Sick

We have many decrepit institutions. PhilHealth is among the sickest of them.

For some reason, the health insurance service has failed to muster the great powers of digital technologies to improve its operations. It owes private hospitals billions. It disappoints clients with its tedious bureaucracy. It cannot seem to properly manage its financial affairs.

Last year, the national government commandeered what it described as PhilHealth’s “excess funds.” The 2025 budget, seriously looted by our lawmakers, saw the agency lose all of the subsidy due it.

Oral arguments were heard at the Supreme Court relating to several petitions asking that the impoundment of funds be declared unconstitutional. One Magistrate surprised everyone by producing a COA report that finds the insurance system “bankrupt.”

All the while, government and our legislators have been trying to picture the agency as swimming in funds. Apparently, those too eager to grab PhilHealth’s funds have not done the basic actuarial computations.

We have gone through a string of executive appointments to get PhilHealth to operate more efficiently. This includes the appointment, at one point, of a retired general – possibly in the hope he could whip some discipline into the agency’s operations.

All of these seemed to little avail. PhilHealth simply continued to fail even as it tried to make a show of expanding its benefit packages to members. The first BBM appointee to head the agency suddenly resigned. The Palace offered only the scarce explanation that, having spent his life in the private sector, Emmanuel Ledesma is “not used to politics.”

Apparently, managing a public agency requires a lot of political gumption. Ledesma had to deal with the highly organized in-house employees’ union.

President BBM has named Dr. Edwin Mercado as PhilHealth’s new chief executive officer. This will, hopefully, produce a better outcome for the problematic agency.

Dr. Mercado assumes the challenging post with impressive credentials. After graduating from the UP, he took advanced training at the Harvard Medical School and the University of North Carolina.

Unlike most of the previous PhilHealth leaders, Dr. Mercado is well-versed in managing health care systems. He has extensive hospital management and global health care experience. His rich insights as a hospital executive should equip him with the practical insights to oversee reforms of a sick public agency.

Mercado’s appointment is generally welcomed by the health care community. He is probably the best choice to transform PhilHealth into a more responsive, transparent and efficient institution.

This seems to be a make-or-break moment for PhilHealth. The lumbering agency must quickly cut red tape, ensure transparency and improve services-delivery. Mercado seems best equipped to transform PhilHealth into a patient-centered institution rather than an impossibly bureaucratic one.

Dr. Mercado should be cheered for accepting a job few others would touch with a long pole. He faces daunting challenges: from insiders resisting reforms to politicians ready to commandeer PhilHealth funds to feed pork barrel politics.

It is never easy to sustainably run a comprehensive national health insurance system. Without a long-term view of the agency’s finances, the agency’s actuarial horizon could shorten very quickly. A major national health emergency, such as the COVID-19 pandemic, could knock out the viability of our health insurance system.

There is so much riding on Dr. Mercado’s talents. Filipinos have come to depend on PhilHealth to provide the support during the most critical moments – support that no other institution could provide.

For the sake of struggling Filipinos, we wish him success.

Carousel

Just weeks ago, we were told that the funny, cruel and redundant Edsa bus carousel will be put up for privatization. We all imagined this system could be rescued from its abysmal state like the Manila International Airport was rescued by San Miguel Corporation.

This week, official thinking appears to have changed dramatically. We are told the carousel system will be either completely dismantled or offered an inducement for higher passenger density vehicles.

From the onset, I thought this carousel to be an anachronism. It is redundant to the commuter rail system we built at great expense. But that rail system, we know, floundered from the start. It was poorly designed and could not accommodate the passenger volume it should.

President Gloria Arroyo worked hard to “close the loop” between the MRT-3 and the LRT-1 during her time. After more than a decade, the loop has not been closed because of the corporate rivalry over control of the central station.

The carousel takes out precious road space from Edsa. In some places the grand avenue has only two lanes available for use. To compound it, some towns reserved a bike lane that no one uses. Between the reserved bus lane and the bike lane, it should not be surprising that traffic flow through Edsa is hell. It is certainly tempting for rascal politicians to sneak into the empty bus lane.

Those who oppose the scrapping of the carousel say there will be no options for pedestrians who need a ride late at night. But late at night, I never saw buses plying the carousel lane anyway.

In well-managed large cities like Tokyo, if you miss the last train your only recourse is to spend a fortune on a cab. We could use some commuter discipline or allow buses on Edsa after 10 p.m.

Any other option will be better than this funny carousel.