In the wake of a social media post that had gone viral about a 47-year-old man whose family was unable to claim any Philippine Health Insurance Corp. (PhilHealth) benefits after his death despite being a paying member for 20 years, Executive Secretary Ralph Recto proposed to tie the type of PhilHealth benefit packages that members could get to the amount of contributions they paid.
This means members who paid more or have higher premium contributions can receive medical benefits better than those who paid less or none at all.
The smaller contributions may be due to the member’s low monthly basic pay or short period of employment. But if he or she is unemployed and is a senior citizen, enrollment in PhilHealth is automatic. No contributions are required.
Recto’s proposal drew strong opposition from several healthcare groups. They urged the government to instead increase the budget allocated for PhilHealth to prevent “polarization” between direct and indirect contributors.
There is no dispute about the government’s moral obligation to make health or medical care available to all citizens regardless of their financial status or capacity to pay.
The funds needed for that purpose are sourced from taxes and premium contributions of PhilHealth’s member-employees and their employers, with which the law requires strict compliance under pain of civil and criminal liabilities.
There is nothing that private and government employees can do when their paycheck is deducted certain sums of money every month to help subsidize the operational needs of PhilHealth.
A similar scheme of compulsory contribution is applied by the Social Security System (SSS) in the case of private employees and the Government Service Insurance System (GSIS) for government employees.
Except for the basis for the computation of contributions and retirement or separation benefits, the two insurance systems are the same. Their primary objective is to give financial assistance to their members when they retire or cease to be gainfully employed.
SSS and GSIS members receive those benefits depending on the amount and number of contributions that they and their employers made during their employment.
Thus, the benefits that members who have worked for longer periods of time and made more contributions are higher than those who worked for shorter periods of employment.
During all the years that SSS and GSIS have been in operation, linking the amount of benefits that their members can and should receive to the contributions they made has not been questioned.
It was (and still is) considered fair and reasonable that those who paid more contributions should be entitled to more benefits. They have earned that privilege and should not be begrudged if other members receive smaller benefits.
Does that difference in treatment cause polarization between members who receive higher benefits compared to those who receive less?
It does not, although those who are not so lucky understandably wish that the amount of benefits they receive would have some upward adjustments to help them cope with the high cost of living.
There is nothing morally wrong in applying the same principle that SSS and GSIS use in the computation of their members’ benefits to PhilHealth members.
Tying the medical package that PhilHealth members should receive to the contributions they have made is simply giving back to them suitable value for the financial sacrifice they were forced to make when contributions were taken from their paycheck.
Incidentally, in the Philippine General Hospital—which relies on government funding for its operation and, as a rule, does not charge consultation fees—patients can ask to be confined in pay wards that have more privacy and amenities than the other wards.
Obviously, that arrangement makes a distinction between those who can afford and those who have to be content with whatever wards are available to them.
Are there any signs of polarization between them? INQ
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