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.
