Funding uncertainty hinders universal healthcare expansion — expert

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February 5, 2025 | 8:25am

MANILA, Philippines — A healthcare expert has warned that the lack of stable and predictable financing continues to hinder the full realization of universal healthcare (UHC) in the Philippines, despite existing legal and financial mechanisms.

During oral arguments on petitions concerning the transfer of unused Philippine Health Insurance Corp. (PhilHealth) funds, Dr. Beverly Ho explained the challenges in achieving universal healthcare in the country.

She said that UHC’s goal of ensuring Filipinos are not denied healthcare due to financial constraints remains elusive, as healthcare funding remains uncertain and dependent on annual budget allocations.

“When health or benefit coverage is uncertain, the patients may be left to fend for themselves, depending on what disease they have,” Ho said, speaking as an “amicus curiae” before the Supreme Court on Tuesday, February 4. 

“When a payer or insurer’s funding source is uncertain, for example, if annually decided or appropriated, it will likely earth towards conservatism in expanding benefits,” she added.

According to Ho, the state insurance agency has made progress over the past 25 years in providing “incremental” and “piecemeal” healthcare to Filipinos.

For instance, PhilHealth currently covers only an average of 40% of total hospital bills for inpatient care.

She cited an example where, out of the agency’s 9,000 case rate packages, only 17 have been upgraded to the more comprehensive “Z benefits,” which provide full coverage from diagnosis to treatment.

“You can say that these are the most generously covered, but for the rest of the case rate packages, you expect a lot of out-of-pocket payments from the patient,” she said.

PhilHealth’s Z Benefits package helps patients with cancer and other severe illnesses.

Following the enactment of the UHC Act, PhilHealth saw significant increases in premium collections, which initially led to an expansion of benefits starting in 2023 and continuing into early 2025.

However, Ho warned that without sustained financial commitment, these gains may be short-lived.

“If we are to make this dream a reality, PhilHealth should maximize this cushion that’s being provided to them to even rapidly increase their benefits,” Ho said. 

“Just as we are determined to expand benefits, we know from experience that this cannot happen overnight without allocating resources and strengthening PhilHealth’s ability to nurture technical experts and brain trusts within the sector to systematically enhance and regularly update the rates,” she added.

Ho is one of the amici curiae during the oral arguments on the petition. She is joined by IBON Foundation Executive Director Sonny Africa and Zy-za Suzara, executive director of the Institute for Leadership, Empowerment and Democracy.

An amicus curiae is an individual or organization invited by the Supreme Court that is not a party to a case but is permitted to assist the court by providing information, expertise, or insight relevant to the issues at hand.

The petitions

The petitions before the Supreme Court are consolidated pleas challenging the constitutionality of the transfer of P89.9 billion in PhilHealth reserve funds to the national treasury.

Among the key issues raised are whether the transfer—executed through a Department of Finance circular—is constitutional and whether Congress can increase the amount of unprogrammed appropriations beyond what was initially proposed by the president in the National Expenditure Program.

During Tuesday’s oral arguments, petitioners, petitioners-in-intervention and respondents presented their opening arguments. The session concluded with the interpellation of Associate Justice Amy Lazaro-Javier.

The Supreme Court will resume oral arguments on February 25 at 2 p.m.

On Oct. 29, 2024, the Supreme Court issued a temporary restraining order blocking the transfer of the remaining P29.9 billion in unused PhilHealth funds to the national treasury.

The first tranche of unused funds, amounting to P20 billion, was transferred on May 10, 2024, followed by the second tranche of P10 billion on Aug. 21, 2024.

The third tranche, totaling P30 billion, was transferred on October 16 last year.


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