Cayetano: PhilHealth package benefits too low, need updating

Senator Alan Peter Cayetano on Thursday said it is time to adjust the Philippine Health Insurance Corporation (PhilHealth)'s packages to account for high inflation that has driven up healthcare costs.

"Kung tatanungin niyo kung may pagtaas sa presyo ng bigas o langis, masasagot kaagad. Kayo po magsabi, y'ung fees sa laboratory or sa hospital, nagtaas na rin ba sila? We want to focus on zero billing kasi iyon talaga ang issue," Cayetano told PhilHealth officials during its program and services briefing with the Senate Committee on Government Corporations and Public Enterprise on October 5, 2022.

He said in order to update PhilHealth packages to current healthcare expenses, there is a need to fine-tune its No Balance Billing (NBB) Policy.

"We are interested in zero billing. How do we address the issues kung passé na y'ung amount? Right now kasi napakalaki ng inflation," he said.

Introduced by PhilHealth in 2012, the NBB policy, also known as zero billing, mandates that no other fees are charged to or paid for by members for health services rendered by government hospitals or select PhilHealth accredited private hospitals.

Also introduced in 2012 was PhilHealth's All Case Rates (ACR) Policy, which refers to the fixed amount that it reimburses members for specific cases or illnesses.

Cayetano said with a decade passing since both policies have been implemented, it may be high time to adjust PhilHealth's packages.

Aside from zero billing, Cayetano also expressed interest in tackling PhilHealth's access and service coverage.

"We'll also be focusing on PhilHealth's access and coverage kasi paano kung kumpleto at maganda [ang offered services] kung wala namang PhilHealth-accredited na hospital sa lugar? Forty percent of our barangays do not even have primary health centers. y'ung sa coverage naman, nabanggit na kanina y'ung sa PhilHealth Plus, check ups, et cetera," he said.

Cayetano assured PhilHealth officials that despite the gaps that need to be filled, he is not out to point fingers or lay blame on them.

"Ang attitude natin dito is not 'committee versus PhilHealth.' We're all in this together and kami naman ang nagpapasa ng budget. Kung may pagkukulang, it's not only on your backs but it's also on us," he said.

Mababang PhilHealth package benefits dapat i-update: Cayetano

Sinabi ni Senador Alan Peter Cayetano ngayong Huwebes na panahon na para ayusin ang healthcare packages ng Philippine Health Insurance Corporation (PhilHealth) sa gitna ng mataas na inflation na nagpapataas ng mga gastos sa pangangalagang pangkalusugan.

"Kung tatanungin niyo kung may pagtaas sa presyo ng bigas o langis, masasagot kaagad. Kayo po magsabi, y'ung fees sa laboratory or sa hospital, nagtaas na rin ba sila? We want to focus on zero billing kasi iyon talaga ang issue," wika ni Cayetano sa mga opisyal ng PhilHealth nang dinggin ng Senate Committee on Government Corporations and Public Enterprise ang kanilang mga programa at serbisyo noong October 5, 2022.

Aniya, kailangang ayusin ng PhilHealth ang No Balance Billing (NBB) Policy para ma-update ang kanilang packages sa mga kasalukuyang gastusing pangkalusugan.

"We are interested in zero billing. How do we address the issues kung passé na y'ung amount? Right now kasi napakalaki ng inflation," sabi niya.

Taong 2012 nang umpisahan ng PhilHealth ang NBB, na kilala rin bilang zero billing, na nag-uutos na walang ibang sisilingin o babayaran ang mga miyembro para sa mga serbisyong pangkalusugan na ibinibigay ng mga pampublikong ospital o mga piling pribadong ospital na kinikilala ng PhilHealth.

Inumpisahan din noong 2012 ang All Case Rates (ACR) Policy ng PhilHealth, na tumutukoy sa halaga na ibinabalik nito sa mga miyembro para sa mga partikular na kaso o sakit.

Dahil isang dekada na ang lumipas mula nang ipatupad ang parehong mga patakaran, sinabi ni Cayetano na maaaring panahon na para ayusin ang packages na nito ng PhilHealth.

Bukod sa zero billing, nagpahayag din ng interes si Cayetano sa access at saklaw ng serbisyo ng PhilHealth.

"We'll also be focusing on PhilHealth's access and coverage kasi paano kung kumpleto at maganda [ang offered services] kung wala namang PhilHealth-accredited na hospital sa lugar? Forty percent of our barangays do not even have primary health centers. y'ung sa coverage naman, nabanggit na kanina y'ung sa PhilHealth Plus, check ups, et cetera," aniya.

Tiniyak ni Cayetano sa mga opisyal ng PhilHealth na sa kabila ng mga pagkukulang nila na kailangang punan, hindi niya gustong ituro o sisihin ang mga ito.

"Ang attitude natin dito is not 'committee versus PhilHealth.' We're all in this together and kami naman ang nagpapasa ng budget. Kung may pagkukulang, it's not only on your backs but it's also on us," sabi niya.