SENATOR SLAMS PHILHEALTH’S 18% COVERAGE TARGET

SENATOR Pia Cayetano strongly criticized the Philippine Health Insurance Corporation (PhilHealth) for its plan to cover only 18% of hospital costs by 2025.

The female senator labeled the target as a “joke” that undermines the principles of the Universal Health Care (UHC) Law, which aims to provide health coverage to all Filipinos through PhilHealth.

During recent Supreme Court oral arguments on the transfer of PhilHealth’s excess funds to the national treasury, Associate Justice Jhosep Lopez pressed PhilHealth Senior Vice President Renato Limsiaco, Jr. on their coverage goals.

In response, Limsiaco stated the agency’s goal to cover 18% of hospitalization costs by 2025, with an aim to increase this to 28% by 2028.

Responding to this news, Cayetano expressed her disbelief and concern over the dismal figures, questioning how such limited coverage could aid Filipino families, particularly those in lower-income brackets.

Notably, from 2014 to 2024, PhilHealth received over P534 billion in sin tax revenues, raising further questions about how the agency can justify covering only 18% of patients’ hospital costs.

“How do you expect the poor, even the middle class, to afford healthcare when PhilHealth only plans to cover 18%?” she questioned.

“People are already struggling to make ends meet. What more when they face unexpected illness,?” Cayetano said.

The senator cited specific examples to illustrate the impact of PhilHealth’s proposed coverage.

“Mismong si Justice Lopez, ginawa niyang halimbawa ang sarili niya. Sa sakit niya, inabot siya ng P7 million. Ang sinalo lang ni PhilHealth ay nasa 2 percent,” she shared in an interview with Cebu media.

“Another example. May nanay na pumunta sa opisina namin at humingi ng tulong dahil ang baby niyang three months old ay nagkasakit ng pneumonia, nasa ospital. Ang bill nila ay P1 million. Alam niyo kung magkano ang tinulong ng PhilHealth? P25,000. Even assuming na hindi inabot ng P1 million ang bill, kung P100,000 lang. Saan kukuha si nanay ng P75,000?” she further cited.

“We can have a thousand hearings, but if PhilHealth doesn’t have the common sense to understand that we must aim for the least out-of-pocket expense for patients, then all these discussions are useless,” said the senator, who chaired the Senate Committee on Health for nine years and has been handling the health budget for the past five years.

Cayetano called on PhilHealth to reassess its coverage targets and align them more closely with the objectives of the UHC Law, ensuring that all Filipinos, regardless of economic status, can access the healthcare services they need without undue financial burden.