The First Philhealth Experience

I've been maximizing my private HMO, provided by my current employer, to the maximum level. Even when I got a very small minor bump on the head, I asked to have my brain X-rayed (I actually wanted a CT scan but they wouldn't approve as they found it unnecessary). Anyway, the point here is that I just wanted to see what my brain looks like. And I got to. All because of the HMO provided by my employer in exchange for my time and labor. I've used it for the worst of things to the silliest of things. 

I love it. Health is wealth and this is probably the biggest chunk of profit in my contract's package. And then there's Philhealth.

I haven't researched so much on it yet but from what I know, there is no mandate or requirement to be a member of Philhealth unless you are an employee. My whole life, until I joined the company I'm in now, I've never had Philhealth. There are many, I've heard, who are not employed but still join voluntarily to get discounts in the case they are hospitalized. Since it's subsidized by government, I am assuming the premium is very low.

The thing is, my legal dependent will be going through a procedure in Makati Med. They found a soft tissue tumor on her left shoulder blade. It's quite alarming as she's already had mastectomy on that same side for breast cancer back in 2009, so they want it removed and biopsied (feel free to contact me if you have second opinion; prayers also appreciated).

My deepest gratitude goes to my employer for providing me an HMO that is willing to cover everything. The weird thing though is that Makati Med is requesting for three mandatory Philhealth documents: 1. Member's data records 2. Claim Form 1 and 3. Certificate of Contribution. So in spite of my HMO's willingness to cover everything, red tapes and extra effort and costs have been imposed on me.

My car will consume gasoline. I will pay for toll. I will pay Binay city parking fee. All for three unnecessary documents even if voluntary market agreements and contracts are already willing to pay for everything.

I know very little about the processes of Philhealth but right on the top of my head I have several questions and insights:
  • Why can't we opt out of Philhealth deductions if there is already a private HMO anyway?
  • On top of the hundreds of billions of budget of Philhealth, there are tons of government sponsored healthcare such as public hospitals, health cards from certain LGUs, drug price reduction and compulsory licensing, ambulances and health centers on baranggay level  -- why, in spite of so many programs, is there still an increase in healthcare price and decline in its quality?
(SEE ALSO The Unintended Consequences of Dictating the Price of Medicine)

  • Aside from the mandatory deductions for employees, why do we place tariffs and taxes on medical equipment and medicine? 
(SEE ALSO: Why Do We Tax Ramen)

Government gets to allocate hundreds of billions for healthcare and yet many receive no healthcare at all. Government place tariffs and taxes on equipments and medicines that only increase the cost of healthcare. 

Regardless of political leaning, we all have one goal -- access to decent and affordable healthcare. It seems there are only differences in policy choices and philosophy (this is assuming that many of my readers are social democrats who are for government universal healthcare).

As much as we can disagree on so many things, I'm sure we can also agree on several topics I touched on above.

Obviously, I'll be researching more on the mandates, regulations, and benefits of Philhealth and write something more substantial soon. For now, I prepare myself again to endure the battles I will face in EDSA just to acquire the said Philhealth documents.


  1. Hi Harry. May I know what happened to your research? I also encountered this. Yung Philhealth na ng mother ko yung ginamit, Sabi nila covered but why use her Philhealth then? Sau naman. Yung Philhealth mu ginamit para sa mama mo??

  2. Sayang nman kung di magamit. I've traded a big salary job for hmo benefits for my parents. tapus gnun lang..tsktsk


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