Press Release
August 12, 2020

GORDON SEES NEED TO OVERHAUL PHILHEALTH SYSTEM, RESHUFFLE, REMOVE OFFICIALS, AT THE VERY LEAST

With corruption issues chronically hounding government health insurer, Philippine Health Insurance Corp. or PhilHealth, Senator Richard J. Gordon pointed to the need to overhaul its system, or at least reshuffle or remove officials at the very least, to ensure that taxpayers' money are spent properly.

Gordon posed the recommendation, aside from proposing legislative measures, during the hearing of the Senate Committee of the Whole on the alleged rampant corruption, incompetence and inefficiency in the PhilHealth as he noted that the agency, which has a record of being a snake pit, has not been scrupulously careful with the peoples' money.

"Itong PhilHealth snake pit Nag-umpisa 'yan na ginagamit ng lahat ng pangulo, nagbibigay ng mga I.D cards, ginagamit pag eleksyon. Iyan ang umpisa niyan. Kaya pag nakikita ng mga tao sa baba na pinupulitika 'yan, gagawin din nila. Makikita po natin sa historical record na ang PhilHealth e talagang notoriously undesirable dahil andami-daming lumalabas na katiwalian. Ang tanong ko, have we been scrupulously careful with the money of the people? Mukhang hindi careful. Ang nakikita ko, lahat may kanya-kanyang paputok. So, kailangan malaman natin, kailangan natin i-overhaul ang system. At the very least, we have to reshuffle," he said.

Gordon pointed out that the regional directors, most of whom, until recently, have remained in their original posts for more than 20 years, have a lot to answer for because they could have stopped the malpractices have they been more stringent in verifying hospital reimbursements.

"Gaya ng case rate pay, lumalabas ang laki-laki na diperensya. Makakita niyo ang halos 153% ang binayad. Halimbawa sa pneumonia ang critical P786,000. Pero actual claim is P511, 000. Sa madaling sabi 153.65%, sino ang naghahati dun sa sobra? Ngayon ang tanong ko, sina ba talaga na in-charge? Sabi ang nasa front line talaga mga regional directors. Ang totoo, 22 years nang hindi nagpa-shuffle ang mga regional directors. Kaya magkakaroon tayo ng mga sabwatan," he said.

The senator also cited other anomalies such as overpayment, reimbursements to health institutions that are not accredited by the PhilHealth and reimbursing for patients who are already dead. He cited a case in Catarman where the PhilHealth made an overpayment to a 20-bed hospital; other overpayments in other provinces and in Metro Manila; and the WellMed case which was only discovered in 2019.

"Hindi ba dapat hawak ng regional director 'yan? Bago dumaan sa inyo e dadaan muna sa kanila? Mga overpayment dapat i-report ng regional directors. Kung umiiral pa rin 'yan ngayon, dapat imbestigahin. Ang lalaki ng sobra sa overpayment, sa mga probinsya pati dito sa Manila," he said.

Gordon, who led the investigation conducted by the Blue Ribbon Committee last year on fraudulent medical claims to the PhilHealth, asked if he could submit to the Committee of the Whole, the Blue Ribbon's findings and other information gathered.

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