The Philippine Health Insurance Corporation (PhilHealth) has faced criticism from several senators for its continued inability to reduce medical costs for its members. This criticism comes almost five years after the Universal Health Care (UHC) Act was enacted. The Act aimed to provide comprehensive health services to all citizens. During a Senate plenary session concerning PhilHealth’s proposed budget of PHP 68.7 billion for 2025, Senator JV Ejercito expressed his concerns about the organization’s performance.
Ejercito pointed out that despite the mandate given to PhilHealth and the Department of Health under the UHC Act, the reforms intended to lower healthcare costs have not been significantly felt by the public. Since the law’s passage in 2019, there has been little progress in making health services more affordable. The senator disclosed several incidents where PhilHealth’s financial assistance was minimal. He provided evidence that in one particular case, PhilHealth only covered PHP 15,120 out of a total hospital bill of nearly PHP 1.5 million, highlighting that the support extended to paying members was insufficient.
The discussion at the Senate also revolved around the financial health of PhilHealth. The institution reportedly amassed a surplus of PHP 89.9 billion, which Senate members argued should have been used for improving healthcare coverage. Senator Ejercito emphasized that PhilHealth should not operate like a private corporation, focusing on profit rather than providing services to the populace. The surplus funds were ordered to be remitted to the national treasury by Finance Secretary Ralph Recto.
PhilHealth President and CEO Emmanuel Ledesma Jr., who assumed his position in November 2022, defended the agency’s performance. He stated that adjustments to the case rates had been implemented within his first two months in office, which marked the first change in over a decade. Ledesma argued that the blame should not fall solely on him, suggesting that systemic issues contribute to the organization’s challenges.
Ledesma’s defense did not satisfy the senators. Senate Majority Leader Francis Tolentino reminded Ledesma to show respect for the legislative chamber and its members. The senators expressed their collective frustration, questioning the leadership and direction of PhilHealth.
The ultimate goal of the UHC Act is to provide accessible health care to all citizens within a decade. However, the senators argued that the law has yet to make a substantial impact on reducing out-of-pocket expenses for healthcare. This ongoing issue affects many Filipinos who are already grappling with rising costs of living, including food and other basic necessities. The Senate’s scrutiny of PhilHealth’s budget underscores the pressing need for the agency to fulfill its mandate effectively.
