Better use of pork barrel

With the calls for the abolition of the Priority Development Assistance Fund (PDAF) dying down, lawmakers thought the initiatives against the pork barrel system will eventually lose steam. Apparently, they are still hoping it will eventually fizzle out until the next big scandal breaks out.

To their chagrin and consternation, it gained ground in the 16th Congress. The initiatives were being led by certain colleagues in Congress who this early have been showing their undisguised moist eyes in the next presidential elections in May 2016. That’s their problem.

The lawmakers who earlier joined the chorus to abolish the pork barrel system, including those from the ruling pro-administration Liberal Party (LP) of President Benigno “Noy” Aquino III, have toned down their hallelujahs. After getting brownie points for supporting calls to abolish their PDAF allocations, the LP congressmen have come up with their suggested schemes on how to go around the public indignation against pork-barrel system.

The consensus was reached at the caucus held at the party’s office in Cubao, Quezon City last Monday. Ninety-seven of 119 LP members from the House of Representatives reportedly attended the meeting. House Speaker Feliciano Belmonte sought the support of LP members on the President’s decision to abolish the PDAF as announced at Malacañang Palace last August 23.

However, more complications arose when the Supreme Court (SC) stepped into the picture by giving due course yesterday to petitions that sought to scrap the pork-barrel system. Under our country’s Constitution, the power of the purse belongs to Congress – which obviously the SC is now treading into – or encroaching?

In the meantime, the lawmakers are now throwing the question back to the executive department: How to handle the hundreds of poor people who seek financial assistance from senators and congressmen, especially those regarding health and medical needs?

Well, former health undersecretary Alex Padilla says he welcomes pork barrel allocations for the medical needs of the poor. This is in his capacity now as the president and chief executive officer of the state-run Philippine Health Insurance Corp. (PhilHealth). Padilla, whose late father ex-Senator Ambrosio Padilla belongs to the so-called “golden era” of Philippine Congress, was our guest in yesterday’s Tuesday Club breakfast gathering at the EDSA Shangri-La yesterday.

In 2012 alone, Padilla reported to us PhilHealth released about P47.2 billion in benefits payment to more than 4.8 million Filipinos who filed medical claims as members covered by this state medical insurance agency. This amount represents an average of P9,400 per claim. PhilHealth released this much money, with 75.82 million estimated enrolled people in the program.

With over 97.7 million population of the Philippines, Padilla noted only 72 percent are covered as of December 2012. Using the new “actual head count” system, he explained, this helps in their actuarial estimates to make the 19-year-old PhilHealth financially viable to enable it to fulfill its mandate to help its members, specially in times of medical and health crisis.

For this year, he disclosed, PhilHealth targets to achieve an 81-percent enrolment rate. This would translate to about 79.13 million enrolled Filipinos in the National Health Insurance Program by December, 2013. Ideally, however, PhilHealth aspires for universal coverage of all Filipinos under this state medical insurance system.

The state’s health insurer is well on track of even surpassing its target. But Padilla clarified being enrolled and being covered by PhilHealth are two different terms. While they have a high 81 percent enrolment rate, only 72 percent are actually covered. The discrepancy is due to members who stopped paying their annual PhilHealth contributions, rendering their accounts inactive.

On a positive note, Padilla cited, there is, however, a 100-percent coverage for the poorest households identified under the National Household Targeting System for Poverty Reduction registered in the conditional cash transfer (CCT) program implemented by the Department of Social Welfare and Development (DSWD).

This means that the P47.2 billion that PhilHealth paid for claims in 2012 is bound to increase further this year, he said.

For the players in the private health sector, that P47.2 billion represents a huge market that cannot just be ignored. So if I am a wise businessman, especially with Padilla and Health Secretary Enrique T. Ona displaying relentlessness in meeting PhilHealth’s target, I would immediately find ways to get a good chunk of that money streaming from the public health insurer.

That is how an effective and efficient PhilHealth can drive the Aquino administration’s public-private partnership (PPP) program in healthcare. This kind of PPP is not the usual type where the private sector would construct a modern medical facility that in a few years will be handed over to the government under the build-operate-transfer scheme.

The country already has an abundance of world-class medical centers. Everybody knows them. However, some have not opened their doors to PhilHealth beneficiaries yet. But in due time, with the vastly growing benefits payment that PhilHealth is releasing annually, the “elitist” hospitals will be welcoming PhilHealth patients more openly.

Padilla stressed the poor should not feel they are poor when it comes to medical care. He pointed out their dignity is safeguarded because they are no longer treated as just charity patients — they are PhilHealth members.

 Now, PhilHealth members know how much they can claim for a particular medical procedure or case. PhilHealth has come up with expanded packages that make it easier for their members and entice more to become members by making them understand how the state insurance system works for them.

This is the game-changer in the Philippine healthcare landscape. PhilHealth is forcing private hospitals to compete, or at least become price-competitive. The bottom line is there is better use for pork barrel of lawmakers that can help achieve this universal coverage of state medical insurance for the Filipino people.