By: Ferdinand M. Brizo || Healthcare remains one of the most pressing concerns for every Filipino, especially in moments of urgent need. If this challenge is evident in Metro Manila, it becomes even more pronounced in far-flung areas like Catanduanes. The recent controversies surrounding PhilHealth have placed healthcare at the forefront of national discussions. These issues should serve as a wake-up call for government agencies tasked with managing and improving our healthcare system, particularly the Department of Health (DOH).
PhilHealth, as a concept, holds great potential, but its implementation leaves much to be desired. The shift to a case-rate system, where fixed amounts are paid directly to hospitals rather than reimbursed to patients for actual expenses, has its drawbacks. While this strategy aims to streamline healthcare delivery, it inadvertently makes hospitals the direct beneficiaries of PhilHealth’s packages, leaving patients at a disadvantage. The responsibility for service failures is often shifted to hospitals, creating a gap in accountability.
The case-rate system was intended to foster partnerships between PhilHealth and healthcare providers to ensure efficient service delivery. However, this vision has not fully materialized. Even with increased package rates for illnesses, some hospitals exploit the system for financial gain. This highlights the need for a thorough review and restructuring of the scheme to protect the interests of patients and ensure that healthcare providers deliver the quality care they promise.
A broader perspective can be gleaned from other nations. A conversation with a friend who recently returned from England shed light on a vastly different healthcare system. In England, healthcare is entirely free for all citizens, regardless of the illness—whether it’s cancer or any other condition. Not only do patients incur no expenses, but the government even compensates individuals who take care of their loved ones. This comprehensive system starkly contrasts with the piecemeal approach seen in the Philippines.
When asked about the secret behind England’s ability to sustain such a system, the answer was simple yet profound: the absence of corruption. In England, a significant portion of taxes—20% of individuals’ income—is allocated directly to public services, ensuring efficient delivery of healthcare. Accusations of corruption are taken seriously, often leading to immediate resignations, reflecting a culture of accountability and integrity.
This stands in stark contrast to the Philippines, where corruption cases often drag on for years, sometimes until a Supreme Court decision is reached. In England, political candidates are even required to post a bond, which they forfeit if found guilty of corruption. Such measures promote transparency and discourage malfeasance, ensuring that public funds truly serve the people.
Adopting lessons from such systems could pave the way for a more effective healthcare model in the Philippines. If PhilHealth’s mandate were expanded to cover all aspects of healthcare, including direct hospitalization costs, the accountability would lie with one agency, simplifying oversight. This would require PhilHealth to move beyond its current contract or case-rate system to a more inclusive and patient-focused approach.
To achieve this, the Department of Health must strengthen its supervision over PhilHealth and harmonize its functions to address the present needs of Filipinos. By reimagining and restructuring the healthcare system, the government can provide accessible, efficient, and corruption-free services that truly prioritize the well-being of every citizen. It is time for a unified approach to healthcare—one that leaves no Filipino behind.
