Dr. Eduardo Banzon, newly appointed president and chief executive officer of the Philippine Health Insurance Corp., yesterday said his marching orders from President Benigno Aquino III is to move toward universal health care where all Filipinos are covered by PhilHealth, and enjoy better benefits.

Banzon, a graduate of St. John’s Institute in Bacolod City, was Senior Health Specialist of the World Bank, providing assistance to the Philippines and other East Asian countries on health financing, health service delivery, and health regulations prior to rejoining PhilHealth.

Banzon, who was in Bacolod for a PhilHealth board meeting presided over by Health Secretary Enrique Ona, was joined at a press conference by Bacolod Rep. Anthony Golez.

The desire  for all Filipinos to have  access to quality health care has been an objective of previous administrations, he said, but “the difference now is that for the first  time we actually  have a president who makes health as an agenda and a congress that supports it.”

Estimates are that about 70 to 80 percent of Filipinos are covered by PhilHealth, Banzon said, but he added that he does not want to accept those figures. Hopefully by February PhilHealth will be able to give a report of an actual headcount of the number of Filipinos it covers, he said.

To sustain universal health care and improve coverage and treatment there is a need to invest more money, Banzon also said.

That means a hike in the government budget for health care and an eventual increase in premiums, he said.

In turn we will improve the benefits of PhilHealth members, in fact a whole range of benefits are expected to be rolled out starting January 1, he said.

PhilHealth will enhance both inpatient and outpatient benefits, he said.

Banzon said among the recent polices implemented by PhilHealth is the case rate as its new payment scheme to members.

Under the new payment scheme, a “no balance billing” policy will benefit PhilHealth sponsored program members and their dependents hospitalized in public hospitals, he said.

CASE RATES

Sponsored Program members include those whose enrolment into PhilHealth was made possible by either the local government units, or corporate or individual sponsors, he said. Also included are families listed under the National Household Targetting System for Poverty Reduction of the Department of Social Welfare and Development.

In private hospitals, the case rates will enable members to know how much is available to them for the ailment they are hospitalized for, he said.

The new PhilHealth case rates for medical cases are: Dengue I (Dengue Fever and DHF Grades I and II) – P8,000, Dengue II (DHF Grades III and IV) – P16,000, Pneumonia I (moderate risk) – P15,000;

 Pneumonia II (high risk) – P32,000, Essential Hypertension – P9,000, Cerebral Infarction (CVA I) – P28,000, Cerebro-Vascular Accident (CVA II) - P38,000, Acute Gastroenteritis  – P6,000, Asthma – P9,000, Typhoid Fever – 14,000, and Newborn Care Package – P1,750.

The cases rates for surgical cases are Radiotherapy – P3,000, Hemodialysis – P4,000, Maternity Care Package - P8,000, Normal Spontaneous Delivery (NSD) Package (Level I Hospitals) – P8,000, NSD Package (Level 2 to 4 Hospitals) - P6,500;

Caesarian Section – P19,000, Appendectomy – P24,000, Cholecystectomy – P31,000, Dilation and Curettage – P11,000, Thyroidectomy – P31,000, Herniorrhaphy – P21,000, Mastectomy – P22,000, Hysterectomy – P30,000 and Cataract Surgery – P16,000.

Banzon said PhilHealth is also set to release the case rates for more ailments soon.

The premium increases will probably be phased in after the roll out of the benefits but it will be calibrated so PhilHealth will not loose its members, he added.

P4.6M FUND

Banzon and Health Secretary Enrique Ona turned over a P4.6 million capitation fund to Gov. Alfredo Marañon at the Capitol in Bacolod.

The provincial government has so far, enrolled 50,000 indigents in PhilHealth.

For every indigent family enrolled by the LGU into the Sponsored Program, PhilHealth pays back P300 to the sponsoring LGU representing capitation amount per year of enrolment. The amount is taken from the annual premium remittance of the LGU to PhilHealth and is released on a quarterly basis.*CPG

back to top