Negros Occidental provincial officials and mayors yesterday agreed to stay with PhiHealth this year after it president offered an easier payment scheme for the premiums of their indigent beneficiaries, Gov Alfredo Marañon Jr. said.
Dr. Eduardo Banzon, PhilHealth president and chief executive officer, met with Marañon and Negros Occidental congressmen, board members and mayors at Nature’s Village Resort in Talisay City yesterday.
Marañon had earlier said that the 31 mayors of the province had agreed to withdraw payment of premiums for their 148,081 indigent enrollees with PhilHealth, and instead pay the amount directly to the Negros Occidental Comprehensive Health Care Programthat will be their health insurance provider instead.
On Wednesday the Negros Occidental Sanggunian also passed a resolution requesting a PhilHealth moratorium on the increase in premium contributions.
This came after it was learned that LGU premium payments to PhilHealth for indigent beneficiaries would increase from P600 to P1,200 this year, which local officials said they could not afford with the expected cut in Internal Revenue Allotment shares of towns and cities.
The premiums to be paid by the local governments will increase to P1,200 because the national government counterpart of P600 had been removed by Congress, Banzon said.
Banzon offered to enter into a memorandum of agreement with the LGUs wherein they register their indigent beneficiaries for two-year coverage, by paying only P600 now and the remaining P1,800 at the end 2013, Marañon said.
The governor said the payment scheme was acceptable to them so they agreed to stay with PhilHealth, since it also promised to provide more benefits to its members.
The PhilHealth data presented yesterday showed that the Negros Occidental provincial government and its towns and cities paid P60.8 million in premiums to PhilHealth for its 146,261 beneficiaries in 2011.
PhilHealth in turn paid P154.1 million in health care claims of the 146,261 beneficiaries, and capitation funds of P38.6 million to Negros Occidental for a total of P192.8 million, its report showed.
That means Negros Occidental LGUs made a profit of P132 million in claims of their beneficiaries and capitation funds paid by PhilHealth in 2011, the report added.
Banzon, who outlined the gains of Negros Occidental would have if its stays with PhilHealth at the dialog, appealed to the local officials to reconsider their plan to withdraw from it.
“It would be unfortunate if you pursue your decision,” he said, as he cautioned them that running an “LGU health insurance scheme on your own is a difficult task.”
Banzon said that before he joined PhilHealth he worked for the World Bank, the academe, and was a researcher “and I tell you, globally, the experience of locally-run health insurance schemes is that they are hard to sustain.”
“You just don’t have the numbers to sustain it – your administrative cost will really be bad…I’m not just saying that just to dissuade you (from withdrawing) but…it may be a decision that you will regret,” he said.
He appealed to the Negros officials to reassess what would be best for everybody.
PhilHealth is in the process of rolling out more benefits, including out patient-primary care, he said.
We expect to nearly double our benefit payments this year, Banzon added.
While the membership of the 146,261 Negros Occidental PhilHealth members expired on December 30, he will ask his board for authority for their health care coverage to be extended for another three months to give the LGUs enough time to enter into MOAs with them, on the new payment scheme, Banzon said.
Banzon said the indigent members covered by PhilHealth were identified under the National Household Targeting System for Poverty Reduction of the Department of Social Welfare and Development.
Rep. Alfredo Marañon III, House chairman of the Committee on Health, said they are currently deliberating on a bill on universal health care.
He said it is high time premiums are increased so PhilHealth can also increase and improve its services.
Rep. Mercedes Alvarez (Neg. Occ., 6th District) and Rep. Alfredo Abelaro Benitez (Neg. Occ., 3rd District) said a congressional inquiry on the increase in PhilHealth premiums may be needed.
Benitez said the payment scheme offered by PhilHealth yesterday would only delay the inevitable, Congress may need to revisit the budget for an allocation to assist LGUs in the payment of premiums.
The concern of the LGUs is the affordability of the premiums, he said.
Alvarez said she will also see how Congress can assist the LGUs.
She said if premiums become too expensive for LGUs it could defeat the aim of covering more beneficiaries under the universal health care targets.*CPG