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Tuesday, March 08, 2005
Philhealth plugs holes in program
By Ryan D. Rosauro
TUBOD, Lanao del Norte -- A top regional official of government-owned Philippine Health Insurance Corp. (Philhealth) assured that adequate measures are being adopted to plug the holes bugging its controversial program for indigents.
This developed as Lanao del Norte province inked an agreement with Philhealth for the membership of indigent families, while Misamis Occidental province announced it is renewing its premium sponsorship of a host of indigent households.
Walter Bacareza, Philhealth assistant regional manager in Northern Mindanao, said the measures principally involve strengthening the "filter mechanism" for determining the actual families who qualify for enrolment as Philhealth members under the indigents program.
Bacareza admitted that currently, from 5 to 10 percent of members listed as indigents are actually "political indigents."
With the assistance of local social welfare offices, Philhealth now conducts asset and income-based surveys as a way of finding out families' real socio-economic status before they get to enroll as indigent members, he said.
The program, known as Plan 525, aims to enroll into Philhealth membership through financial sponsorship some five million indigent household heads, which translates into 25 million individuals covered with health insurance.
In the run-up to the 2004 general elections, the Philhealth premiums of indigents were paid mostly with funds from the Philippine Charity Sweepstakes Office (PCSO) channeled through the Presidential Social Fund.
Key factor
This has been criticized as the administration's vehicle for political patronage at the expense of government resources that could have been used on more vital programs.
Acknowledging the program's potential for gaining political mileage, Bacareza however clarified that it was not conceived for such purpose.
He said the program has been in the drawing board in 2000, prior to the ouster of then president Joseph Estrada, with the World Bank and US Agency for International Development involved in the discussions.
He explained that with the projected inflow of resources into health delivery services through the program, it would be a key factor to financially pump-prime the country's health sector and help rollout the health sector reform agenda.
"We are actually calling it the health revolution," Bacareza enthused, referring to the expected radical change in the picture of access to health services by the poorest families once they become Philhealth members.
Because PCSO can no longer subsidize the premiums of the indigents, Philhealth today has shifted to arranging with provincial governments for the sponsorship of the indigents' premiums, said Cassan Marahombsar, a regional Philhealth official.
Recently, it entered into a memorandum of agreement with the provincial government of Lanao del Norte for a premium sponsorship in order to renew the membership of some 51,000 indigent families.
Good news
According to Bacareza, the agreement, which is the first throughout the country, would cost the provincial government some six million pesos in annual premium payments.
In return, it would have disposal over a capitation fund worth 15 million pesos that can be used to improve the rural health units in the province.
Based on Philhealth's study, the local hospitals, both private and government-owned, would also be expected to rake in about 45 million pesos in annual claims for services rendered to indigent Philhealth members and their families.
"This is good news for our provincial and six district hospitals where most of indigent families seek medical attention," said Governor Imelda Quibranza-Dimaporo.
Marahombsar said they are targeting provincial government units as sponsoring partners in order to optimize the plow-back of health insurance returns into their respective localities through maximum use of the capitation fund like the improvement of a district hospital that cannot be availed of by a town unit.
Bacareza urged other provinces to follow the example set by Lanao del Norte.
At the sidelines of the 67th meeting of the Regional Development Council, Governor Loreto Leo Ocampos said the provincial government of Misamis Occidental is also set to renew the membership of indigent families.
(March 8, 2005 issue)
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