Assessment of the Philippine Health Insurance (PhilHealth) Program as an Achievable Tool for Welfare-orientedness

Abstract

This study entitled "Assessment of the Philippine Health Insurance (PhilHealth) Program as an Achievable Tool for Welfare-orientedness" is an evaluation of the extent of sustainability of the operations and projects of PhilHealth after eleven years of existence. The main areas of assessment of sustainability of the Program were (a) Republic Act 7875, or the Philippine Health Insurance Act, (b) financial status of PhilHealth Corporation; and (c) the Indigent or Sponsored Program The study arrives at a conclusion that the law creating PhilHealth has enough safety clauses to protect the National Health Insurance Program (NHIP) from financial harms like bankruptcy However, certain principles upheld under the by-laws are not yet achieved including the principle of equity. Generally, the financial status of PhilHealth remains in a favorable condition as of the current assessment despite less support coming from the national government. Politicization of the funds is an external factor that affects the credibility of PhilHealth. The Indigent Program, while it significantly increased the size of its membership, is faced with the basic problems of lack of hospitals, medical facilities and medical professionals. These become the reason for the inequitable accessibility of the program. Hence, the PhilHealth Program in relation to being a welfare-oriented national health insurance system, is confronted with certain limitations to address the evergrowing demand for welfare-oriented programs but is generally sustainable as a financial institution.