Press Release
August 8, 2020

'Big COA detachment, resident Ombudsman, oppo board rep, stronger internal affairs, clip pres'l discretion'

Whoever are fired or hired, these must be done:

1) More than special audit, PhilHealth requires constant audit. I doubt if COA auditors in that agency number more than 25. Too small for a P140-billion-a-year agency, which transacts 35,000 claims a day from 8,500 hospitals and 40,000 healthcare professionals.

COA has 5,782 job vacancies on its plantilla, including at least for 516 CPAs. Invite millennials from the ranks of the 7,390 CPA board passers since January last year to fill these. This bigger COA detachment should be reinforced with other COA auditors to do fraud and performance audits from time to time.

2) Appoint a resident Ombudsman. If there is one, add more investigators. Two watchdogs - COA and Ombudsman - make one strong tripwire against fraud.

3) Strictly follow qualification standards for Board Members, for the eight appointees outside the five ex-officios, as stipulated in Section 13 (a) of RA 11223 or the UHC Law.

For President and CEO, it should be seven years of experience in public health, management, finance and health economics or a combination of any of these expertise. This should not be ignored or overruled by presidential discretion. (Sec. 14)

4) Non-ex officio members of the Board and senior executives should be independently vetted by the GOCC Governance Commission if they meet the mandatory "fit and proper" rule. No GCG clearance, no appointment. That is the only way to get the best and the brightest, and not the recycled and reassigned.

5) Consider appointing an opposition representative to the Board who shall meet the primary qualifications. We need this embedded fair but firm fiscalizer. This will also benefit the appointing power, as no one will exercise greater vigilance than such an appointee.

6) Strengthen the anti-fraud office with more personnel and a greater mandate so it can function as a truly independent internal affairs office. The Fact Finding Investigation and Enforcement Department (FFIED) and the Prosecution should be revamped. A revitalized anti-fraud group should be empowered to contract the services of outside experts, like auditors, if and when needed.

7) Suspend the power of the five Cabinet men in the Board (the Secretaries of Health, Social Welfare and Development, Budget and Management, Finance, and Labor and Employment) to designate alternates or representatives. Unless lifted by the President, they should function as full-time, hands-on government and presidential representatives to the board. They can tap their squad of Asecs and Usecs to assist them, but the latter should not be empowered to act on their behalf. We need these Big Brothers, this Cabinet 5, to closely exercise oversight during PhilHealth's reform and rehabilitation phase.

8) Harness the full power of IT to promote transparency and client satisfaction in all PhilHealth transactions. But tap outside experts to guide the design, pricing, procurement and installation of this. Contract this out - in an open bidding - to leading companies with good track records and not fly-by-night carpetbaggers. Create an ad hoc IT advisory council with business and NGO representatives.

Changing the system, not just the personalities, will stop the revolving door of anomalies.

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