On the corruption allegations against PhilHealth

I get our anger and frustration over the issue. But the claims forms (CF1, CF2, CF3, CF4) are not there to make it “easier” for PhilHealth to pursue corrupt practices. Actually, the forms are there to safeguard the interests of PhilHealth members by allowing the hospital to declare that the standards of care have been met. These forms are used so that hospitals can be reimbursed for the services they rendered to their patients.

I believe some PhilHealth employees are demoralized because of this issue. If the allegations are true, please spare other hardworking, honest employees who have given more than enough to improve health financing in the country.

Let us focus our frustration and disappointment on high ranking officials who swore to protect the interests of the people. PhilHealth, for the longest time, has not kept its promise of adequate financial risk protection. We still see patients who continuously suffer from huge out-of-pocket expenses that sometimes lead them to financial catastrophe.

This issue will have a great impact on our transition to DRG-based global budget payments. Ultimately, policy decisions made after this fiasco will determine how we will run the health financing system that will drive the universal health care we’ve always dreamed of.

We have the right to be angry, frustrated or disappointed. We have the right to demand for a better management. We have the right to demand accountability from those guilty of graft and corruption. And, yes, we have the right to a better health system that will ensure financial risk protection and achieve better health outcomes for all Filipinos.

Pen Point 51

The deluge of health information poses a great challenge to patients, especially if the information cannot be critically analyzed and synthesized. Therefore, it is incumbent for health care providers to examine and integrate into a coherent whole all the pieces of evidence coming from disparate sources, and help patients make sense of the rapidly changing health care landscape.

Pen Point 50

Evidence-informed policies sound sensible, right? But why does it not often happen, especially in the Philippines? While the use of evidence in decision-making seems logical, policy-making (sadly) often isn’t rational. It’s almost always political.

Pen Point 49

Various provider payment mechanisms will continue to exist in the country’s health care system. Emphasis is placed, however, on the current movement towards using performance-driven, prospective payments (e.g. Global Budget Payment) based on diagnosis-related groups (DRG). The shift to DRG-based GBP will not be easy. Mechanisms should be in place to avoid underprovision and ensure quality health care.

At the end of it all, “mixing” of provider payment mechanisms can be complementary or compensatory. It is promising how incentives will come into play when these mechanisms align themselves during the implementation of the UHC law.

Happy to know that PHIC is now working on this with various agencies. Very few hands on deck though.

Pen Point 48

Good news if we’ve truly flattened the curve. But have we improved our health system’s surge capacity? Some hospitals lack manpower and PPE. Ending the ECQ may mean well for the economy. However, without health systems strengthening and evidence-based measures to control community transmission, we’ll continue to strain our overburdened health care system.

Pen Point 47

Duterte & his allies have mastered the art of deception and selective justice. Deception of people for the sake of the people is a contradiction in democracy. Indeed, politics is a dirty game. Remember that there are no permanent friends, or enemies, only permanent (sometimes selfish) interests.

Inaction is action. Our government is responsible both for the things they do and the things they don’t do, especially when they could choose otherwise. Not until the majority of us choose to side with true democracy, we will continue to fail as a society.

Haven’t you had enough?

Pen Point 46

Clearly, we now see the need to invest more in our health system to improve its capacity to address the growing needs of the Filipino people. After this pandemic, let us urge our lawmakers to push for more funding, innovation, and research.

Pen Point 45

Why do we keep treating people for illness, only to send them back to the conditions that created the illness in the first place?

It is a bit frustrating to give your all just so they can be wasted in the end. Clearly, the current system is inefficient and cure-centric. How do we cure a sick health system?

Pen Point 44

We don’t usually depend on what others say about us or how they see us because we need to own our truth. But, up to which point do we continuously neglect the truth, as perceived by others? They, too, are mirrors to our truth.