Social Health Insurance for All Filipinos

In these times when even one’s basic needs are almost beyond reach, parents can only do so much for their children. Filipino families are left with no resort but to make do with the measly amount of food on the table. In generous days, a can of sardines and a kilo of rice will suffice for the whole day for a family of seven (7). However, during lean days, two packs of instant noodles simmered in one liter of water will feed seven (7) empty stomachs for a day.

In Baguio City, the melting pot of the Cordillera Administrative Region (CAR), people from nearby provinces converge in the City for all sorts of reasons. They bring their families with them with a sense of permanence and try to make ends meet, envisioning that urban life is better than the rural one they left behind. Consequently, the number of urban poor in the City has increased over the years. People now sleep in the famed Session Road and in some busy streets in the City of Pines, while beggars abound in the thoroughfares. The influx of newcomers brought overwhelming management problems in education, health, safety, and environment for the City officials and residents alike.

To fulfil its mandate of Universal Coverage, the PhilHealth Regional Office – Cordillera Administrative Region (PRO-CAR) through its Local Health Insurance Office (LHIO) in Baguio City joins the City Government in its monthly conduct of the Pasadang Pambarangay to bring basic services to the barangays within the City. Services include medical, dental, and optometric services in coordination with both the public and private sectors; frontline services from different government agencies such as TESDA, SSS, DOST and PhilHealth; anti-rabies vaccinations for pets; and therapeutic massage and hair cut services.

At the April 22 Pasadang Pambarangay which was held at Barangay City Camp Central, I met Nanay Tessie, a 64-year-old widow with four children. She traces her roots to Cebu and Batangas but she grew up in the said barangay. She is a PhilHealth member through the senior citizen category pursuant to Republic Act No. 10645 or the mandatory PhilHealth coverage of senior citizens. She came to know about PhilHealth when she worked as a utility aide under the employ of the barangay. She claimed she has never availed of her PhilHealth benefits but she narrates that PhilHealth is a big help in times of emergency. “Malaking tulong ang PhilHealth lalong-lalo na kapag may emergency at wala akong mapagkukuhanan ng pambayad sa ospital,” she said.

On the other hand, Manang Loida, a 40-year-old housewife who sells halo halo during summertime and foot rugs during the rainy season to help her husband who works as a seasonal painter in construction sites, is a PhilHealth Indigent Program member way back in 2012. However, she was not renewed under the Program and has not been able to continue her membership until now.

Manang Loida narrates that she was able to avail of her PhilHealth benefit when she delivered her baby in May 2012 via the caesarean section delivery where, according to her, she paid only P3,000.00 in excess. The rest of the hospital bill was shouldered by PhilHealth. “Gustung-gusto ko pong ituloy ang PhilHealth ko ma’am dahil maganda at maraming benepisyo lalo na sa amin na kinakapos. Malaki ang maitutulong ng PhilHealth sa amin na hindi makaipon at makapag-budget para sa pampaospital sakaling magkaroon ng emergency. Kaya lamang po wala naman po kaming pera ng asawa ko para makapaghulog sa PhilHealth. Kulang nga po yung kinikita naming ng mister ko para sa araw-araw na gastusin ng mga bata,” she said.

Ronald A. Alo, a Baguio LHIO personnel tasked to handle the PhilHealth service desk during the said Pasada, informed Manang Loida that the DSWD is conducting a validation survey for the poor in relation to the National Household Targeting System for Poverty Reduction (NHTS-PR) and advised her to seek the DSWD’s help on how to be part of the said List and be an automatic Indigent Program member of PhilHealth. However, Alo said that in the event that she does not qualify under the NHTS-PR list, she may continue her PhilHealth membership as a self-paying individual under the Informal Economy sector. “It breaks my heart that PhilHealth can only do so much for the likes of Manang Loida and her family, but I know that we, in PhilHealth, are doing the best we can to help those who are within or beyond the poverty threshold,” Alo responded when I asked him how he felt after answering Manang Loida’s query on what to do to acquire PhilHealth membership once again. “Since I am not part of the team drafting PhilHealth policies, on my part, I just see to it that every client that comes to me either for assistance or inquiry will not be leaving my desk short-changed with information. I serve them enthusiastically and make them feel that there is sincerity in the way we care about them. That is the least I can do for them,” Alo continued.

The concept of social health insurance for all pertains not only to the financing aspect but rather to a more holistic and progressive health insurance program with constant innovations, implemented with quality service and utmost integrity, and operates within the principles of equity and social solidarity. Indeed, PhilHealth not only serves with total care; it also administers the NHIP with a heart especially to those in dire need of access to efficient health care services.