PhilHealth premium should remain at 4%, says Quimbo

State-run Philippine Health Insurance Corporation's (PhilHealth) premium rate should remain at 4% of a member’s monthly salary, given its huge earnings and limited coverage of healthcare expenses, House appropriations panel senior vice chairperson Stella Quimbo said Wednesday.

Quimbo made the remark during a public hearing conducted by the House health panel, saying that PhilHealth is expected to generate P173 billion from premiums alone.

“This amount does not even include income from investments. Every year, they not only collect premiums from workers. They also get very huge appropriations from Congress. There’s P80 billion for premium subsidies and on top of that, P20 billion for benefit expansion,” she said.

“This is how huge the amount PhilHealth is getting annually. Ironically, PhilHealth's benefit spending is too low. The out-of-pocket spending on the average is about 50 percent. That's among the lowest in Southeast Asia. This is proof that it is overcharging its members. What we should do is to adopt an actuarially fair premium. Perhaps we can begin with 4%,” she added.

Under the law, the PhilHealth premium rate for 2024 should be at 4.5%, but this has since been deferred by President Ferdinand "Bongbong" Marcos, Jr. thus retaining the 4% of salary monthly premium rate.

The PhilHealth premium rate is scheduled to go up to 5% in 2025.

“The problem with PhilHealth premium rates is that it's on a schedule under the law. That is why I will propose, perhaps, that we should do away with the schedule,” Quimbo added.

PhilHealth Chief Operating Officer Eli Santos responded by saying that their budget requests to Congress are based on studies, and that the lawmaker’s concerns can be addressed by amending the Universal Healthcare Law.

“We are concerned not only in increasing the benefits but also on the sustainability of the program. That’s why, on a yearly basis based on actuarial and computation, we request the subsidy [from the national government],” he said.

“But we agree to the point [that we should do more]. At present, we are increasing the PhilHealth benefit packages. But as to the decrease in a member's contribution, again, this is provided by law. That is why we fully support the initiative of the Committee on Health in amending the UHC law, particularly on PhilHealth premium contribution,” Santos added. — BM, GMA Integrated News