Political gimmickry or marketing genius?
August 9, 2004 | 12:00am
Is the proliferation of PhilHealth cards for the masses a populist political gimmick to win elections, or is it an example of marketing genius by a state-owned firm pioneering new services? Are the photos of politicians in those health cards justifiable? How are those health insurance funds (worth P45 billion) being managed and disbursed?
PhilHealth is the nation’s largest social security agency with 64 million Filipinos as members, which makes it bigger than both SSS and GSIS combined.
Dr. Francisco T. Duque III, president and CEO of Philippine Health Insurance Corporation (PHIC), recently sat down with Philippine STAR to shed light on certain issues.
Unknown to most people, Dr. Duque comes from a family of doctors with strong entrepreneurial traditions. His family owns two major universities – Lyceum-Northwestern University in Dagupan City, which was founded by his parents, and the University of Pangasinan, which the Duque family purchased in ‘89. Dr. Duque was also in the real estate business before entering public service. His brother Cesar Duque is also a developer of condominium projects such as the Chateau Verde in Valle Verde 1 and a former part-owner of Mindanao Development Bank.
Studying pre-med and medicine at the University of Santo Tomas, Dr. Duque completed his Master in Science in Pathology in Georgetown University in ‘87, the same university where President Gloria Macapagal Arroyo and ex-President Bill Clinton of the US studied two decades earlier.
Philippine STAR: Was President Gloria Macapagal Arroyo exaggerating when she once proclaimed that PhilHealth is the "No. 1 showcase of this administration" and "the most effective poverty alleviation program" of her government?
FRANCISCO DUQUE: No, she’s not exaggerating. PhilHealth is a great success for the GMA administration. Because of PhilHealth, 30 million indigent Filipinos are now covered by health insurance.
What’s so unique about it since we used to have Medicare under the Marcos regime and other administrations?
PhilHealth used to be Medicare, which was once headed by Dr. Pacifico Marcos during the administration of his brother, but it was a failure in the indigent program implementation.
Why did it fail?
Medicare failed to help indigents because they had no political will. They feared to enroll the poor, maybe because they thought that the funds would run out. This failure in helping indigents continued under different presidents until ‘94. In ‘95, the PhilHealth law was enacted. The massive enrollment of poor Filipinos in PhilHealth started only in 2001 under GMA’s term. Nobody among our past presidents had the political will to insure the health of the poor people before GMA came to power. It was a tragedy, because the poor have never had any form of social security protection. In 2002, we had 4.5 million indigent Filipinos enrolled in PhilHealth, but by 2003, we had eight million poor Filipinos enrolled.
When and why did you start using photos of politicians in your PhilHealth cards? Don’t you think this is done in bad taste? Were there criticisms that the project was a form of electioneering?
We started putting photos of politicians in our cards in January 2002, and we still do up to now, so it’s not as if we devised it for election purposes.
The idea of using GMA’s photo in PhilHealth cards was my personal idea. At first the President didn’t like it, but we were able to finally convince her that this project had all the makings of a worthy legacy.
GMA and the administration politicians aren’t the only ones you’ll see in PhilHealth cards. We also have opposition politicians like Senator Loren Legarda, Makati Mayor Jojo Binay, Imee Marcos, Bongbong Marcos, even Senator Ping Lacson’s spokesperson Gilbert Remulla, and Cavite Governor Atong Malixi. PhilHealth is a non-partisan program, contrary to some misconceptions.
Where did all these politicians source the money to pay for your PhilHealth cards for the poor?
We have about 100 congressmen who used their Priority Development Assistance Fund or pork barrel to buy PhilHealth cards for the poor. As much as 93 percent of the local government units (LGUs) nationwide also support this program. This is a win-win situation. PhilHealth cards benefit so many poor Filipinos previously not protected by any form of health insurance. This is a big help to the poor. Do you know that we at PhilHealth pay up to P21,000 for a caesarian delivery, and up to P16,000 per eye for the operation of cataract patients? PhilHealth is not only for the poor. There are now a total of 64 million Filipinos who are members of PhilHealth, equivalent to 77 percent of our total population of 82 million Filipinos.
