‘PhilHealth cash pile sufficient sans increase in contributions’


ALLAYING concerns of the public, Philippine Health Insurance Corp. (PhilHealth) officials said the state-run insurer has sufficient cash pile to enhance existing packages and even roll out new ones sans the increase of its premium contribution this year.

The officials even went on to say that PhilHealth will survive even if the suspension on the increase of premium contribution  and income ceiling would be implemented until next year given the “robust” cash position of the agency.

PhilHealth Acting President and CEO Emmanuel R. Ledesma Jr. touted the current cash position of the agency and its “unprecedented” net income last year, which he estimated could have closed at P50 billion.

“We have an unprecedented cash position. It is close to P400 billion,” Ledesma said during a news conference last Wednesday. “And our net income [last year] was nearly P50 billion already, which is also unprecedented.”

He said he wants to “assure [the public] that the benefits will not just continue but they will even improve this year.”

“They will not be affected but they will even be better,” the PhilHealth chief added.

Ledesma also disclosed the government-owned and controlled corporation has estimated that the suspension of the premium contribution and income ceiling would mean an opportunity loss of about P17 billion.

More than enough

PHILHEALTH officials emphasized that the agency’s current budget this year is more than enough to offset the estimated opportunity loss.

PhilHealth Senior Vice President for Fund Management Renato L. Limsiaco Jr. explained that the agency has P221 billion in operating budget, of which P204 billion would go to benefit payments while the P17 billion is allocated for the konsulta package program.

Limsiaco said the benefit-payments budget is higher than the P140 billion “usual budget” for the said expenses of the agency.

The PhilHealth’s total fund also includes the P21 billion remitted by the Philippine Amusement and Gaming Corp. and the Philippine Charity Sweepstakes Office to the agency as mandated by the Universal Healthcare (UHC) Act.

PhilHealth officials pointed out that the P21 billion remittance is already more than enough to offset the losses from the suspension of the implementation of the provision of Republic Act (RA) 11223 (UHC Act) mandating the increase in premium contribution.

An Isla Lipana & Co. article explained that under the law, PhilHealth contributions are to increase yearly, starting in 2020, when they were due to rise 3 percent, followed by 3.5 percent in 2021, 4 percent in 2022, 4.5 percent in 2023, until the increases hit 5 percent in the years 2024 to 2025.

Limsiaco also disclosed that they project that PhilHealth’s net income this year would settle at P25 billion, already taking into account the P17-billion opportunity loss. He noted that they earlier estimated a net income of P42 billion. That was before President Ferdinand R. Marcos Jr. ordered the suspension on the hike in premium contributions.

“We have very strong income and very, very healthy and robust cash flow,” Ledesma said.

Two new packages

AS of end-September 2022, PhilHealth’s net income already reached P46 billion, 721 percent higher than the P5.609 billion it posted in the same period of 2021.

The latest financial statement of PhilHealth showed that the increase in net income was due to higher premium contributions last year and lower benefit claims expenses.

Despite the suspension of its premium contribution hike and income ceiling, PhilHealth officials said they will push through with the roll-out of at least two new packages this year: the out-patient therapeutic care for severe acute malnutrition and out-patient mental health benefit.

For one, PhilHealth will be expanding its hemodialysis package to a total of 156 sessions, allowing beneficiaries to take the maximum recommended sessions per week all year round.

PhilHealth officials also disclosed that the state-run agency is rationalizing select in-patient case rates such as those for moderate and high risk pneumonia and acute stroke (both ischemic and hemorrhagic). PhilHealth will also enhance its Z benefit packages that involve orthopedic implants, kidney transplantation, breast, cervical and prostate cancers, among others.

PhilHealth is also rationalizing its Covid-19 benefit packages in accordance with the updated pandemic protocols, which could result in a lower or higher amount of benefit under the packages.

Nonetheless, the officials assured the public that they will have the “interest of the Filipino people at heart” in rationalizing PhilHealth’s benefit packages.