Maraming namamatay sa makupad na dagdag benepisyo! LEE FILES BILL AMENDING UHC LAW TO FAST-TRACK PHILHEALTH BENEFIT ENHANCEMENT

Manoy Wilbert Lee filed House Bill No. 11297 amending the Republic Act No. 11223 or the “Universal Health Care (UHC) Act” to increase the budget for administrative costs of the Philippine Healthcare Insurance Corporation (PhilHealth) so it can boost its actuary teams and other necessary personnel in implementing healthcare benefit increases.

According to Lee, the current version of the UHC Law puts greater emphasis on premium collection rather than the enhancement of benefits, thus, there is a need to strike a balance between these responsibilities to improve service delivery and provide sufficient healthcare coverage.

“Dapat busy ang PhilHealth sa pagdaragdag ng mga benepisyo at pagbabayad ng claims, hindi lang sa pagkolekta ng premium,” Lee said at the sidelines of the House Committee on Good Government and Public Accountability hearing on Wednesday.

“Lumalabas na isang dahilan ng delayed payments, delayed na pagtaas ng benepisyo ay dahil sa kakulangan sa tao at actuary teams na sumisiyasat sa mga case rates. Isipin po ninyo, kung inaabot ng anim na buwan para maaral ang isang case rate, tapos 9,000 ang case rates, talagang aabutin nang siyam-siyam ang mga dagdag benepisyo kung iisa lang ang team na gumagawa nito.”

“Mahalaga na na ma-review agad ang mga case rates para makasabay ito sa pangangailangan ng mga miyembro, lalo pa’t nagmamahal ang serbisyo dahil sa inflation. Di pwedeng makupad ang usad nito dahil hindi naman nakakapaghintay ang sakit at mababalewala ang mga pagtaas kung hindi rin lang naman ito mararamdaman ng mga Pilipino,” the solon from Bicol added.

Lee, the first to expose that PhilHealth has billions of available funds in September 2023, paved the way for the implementation of its improved benefits after over a decade of not being reviewed, making it no longer responsive to the hospitalization cost of the beneficiaries.

Among the benefit enhancements of PhilHealth that Lee successfully fought for include the 30% increase in benefits implemented last February 2024, another 50% increase this 2025, free eye check-up and free prescription glasses, free dialysis, expanded coverage for breast cancer treatment, new benefit package for kidney transplant and heart ailments, and outpatient emergency care services.

Earlier, Lee also filed his initial amendments to the UHC Law through HB No. 10995. Among the key changes included in this measure is the provision that the Health Technology Assessment (HTA) Council will review and assess the amounts of each PhilHealth benefit package and ensure that these are up-to-date.

“Napakaraming pera ng PhilHealth na dapat gamitin para sa mga serbisyong pangkalusugan. Kaya nga humantong sa zero subsidy ngayong 2025 dahil hindi nagamit ang bilyon-bilyong pondo para maipagkaloob ang mga benepisyong nararapat sa Pilipino,” Lee pointed out.

“Walang rason ang DOH at PhilHealth para maging mabagal sa pagpapatupad ng mga dagdag pang benepisyong pangkalusugan. Kung patuloy itong magiging makupad, marami pang Pilipino ang lalala ang sakit o mamamatay, dahil pipiliin na lang na maratay sa bahay o hihintayin na lang ang ‘oras’ nila, dahil mas natatakot pa sa mahal na gamot at pagpapagamot. Gamitin agad ang pondo sa kalusugan hanggang sa maabot sa lalong madaling panahon ang libreng gamot at pagpapagamot!” he added. ###