Inclusion of informal sector in PhilHealth coverage proposed

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Tuesday, March 29, 2011


THE National Health Insurance Program (PhilHealth) should widen its membership and insurance coverage to include those in the informal sectors such as street hawkers, market vendors, pedicab and tricycle drivers, small construction workers and home-based industries and services.

House Bill 102, filed by Ilongga Rep. Janette Garin representing the 1st District of Iloilo, seeks to strengthen PhilHealth which is tasked to provide insurance coverage to all Filipinos with at least the minimum health insurance package.

The bill also gives PhilHealth “more teeth in going after criminals defrauding the corporation's funds through false claims,” she added as the proposal grants PhilHealth visitorial powers to check whether healthcare providers and employers are following the provisions of Republic Act (RA) 7875 or the National Health Insurance Act of 1995.

There is also a need to expedite the resolution of grievances and to classify abuses and unethical practices, said Garin, who is the vice chair of House committees on Health and Population and Family Relations.

"It is necessary to verify the truthfulness of the report on false claims as it is vital to strengthen RA 7875 so that PhilHealth can readily address cases of unscrupulous individuals and organizations defrauding the national health insurance funds," she stressed in a statement, claiming that PhilHealth lost P4 billion to fraudulent reimbursements through various unnecessary and overpriced procedures since 1995.

The bill imposes a fine of P100,000 to erring healthcare providers and proposes a 60-day filing period within which hospitals must file their claims from the date of discharge of their patients.

Another proposal, HB 655, meantime seeks to increase and expand PhilHealth coverage to include the children. "Let us make our children not only dependents but beneficiaries as well; it is a must for them to benefit from public health insurance programs."

"If before, the poor stayed at home when they’re ill because they’re unable to afford the cost of medical treatment, this time, their PhilHealth membership will make it possible for them to enter a hospital,” the proposal explained.

The bill pushes for a Children's Health Insurance Program (CHIP) for low income families who cannot afford to insure the health needs of their children. “Children from low income families shall be entitled to a full range of health services such as regular checkups, immunizations, prescription drugs, lab tests, x-rays, hospital and clinic visits, dental and eye care, among others.”

Poor parents aged 50 to 59 years old should also be made legal beneficiaries of their single working children and be covered by PhilHealth benefits. "Although our mandatory retirement age is at 60 years old either in the private or public sector, those PhilHealth members who are still single and have worked early and would like to provide health care benefits and services to their parents under the automatic membership should also be considered." (CGC)

Published in the Sun.Star Bacolod newspaper on March 30, 2011.

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