Shekinah Jedidiah M. Alima  Marikina 2nd District Rep. Stella Quimbo wants the Philippine Health Insurance Corporation (PhilHealth) to match the quality of its services with the skyrocketing profit it acquires annually, as she said during a hearing before the House of Representatives Committee on Health last Wednesday regarding the proposed amendments to the Universal Health Care (UHC) Act.


Quimbo pointed out that PhilHealth’s annual gross margin was P173.4 billion last year, excluding other investment revenues outside the government's national budget allocation, which made her concerned about the deprived services beneficiaries receive.
“But ironically, the benefit spending is too (high). The benefits that we, as members, receive are too low. How do we know that? Out-of-pocket spending is too (high),” she said.
The lawmaker observed that the P80 billion allocation for premium subsidies and P20 billion of benefit expansion allocations do not match the expected quality of benefits patients are getting.
She also stressed that the benefits recipients get from MAIP (Medical Assistance to Indigent Patients) were even bigger compared to PhilHealth’s, which the lawmaker found cynical.
Quimbo wants PhilHealth to lower the 5 percent premium workers pay and suggests having health maintenance organizations serve as third-party healthcare providers and improve their benefits.
Even President Ferdinand Marcos Jr. recently said he wants to see improvements in PhilHealth’s benefits and a hike in its premium.
Okay, if you’re going to increase it, show the other side of that. What will be the increase in services? What will you be able to cover? What more will you be able to cover?’” Marcos said in a media interview.
Last January, the Department of Health (DOH) chief Teodoro “Ted” Herbosa demanded PhilHealth be particular about the workers’ premium increase and have a concrete policy based on a study.
“You need to have a science-based policy. Hindi ‘yung [on a] whim na itataas mo lang,” Herbosa stated during a forum.
PhilHealth, through its information officer Liza Joyce Sangcayawon from the Local Health Insurance Office (LHIO) Antique, assured its service expansion with the premium rate adjustment last February.
Currently, PhilHealth provides both employed and unemployed Filipino workers with inpatient and outpatient benefits, with insurance coverage varying depending on the severity of their illness or cases.