Solon points to ‘confusing’ computation
THE Philippine Health Insurance Corp. (PhilHealth) appears to be overcharging the government with subsidized premiums for indigent families because of its “confusing” process of computation, a senior vice chair of the House committee on appropriations said.
Marikina Rep. Stella Quimbo made the statement during the panel’s hearing on Monday night on the proposed P301 billion budget for 2023 of the Department of Health (DOH) and its attached agencies.
Quimbo told PhilHealth that the P100.2 billion that the state insurer is asking the government for premiums next year seems to be bloated.
“Bakit hindi ninyo ayusin (Why don’t you fix this) once and for all? Para magkaintindihan tayo kung ano ang proper na singil. Kasi ako unang tingin palang dito (So that we’ll understand each other as to what is the proper amount to be charged. Because for me, at first glance I already know that), you are overcharging (the) government,” Quimbo told PhilHealth Vice President Lemuel Untalan.
PhilHealth said the budget will cover the premiums for 12.75 million indigent beneficiaries, 8.02 million senior citizens; and 99,800 individuals, for a total of around 20.87 million beneficiaries.
Quimbo questioned the state insurer’s data on the 12.75 million indigent beneficiaries who were supposedly identified by the government’s National Household Targeting System (NHTS).
She noted that as of last August, the NHTS data showed that there are only 5.59 million indigent households in the country.
“So paano po nangyari na 12.75 million ang sinisingil niyo sa government? (So how come you’re charging government premiums for 12.75 million people?” asked the economist-lawmaker. “Parang lumalabas kayo po ay nag-o-overcharge sa gobyerno kasi napakalaki po ng hinihingi Ninyo -P100.2 billion (It seems that you’re overcharging the government since you are asking for a huge budget of P100.2 billion).”
Quimbo said PhilHealth has to review its figures and computations, especially since she will be the one to defend its budget on the floor when the deliberations reach the plenary.
“Unfortunately kahit ako po ang sponsor ninyo (even if I’m your sponsor), I’ll be honest with you na hindi maliwanag ang computation ng singil ninyo sa national government (that your computation of the amount to be charged to the national government is unclear),” she said.
Untalan explained that since the National Health Insurance Program defines a dependent as a person below 21 years old, the other children in the same family who are 21 years old and above will have to pay a separate premium.
Quimbo found this explanation absurd. To illustrate, she said her family is being charged two PhilHealth premiums: one for the mother, the father and three children below 21 and then another premium for the only child who is more than 21 years old.
“So for my family, kung ako ay nasama sa indigent (had I been among the indigents) you are charging the government two premiums for my family only because I happen to have a child who is more than 21 years old,” she said. “Why are you charging my family two premiums? So kung nagkataon na meron akong isang anak na 21 at isa pang anak na 22 (So if I had a 21-year-old child and another one who’s 22), you are charging the government three premiums for my family. That doesn’t even sound right.”
The lawmaker, the wife of former Marikina Rep. Miro Quimbo, pressed PhilHealth to assure Congress that it is not overcharging the government after a thorough review of its data and computation method which Untalan vowed to “revisit.”
ACTUARIAL LIFE
Quimbo also slammed PhilHealth for its penchant of warning the public that its actuarial life may soon end after PhilHealth officer Eli Dino Santos told the panel it may only last until 2027 even if it is subsidized by other agencies like the Philippine Amusement and Gaming Corporation (Pagcor) and the Philippine Charity Sweepstakes Office (PCSO).
Santos earlier in the hearing said that even if subsidized, PhilHealth would only last until 2027 but may go on to operate beyond that if it would receive additional funding from higher sin tax revenues.
“We have another scenario, madam chairperson. If we will only receive Pagcor and PCSO pork for 2023, per DBM-recommended (Department of Budget and Management) NEP (National Expenditure Program], the subsequent years, we will have until 2027, Madam chairperson,” Santos said. “If we receive all this support then definitely, then PhilHealth will definitely last beyond 2027.”
Quimbo reminded officials that every time PhilHealth introduces benefit payments, it is always subject to actuarial validation which means that the only way for the state insurer’s fund to completely dry up is when it pays benefits “way more than what you have.”
“Nakaka-nerbyos po ‘yung mga pronouncements na ‘yun. Baka iniisip ng ating mga kababayan na nalulugi na ang PhilHealth (Such pronouncements of limited actuarial life make us nervous. The public may think that PhilHealth is going bankrupt),” she said.
PhilHealth data shows that it still had a net income of P32.8 billion last year despite paying benefit expenses amounting to P140.2 billion and its operational expenses of P7.8 billion which were deducted from PhilHealth’s total income of P171.2 billion, plus interest and other income amounting to P9.7 billion.
“PhilHealth will last forever,” Santos later reassured the panel to which Quimbo replied, “Salamat po sa reassurance at sana po beginning today, huwag na kayo magsabi ng taning sa buhay ng PhilHealth kasi talagang kinakabahan ang lahat ng miyembro na nagko-contribute (Thank you for the reassurance and hopefully, beginning today, there’ll be no more warnings on PhilHealth’s actuarial life because contributing members really become nervous).”
