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PhilHealth must improve enrollment in the formal economy to achieve full coverage – PIDS study

If you wish to know more about this study, you may download the Policy Note here.

Gauging the efficacy of enrollment in PhilHealth’s Employed Program will help policymakers in the health sector determine a more effective approach in achieving the goal of universal coverage.

Last year, PhilHealth officials iterated their commitment to achieving universal coverage by 2016. President Benigno Aquino III signed an amendment of the National Health Insurance Act highlighting the responsibility of the national government to cover the health insurance premiums of Filipinos in the informal sector.

However, full coverage in the formal sector also needs due attention and improvement. Thirty percent of PhilHealth’s members come from the formal economy where enrollment is mandatory. But based on a study by state think tank Philippine Institute for Development Studies (PIDS), “full coverage” is “yet to be achieved”.

The private sector currently sits at 95-percent coverage, while the government employed sector sits at 75 percent. Denise Valerie Silverberg, author of the study, argues that examining the level of PhilHealth coverage and enrollment in the formal sector will help policymakers bridge that gap.

Silfverberg surmised that the gap in coverage can be explained by looking at how some agencies comply with labor policy. For example, the low coverage rates may be attributed to the significant number of contractual employees in government who do not enjoy the benefits of being enrolled in PhilHealth.

The perpetuation of contractual employees—something the private sector is just as guilty— allows firms and agencies to stall enrollment of employees into the PhilHealth Employed Program and withhold “appropriate benefits”. 

But companies deliberately shortchanging employees are not just the only flaws. Variations of enrollment rate can also be produced by characteristics that set the private and government sector apart, and other factors like establishment size and area.

For the private sector, sectoral employment, nature of employment, union coverage, union-employees ration, and number of employees all influence variations of coverage rate. But in the provinces, it is the size of the firm that matters.

“More employees hired by medium-sized establishments lead to a higher likelihood for the province to have lower coverage,” Silfverberg pointed out, “On the contrary, the greater the number of employees in large-sized enterprises, the more likely it is for the province to have higher coverage levels.”

Silfverberg concluded that before the country can work toward full coverage, policymakers must find a way to address the problems that impede effective implementation of the national health insurance program. Enrollment should be more targeted, depending on the sectors where undercoverage occurs the most.

Monitoring by PhilHealth should also be strengthened. Medium-sized establishments, surmised by Silfverberg, are more likely to short change employees when it comes to health insurance enrollment if they are not closely monitored.

Employers have to be held accountable to follow the labor code provision on employee regularization. The rules are often undermined by resorting to a six-month cycle to prevent employees from being regularized, and to refrain from giving them their due benefits.

Employers—both public and private—should enroll their employees into the program, whether they are regular or casual.  Compliance at the local government level should be also closely monitored. After all, it would be harder to close the gap if government units themselves do not implement the health insurance program in their own offices. 

VRP, A New Year for Health

With the fiery new year comes new changes, VRP Medical Center embarks on a major
renovation plan for its people ­­ stakeholders, doctors, and patients alike. Since its renovations
earlier last year, VRP focuses on a more customer­ oriented approach. A family­ based
corporation never distracted from its vision: “A Hospital That Cares,” VRP opens its hearts to
developing and improving quality service, technological advancement, and a warm, calming

Doors open to a fresh Central Registration Area, a well­crafted mural to greet the children and
families, and a spacious waiting area for visitors and friends. From a 148 square meter room,
the Emergency Room will be extending to 224 square meters to accommodate patients and
those waiting in line. VRP sets into motion an additional 48 rooms to shelter its current 178 bed
Focusing on comfort, modernity, and care, VRP continually strives to improve their wide array of
facilities in order to better serve the people.

The hospital launched their new Nuclear Medicine Department last October 2015 under the guide and eye of Dr. Jeanelle Margareth Tang, an immigrant from Canada who decides to come home to the Philippines and finish a training course, with hopes to set up a practice in Nuclear Medicine. In partnership with Mandaluyong Medical Services Inc. (MNMSI), VRP already has a solid support right from the start ­­ from its supplier, Intermedical SE, to its doctors, partners and stockholders.

The rise of the Nuclear Medical Department brings forth new services for its patients such as thyroid function tests, general nuclear imaging, bone scans, reflux studies, GFR and radionuclide therapy. It also boasts a new set of high­quality equipment like the Multicam 1000, a camera that provides
hi­res solution and better imaging under medical procedures, and the Berthold Multicrystal
LB2111 Gamma Counter.

Dramatic change is everywhere, both inside and out. With an idea of a holistic healing, the roof deck will be converted into an intimate chapel for those in search of spiritual guidance.

Additional offices, departments, and a Physician Center is also in the works.

The facade will also undergo a major contemporary aesthetic change which could reflect beauty and care of VRP.

With its fresh, newly minted facility and developed professional care, patients could only expect more from the newly improved VRP Medical Center. As a family and as a community, VRP
welcomes the year right.

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