PhilHealth should seek help from private sector: solon


Posted at Dec 09 2021 11:37 AM | Updated as of Dec 09 2021 12:11 PM

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MANILA – State insurer PhilHealth should consider tapping the private sector to improve the way it manages its funds, a lawmaker said Thursday.

“As we know, health insurance companies are doing quite well in the private sector. We don’t hear of these management problems, right?” Marikina Representative Stella Quimbo said.

“So clearly, there is expertise in the private sector and so this bill allows the PhilHealth to precisely outsource from the private sector certain segments of their operations, and in fact create a management transition team."

"Meaning, we can use the experts from the private sector to really set up the management operations of PhilHealth and sort of train the career executives, in other words have a transfer of skills and technology from the private sector to PhilHealth,” she said.

Quimbo’s comments came after the Commission on Audit bared that the state health insurer released P14.97 billion to hospitals last year under the Interim Reimbursement Mechanism (IRM) supposedly without legal basis.

The lawmaker said Congress should immediately discuss her proposed Social Health Insurance Crisis Act which she filed on August 19, 2020.

Quimbo said PhilHealth may benefit from tapping the skills of fund managers from the private sector.

“We have to really accept that the management of a health insurance fund is not easy. So you really need managers with a proper skillset and most of the time, you won’t find that in government.”

“So you really need to find, you need to first of all pay them well, you know you really need to increase salary levels so that you’re able to attract the best talent throughout the country," she said.

The lawmaker stressed, however, that she is not for the privatization of PhilHealth.

“There’s a big difference between privatizing a program and outsourcing from the private sector certain segments of the operation,” Quimbo said.

“We will certainly not privatize a social health insurance problem because it doesn’t make sense, right? When you privatize, that means profits will be an important objective, right? So we cannot do that.”

She further explained, “What I am proposing instead is to outsource, meaning, for example, in the case of lawyers, if they have a problem prosecuting cases, that they don’t win cases in courts, why don’t you outsource it from a private law firm? Meaning, hire private lawyers. So that’s my proposal.”

“So hire experts from the private sector so that a social health insurance, a government program is effectively run.”

Outsourcing portions of a government agency’s functions to a private company is not new, she said.

“You know we have government-owned corporations like Pag-IBIG fund, for example. A lot of their operating segments are already outsourced to the private sector. Again, in recognition that in many of the services are actually more efficiently provided in the private sector.”

“So we have things like IT, or maybe legal or maybe accounting or maybe even customer service, we can outsource that from the private sector. And that’s going to be so much cheaper,” she said. 

The state health insurer has been embroiled in multiple controversies involving graft and corruption.

PhilHealth is among "graft-prone" government agencies in the country, the justice department said last September.

--ANC, 9 December 2021