatlong beses ng halaga ng binayad ng myembro bilang sanction na rin sa ospital," Padilla said.

Padilla was at the Senate on Tuesday to discuss universal health care issues.

He clarified the sanctions are applicable for now in government hospitals.

"Ang sistema ay hindi pa perpekto, pero under the ‘no balance billing’ wala na dapat babayaran," said Senator TG Guingona, who led the hearing.

The indigents need not carry any document to avail of the Philhealth services, Padilla said. They will only be required to fill up an application form at the hospital.

The household helpers or kasambahays are part of this program, Padilla said.

Guingona is also inclined to investigate why some public hospitals still ask the indigents to buy medicines outside the hospital.

During the hearing, Social Watch Representative Mercy Fabros said the problem is not with Philhealth but with government hospitals that often lack supplies.

"No amount of Philhealth enrollment will suffice kahit 100% kung ang ospital ay walang supply for healthcare," Fabros said.

At present, Philhealth has 76.9 million members nationwide. An increase in premium rates from P1,200 to P2,400 was defended during the hearing.

Philhealth showed data that it is shelling out more benefits to its members vis-a-vis premium contributions they are collecting.

Meanwhile, Fabros appealed to Philhealth that it consider its composition, mostly doctors.

Fabros is suggesting that ordinary health workers must also have representations in the board of Philhealth, something that Padilla said they will look into further.