What do you think is the real number of poor Filipinos in the country today? Isn’t it larger than official government statistics, maybe as much as 70 percent of the population?
There are about 32 million poor people in our society. Maybe you will consider this a conservative estimate. Some say this figure is only 37 percent only of our total population. I personally think this is accurate. We at PhilHealth realized that disease is a poverty converter – meaning, it’s a vicious cycle. The poorer you are, the easier it is to get sick; and the sicker you are, the poorer you become. If we don’t break this vicious cycle of disease and poverty, the cycle will go on and on. We at PhilHealth hope to provide every Filipino, whether rich or poor or middle-class, with universal health insurance coverage. The success of PhilHealth is one of the truly outstanding and enduring legacies of GMA. It is unprecedented.
US President Bill Clinton considers his unsuccessful attempts to reform health care as his biggest mistake. Why did he fail?
Clinton failed because he didn’t get the support of the stakeholders like doctors, hospitals, institutions and professional health care providers. He also didn’t get the political support of the Republican-controlled Congress.
How much is your yearly budget in PhilHealth? How many employees? With our politicians’ tendency for overspending and wastage, would there still be enough government funds to sustain your PhilHealth program in the long-term?
That is a valid question. We had benefit payouts of P11 billion last year. We pay 1,600 accredited government and private hospitals through reimbursements of the medical costs of members. PhilHealth has internally-generated funds. Our funds come from contributions from the private business sector, the government sector and from those who are self-employed. We hope that all employers – whether the private sector or government – should continue to remit their proper contributions to the health insurance system. If employers fail to sustain their contributions, then we might encounter some problems. We’re studying how to have a mechanism for the poor to somehow pay part of the premiums for PhilHealth, so that this program will not all be just dole-outs.
If the Republic of the Philippines is a medical patient, what are the top three diseases and what cures do you recommend?
The country’s three major diseases are the economy, dysfunctional literacy and lack of patriotism. For the economy, we have to increase agricultural productivity, attract more investors and accelerate growth of the tourism industry. For dysfunctional literacy problem, we should give more educational opportunities to the poor such as increasing the classrooms/teachers-to-student ratio. We should build more schools and continue to improve English language education. I think we’re moving in the right direction with English under GMA.
On lack of patriotism, we should end this disunity of the nation. The sense of pessimism or self-flagellation is so pervasive. Why are we so negative? Why don’t we highlight instead the success stories in our country? Look at certain segments of the mass media that focus on massacres, headless corpses news on primetime TV, plus other very adversarial, conflicted, contracted and negative news?
How do you describe the management style or leadership of GMA?
She’s very hands-on, very strategic, very conscientious, dedicated, focused and legacy-oriented.
Foreign investors and our business community are curious as to how different GMA will be in the next six years compared to her past three years in power?
GMA is going to be more impatient about results. She’d be more certain about her decisions and positions. She was merely very consultative in the past three years. GMA’s fresh election mandate would augur well for the economy and a brighter future for the country. Her sincere and doable reforms are more certain now, because she has a mandate. GMA will do the right things and deliver over and over again.
As a doctor and the national czar for health insurance, how do you view GMA’s family-planning program to alleviate massive poverty and health problems?
It is really difficult, there seems to be a dichotomy for GMA the economist and the devout Catholic, and it’s hard for me to answer for her. I think it’s really because of her religious background.
She has a strong bias for natural family planning. Personally, I think family planning should be the informed method. All methods should be made available by government. This is just my personal view. Even contraceptives and artificial family planning methods should be made available to all. Let’s do it now. Not in 30 years or 50 years. It’s the wrong attitude to waste time. There has to be a sense of urgency. I believe difficult times call for heroic actions, and heroic actions are founded on a sense of urgency to make good things happen. My late father told me public service is the most important thing. He said you live here on earth for others, so that their lives would change for the better. That’s his lifelong motto that inspires me every day.
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