PH medical group questions PhilHealth data in Aquino Sona

MANILA, Philippines—The Philippine Medical Association (PMA) on Tuesday expressed doubts over the claim of the Philippine Health Insurance Corp. (PhilHealth) that 81 percent of Filipinos had so far been enrolled in the government’s universal healthcare program.

PMA president Dr. Leo Olarte said state health insurance had long been having difficulties with its information and communication technology (ICT) system to come up with a scientific count.

In his fourth State of the Nation Address on Monday, President Aquino reported that PhilHealth had been able to cover 81 percent of the country’s population so far.

“If we assume that the total population of the Philippines is 100 million, then 81 percent of Filipinos who are supposedly enrolled in PhilHealth numbers to around 81 million,” Olarte said. “If we follow this kind of logic, a total of eight out of 10 hospital admissions across the country should be PhilHealth cases.”

But reports from various hospitals nationwide did not support this claim, said the head of PMA, an umbrella organization of medical doctors in the country.

“We are just curious and very interested to see the scientific basis of this particular PhilHealth declaration mainly because of some conflicting claims in the past,” Olarte said, pointing to the 2008 National Demographic Health Survey showing that only 38 percent of respondents were aware of at least one household member enrolled in PhilHealth.

He also stressed that PhilHealth’s ICT system was problematic that scientific data gathering would “definitely be affected.”

“If you go and enroll yourself today at PhilHealth, chances are you will be given a piece of paper [and] not an electronic ID,” Olarte said, adding this made it difficult to accurately track down members’ data for enrollment and claims settlement.

“The Aquino administration’s universal healthcare program, or Kalusugan Pangkalahatan, is largely linked to PhilHealth coverage. If proven that the data that PhilHealth extrapolated was not accurate due to a poor ICT system, then we may have a big problem in our hands,” said Olarte.

PhilHealth president Alex Padilla admitted that the state insurance firm was having problems with its database and was currently cleaning up the system.

He said that three years ago, data would show that 86 percent of Filipinos were enrolled with PhilHealth but with the ongoing cleansing of double entries on the list, the figure had been reduced to 81 percent.

“That’s the best figure that we can give thus far. I am not saying that it’s not going to change but if it will, it won’t be that far,” he told reporters.

Padilla said that while double entries of members were being deleted, dependents were also being added to the list, which was something that PhilHealth did not religiously do in the past. –Jocelyn R. Uy, Philippine Daily Inquirer

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