Vulnerabilities in Healthcare Decision-MakingVulnerabilities in Healthcare Decision-Making An oversight hearing by the House Committee on Appropriations revealed significant vulnerabilities in the decision-making processes of the Department of Health (DOH) and Philippine Health Insurance Corporation (PhilHealth). No Balance Billing Policy Issues Northern Samar Representative Paul Daza criticized the DOH’s failure to fully provide essential services, medicines, and diagnostics to underprivileged patients under the No Balance Billing (NBB) policy. He emphasized the government’s responsibility in ensuring these services are accessible. DOH Secretary Teodoro Herbosa claimed that the policy was straightforward, but acknowledged that not all medications were supplied by the government, leading to additional expenses for patients. The panel instructed Herbosa to clarify the NBB policy within two weeks. PhilHealth Data Leak and Concerns The panel also discussed the PhilHealth data leak that affected 42 million individuals in October 2023. Lawmakers expressed the need to inform those affected and address concerns about the breach’s nature. Previously, the committee examined PhilHealth’s borrowings of $2.21 billion for COVID-19 response projects, including concerns over expensive testing and irregularities. The misuse of P12.8 billion in borrowed funds for expiring COVID-19 test kits was highlighted, urging accountability from the Procurement Service-Department of Budget and Management (PS-DBM) and PhilHealth. Lack of Government Procurement Strategy Marikina City Representative Stella Quimbo attributed the poor budget execution of PhilHealth and DOH to the absence of a comprehensive government procurement strategy. She stressed that this hindered timely health service delivery and increased costs, particularly during crises like the pandemic. The oversight hearing exposed critical vulnerabilities in healthcare decision-making processes that need immediate attention to ensure the effective provision of essential health services to all Filipinos, especially during national emergencies.
VULNERABILITIES in the decision-making processes of both the Department of Health (DOH), Philippine Health
Insurance Corporation (PhilHealth), and other coordinating agencies were identified during the oversight
hearings of the House Committee on Appropriations on Monday, June 8, 2024.
Northern Samar Representative Paul Daza said that DOH failed to fully provide all services, medicines, and diagnostic services to underprivileged patients stated in the No Balance Billing (NBB) policy, insisting that DOH is responsible for providing essential medicine supplies and diagnostics to patients.
The NBB policy states that “no other fees or expenses shall be charged or paid for by indigent patients
above and beyond the package rates during their confinement period.”
DOH Secretary Teodoro Herbosa said there are no complications in the policy, adding that not all
medications are supplied by the government, which result in additional payments.
The panel ordered Herbosa to issue a circular within two weeks to clarify the NBB policy application.
The panel also discussed the PhilHealth data leak that happened on October 3, 2023, and to inform the 42
million affected about the breach’s nature.
Lawmakers previously examined the PhilHealth’s borrowings of $2.21 billion for Covid-19 response projects,
expressing worries about expensive testing and irregularities in PhilHealth.
The misuse of P12.8 billion in borrowed funds for expiring Covid-19 test kits was also highlighted, urging
accountability from the Procurement Service-Department of Budget and Management (PS-DBM) and PhilHealth for
improper fund allocation.
Marikina City Representative Stella Quimbo attributed the poor budget execution of PhilHealth and DOH to the lack of an overall government procurement strategy, which hampered timely health service delivery and increased costs, especially during crises like the recent pandemic. (Stephen Joseph T. Enrile/UP-Tacloban intern)
