Controversy brews over PhilHealth premiums
by Susan Ople
First posted in Arabnews.com
Appeals from various overseas Filipino community groups for the Philippine Health Insurance Corporation (PhilHealth) to reconsider its premium adjustments will likely fall on deaf ears now that the Office of the President has publicly declared support for the new rates.
Communications Secretary Herminio Coloma said in his weekly media briefing aired over state-run Radyo ng Bayan that the Palace has no intention to stop the increases, citing the need to sustain the government’s social protection program.
Effective Jan. 1, 2014, the monthly PhilHealth contributions of members with the lowest salaries was doubled to 200 pesos, with the additional 100 pesos contribution to be shouldered equally by the worker and his or her employer. In the case of overseas Filipino workers, this adjustment translates into a 2,400 pesos annual contribution compared to last year’s 1,200 pesos annual rate.
PhilHealth Circular No. 0025 s. 2013 issued in October 2013 provides for two payment options for OFWs set to leave this year:
1. Pay the 2,400 pesos annual contributions in one sweep at all PhilHealth accredited collection agencies including the Philippine Overseas Employment Administration and accredited recruitment agencies; or,
2. Pay 1,600 pesos valid for six months premium with an understanding that the contributions for the succeeding six months will be settled within six months after the expiration of the initial coverage in order for the OFW to enjoy full benefits of the program.
As all OFWs know, one cannot obtain an Overseas Employment Certificate (OEC) from the Philippine Overseas Employment Administration unless contributions to OWWA, Pag-Ibig, and PhilHealth are updated. Combining these three membership-based contributions means that every departing OFW would have to pay at least 4,416.25 pesos in membership dues to get their OEC. This amount is not insignificant considering that the OFWs usually end up paying all these premiums and membership dues with no foreign employer sharing the burden.
According to the PhilHealth circular, the said premium adjustment would enable OFWs and their beneficiaries to be entitled to out-patient care services provided under its Primary Care Benefit, and in-patient hospital care including all case rate packages and catastrophic illnesses under the Z-benefit package and other special benefit packages.
This is all well and good but who would explain such packages and facilitate OFWs’ needs and queries when PhilHealth has yet to invest in overseas personnel to help its members? Certainly, given the doubling of premiums across the board, this government corporation can afford to set up offices overseas or at least tap overseas health professionals to represent them in key posts abroad? In essence, an OFW contributes more to PhilHealth than it does to OWWA, its own welfare institution, and yet OWWA has a presence in a majority of labor-destination countries. An OWWA two-year membership is pegged at $25 (around 1,116.25 pesos in today’s exchange rate) compared to PhilHealth’s annual premium of 2,400 pesos.
Based on the PhilHealth circular announcing the new premium rates for OFWs, the corporation noted that benefit payments to OFW members and their beneficiaries for confinements abroad and in local hospitals in fiscal year 2013 has reached 130.53 percent over premiums collected.
“It is imperative and of primordial importance therefore, that PhilHealth implements the adjusted rates across all membership categories — Employed, Individually Paying, Indigent Program, and Overseas Workers’ Program (OWP) — with 2,400 pesos as the lowest premium rate in order to ensure financial sustainability and viability.”
Certainly, no OFW wants to see an indigent PhilHealth member be deprived of basic health services. But is it fair that an OFW is being tasked by law to help make these institutions viable after making the supreme and difficult sacrifice of leaving to work abroad?
OFW groups will continue to protest the increase, but the law needs to be changed for these adjustments to be nullified.