PRESIDENT Marcos Jr.’s marching orders to new Philippine Health Insurance Corporation (PhilHealth) president and chief executive officer Edwin Mercado is to further expand services and benefits the agency provides to the public, despite funding issues hounding it.
Mercado, in a briefing in Malacañang yesterday, also said the state insurer will abide by whatever ruling the Supreme Court will issue concerning the agency’s funds.
The High Court on Tuesday held oral arguments on petitions questioning the transfer of P89.9 billion excess funds of PhilHealth to the national treasury.
PhilHealth transferred P60 billion in unused funds to the Treasury in 2024, with the remaining P29.9 billion stopped after petitions questioning the transfer were filed.
“We respect the process that the Supreme Court is undergoing and we will abide by whatever ruling the Supreme Court will have,” he said.
On Marcos’ marching orders, Mercado said he would review the agencies programs, projects, activities and even funding requirements and decide how to proceed from there. Once he has the needed data, PhilHealth would then be able to determine its how much funds it needs to be able to maintain the “level of care” for the people.
PhilHealth was given zero subsidy for this year.
Mercado said his priority at the moment is to implement reforms in PhilHealth’s processes to ensure uninterrupted services and expand benefits from the agencies, as the President directed.
He said he initially identified benefit management and financial reporting as among the agency’s major “ills” that need to be addressed.
Mercado said he would look into the actuarial capacity of PhilHealth or the benefit cost vis-à-vis the collection to find out how much fund the agency really needs, and what actual illnesses and services use the most funds, among others.
He said not all major illnesses actually receive the most treatment or subsidy from PhilHealth.
Mercado said another priority is improving the settlement of current and unpaid claims. Currently, claims take usually about 25 days to process.
He said he wants to avoid unnecessary delays such as the submission or inaccurate documentary requirements from incomplete medical reports to misspelled names, among others.
He said he wants the processes of filing claims revisited and to avoid “return to hospital” claim applications to prevent delays in payment of claims.
Another priority of the new PhilHealth head is the digitization of PhilHealth which would hasten the processing of claims.
Senate deputy majority leader Joseph Victor Ejercito advised Mercado to give priority to the state insurer’s members’ welfare rather than treat it like a private owned corporation whose main objective is to rake in much profit.
“His top priority should be public welfare, the implementation of the Universal Health Care law, instead of treating PhilHealth like a private, profit-driven corporation,” he said.
He said he expects Mercado to significantly improve PhilHealth services and benefit packages in line with the vision of the Universal Healthcare Act of reducing out-of-pocket costs to ease the burden of every Filipino family.
He said also Mercado must ensure that members get the full benefits for every centavo they contribute to PhilHealth. — With Raymond Africa