Gamble away

In a 2022 interview, I was asked an existential question. On Judgment Day, what would I tell my Creator as my most significant contribution to the nation? My quick response was the Universal Health Care (UHC) Act of 2019.

Its enactment occurred at a time when six out of 10 Filipinos died without ever seeing a doctor due to extreme poverty. The high incidence of death from poverty is simply outrageous for a country on its way towards upper middle-income status. If I could somehow help reverse the grim statistic through legislation, I could say that my earthly mission is done.

But I must have spoken too soon. The administration appears to be undermining the funding for UHC’s implementation. A few columns ago, I discussed that the PhilHealth (Philippine Health Insurance Corporation) Board approved the remittance of about P90 billion in surplus funds to the Bureau of Treasury (BTr) in four tranches. I pointed out that the fund transfer between PhilHealth and BTr is illegal under Section 11 of Republic Act 11223.

Apparently, in the eyes of the Marcos administration, there is a higher and “more noble cause” than saving and protecting the lives of Filipino families, particularly those from the lower-income brackets. I received information that the government will invest the revenues and income of PhilHealth and other government-owned and controlled corporations (GOCCs) in the Maharlika Investment Fund. The budget department said the sovereign wealth fund will be invested in foreign currencies, fixed-income instruments, domestic and foreign corporate bonds, commercial real estate and infrastructure projects, among others.

I am quite disturbed by the news. Why does the government want to gamble away the limited resources for the medical and health needs of every Filipino?

Health care

As my pet bill, I want the UHC to be fully realized soon. For the first time, the Philippine government under the Duterte presidency took a concrete step towards institutionalizing an effective health care system that would improve public health and progressively eliminate the financial consequences of medical care for the citizenry. It is the State’s fulfillment of its “right to health” obligation to the Filipinos.

In pushing for the law, I urged the government to pour all its resources into stopping poverty from killing more Filipinos. As such, we shall finally receive the treatment we need with the financial assistance we deserve. We shall experience and reap the benefits of free consultation, medication and hospitalization, which our counterparts in Europe and some Asian nations have enjoyed for many decades.

Coinciding with the UHC passage was a World Health Organization and United Nations Development Program (UNDP) report, which found that non-communicable diseases (NCDs) cause 68 percent of deaths in the country. At least 29 percent of the population between the ages of 30 and 70 years might die of cancer, diabetes, cardiovascular diseases or chronic respiratory illnesses should these NCDs remain uncontrolled. In 2019, the economic cost of NCDs to our country was pegged at P756.5 billion per year, equivalent to 4.8 percent of our annual gross domestic product.

Referencing the UN study and Department of Health data, the government through PhilHealth has prioritized medical services for patients with hypertension, diabetes, heart ailment and tuberculosis. Given its progressive realization, the UHC cannot cover all diseases and medical cases. Sufficient funds, however, will enable the UHC to provide free treatment/medication to all Filipinos.

Apart from advocating for the UHC, I also called for the abolition of the anomaly-ridden PhilHealth when I was still in Congress (and even when I transferred to the Executive department). I batted for a corrupt-free National Health Service, patterned after the agency in the United Kingdom, to implement our own UHC. In a congressional inquiry, my colleagues and I were horrified by the systemic corruption in the state-run agency.

Investment fund

Unfortunately, my proposed measure was stymied by the counterpart bill filed by then-senator Ralph Recto. The Batangas solon was against abolishing PhilHealth.

Ironically, the former senator is now head of the Department of Finance, an agency that has taken away unused funds from the state-run agency. The first tranche of P20 billion was already transferred to BTr on May 10. It is supposed to finance the “nobler causes” of the Marcos administration.

However, RA 11223 stringently prohibits the transfer of any portion of its reserved fund or income to the national government, other agencies or instrumentalities like GOCCs (Section 11). In the Implementing Rules and Regulations on Program Reserve Funds, PhilHealth is mandated to set aside a portion of its accumulated revenues not needed to meet the cost of the current year’s expenditure as reserve funds (Section 11.1).

Under Section 11.3, it is clearly stipulated: “Whenever actual reserves exceed the required ceiling at the end of the fiscal year, the excess of the PhilHealth reserve fund shall be used to increase the Program’s benefits and to decrease the amount of members’ contributions.”

So, why is the agency doing exactly the opposite? Is it not another blatant transgression of the law? Every Filipino, especially the impoverished, disadvantaged and marginalized, are banking on the agency to expand the medical services and lower the premium contributions of members.

So, what has gotten into the heads of this administration? The PhilHealth is not a fund-raising or a revenue-generating institution.

Not content on dipping their hands in the Land Bank of the Philippines, which finances small farmers and fishers; the Development Bank of the Philippines, which supports small and medium-scale entrepreneurs and the Government Service Insurance System and Social Security System, which provide social benefits to pensioners, the Marcos government still wants to deprive PhilHealth members of much-needed health benefits.

All for a sovereign wealth fund that has no foreign investors so far. Desperate? Shameless? Unconscionable? Or all of the above?