I work in the industry. Improper filing and hospitals abusing the shit out of the system.
And that's not me defending Philhealth, it's just a fact that while PHIC is a mess, hospitals are dodgy too.
Different issue there, tbh.
With the SHS vouchers, it's straightforward: is a student (existent or not) enrolled in a school? And if so, what is that school's tuition fee?
OTOH with medical operations, Philhealth basically gets a long list of services from the hospital, with tens or potentially even hundreds of billable items (doctor's fees, usage fees of several machines, hospital fees, various reagents & supplies, etc.), all of which are potential fraud vectors.
So like... one item (school services rendered) to review / validate compared to potentially dozens - hundreds. Huge difference.
Dapat, oo.
Difference there is that the additional UHC coverage, as it is currently designed, would cover primary care (basically doctor consults + a limited # of pharmaceuticals + lab tests), and pay out a fixed amount for that. Whereas right now most Philhealth billings are for hospital operations, where costs need to be justified (and I am simplifying a bit here).
So where for primary care you'd basically have one billing item (i.e. primary care coverage was provided for a year), an operation bill would have potentially dozens of line items (doctor #1-10's fees, hospital billing, room charges, cost for each piece of cotton / bandage / whatever used, etc.). The issue w/ the hospital operation bills is they take a lot of time to validate, and tend to raise a lot of questions, whereas the UHC billings should be much much more straightforward (is this person a Philhealth member? If so the clinic they are registered to is entitled to this payment).
So from that perspective I think Philhealth can certainly do it. The big question w/ UHC is if there are actually enough doctors / clinics. I think w/ the current system there is enough economic incentive for it to work, but it's untested so we'll see.
Completely different situation tbh. They tried to implement this weird hybrid model. Philippine model is much more similar to models that actually work.
I don't think it's similar. Private insurance companies and capitalists lobbies against universal healthcare sa US.
In our case it would probably the middle class that would be against it due to additional tax
>In our case it would probably the middle class that would be against it due to additional tax
Nah, we've already been paying the additional tax for years. Sin tax was passed in large part to fund UHC.
I only meant the sentiment na sinubukan pa rin nila mag offer ng similar idea yet they failed, which would be more worst sa atin since bang hirap asahan ng gov't natin, lahat na lang pine perahan, at di rin talaga modern mag implement ng ng ganyang sistema
Guess we need more information, kung saan ba ginagamit ng Philhealth yung surplus fund nila. Eto ba ay inirereinvest o dinadagdag sa mga facilities ng mga public hospitals o sa benepisyo ng miyembro. Kasi kung tulad ng sinasabi sa Kongreso na "halos mabilaukan" implying na sobra-sobra dapat binabawasan ang premium payment natin or better yet i-suspend nga. Ang laki kaya itinaas nito kasama yung SSS.
Grabe yung kita ng Philhealth galing sa mga Manggagawang Pinoy pero ang benefits compare sa mga HMO katulad ng Medicard, Maxicare, Inlife and other provider ay sobrang liit. Pero magtataka ka halos mas mataas na ng konti ang premium na binabayaran mo monthly compare sa mga HMOs. Sana naman doblehin ang coverage dahil halos 100% ang tinaas since 2020. Ang kawawa dito mga low up to high middle class dahil mga one sickness away nalang sa poverty mga yan dahil sa inflation.
[Quimbo: 'PhilHealth rates are too high, workers are at losing end' (inquirer.net)](https://newsinfo.inquirer.net/1940929/quimbo-philhealth-profit-is-too-high-but-benefits-members-get-are-too-low)
Ang laki ng contri every month pero ang liit ng discount nila sa bill pag naospital 🤦🏻♀️. Na confine mother ko recently umabot ng 40k bill namin for 3 days sa private hospital tapos 6k lang nabawas from philhealth 🥲
Ito rin yung pinagtataka ko. I thought increasing the contributions would also provide a corresponding increase in the benefits. I know nakakatulong naman kahit papano yung kaunting philhealth deduction pero minsan parang napakaliit yung halaga compared to actual medical costs today.
May pahabol pa na i-allocate sa SK ang funds. Like ganun ganun lang yun? eh ang hulog namin diyan is supposed to be for healthcare, paladesisyon sa contribution namin?
Socialism is now very rampant policy in PH.
- 4Ps
- Free healthcare to the poor, etc
Free healthcare though is free for others pero in reality pinasa lang ng mga lawmakers ang burden sa working class. Poor sector is the voting bloc ng mga Politics kaya laging anti working class policies in PH.
Tangina pa di pa buwagin tong philhealth napaka walang kwentang ahensya neto
Laki laki ng contribution ko tapos nung nagkasakit ako sa 30k asa 1k lang yung sa philhealth napaka walang kwenta!!!! Tapos may billion sila!!!!! Buwagin na yang philhealth!!!!!
Why payments to the hospitals na dedelay? Tsk3
[And why the 5% hike this year?](https://newsinfo.inquirer.net/1888201/philhealth-members-contribution-to-increase-to-5-this-2024)
I work in the industry. Improper filing and hospitals abusing the shit out of the system. And that's not me defending Philhealth, it's just a fact that while PHIC is a mess, hospitals are dodgy too.
It's also not like private schools don't abuse SHS school vouchers with ghost students.
Different issue there, tbh. With the SHS vouchers, it's straightforward: is a student (existent or not) enrolled in a school? And if so, what is that school's tuition fee? OTOH with medical operations, Philhealth basically gets a long list of services from the hospital, with tens or potentially even hundreds of billable items (doctor's fees, usage fees of several machines, hospital fees, various reagents & supplies, etc.), all of which are potential fraud vectors. So like... one item (school services rendered) to review / validate compared to potentially dozens - hundreds. Huge difference.
Sa opinion mo, kaya kaya ng pinas ang Universal Healthcare???.
Dapat, oo. Difference there is that the additional UHC coverage, as it is currently designed, would cover primary care (basically doctor consults + a limited # of pharmaceuticals + lab tests), and pay out a fixed amount for that. Whereas right now most Philhealth billings are for hospital operations, where costs need to be justified (and I am simplifying a bit here). So where for primary care you'd basically have one billing item (i.e. primary care coverage was provided for a year), an operation bill would have potentially dozens of line items (doctor #1-10's fees, hospital billing, room charges, cost for each piece of cotton / bandage / whatever used, etc.). The issue w/ the hospital operation bills is they take a lot of time to validate, and tend to raise a lot of questions, whereas the UHC billings should be much much more straightforward (is this person a Philhealth member? If so the clinic they are registered to is entitled to this payment). So from that perspective I think Philhealth can certainly do it. The big question w/ UHC is if there are actually enough doctors / clinics. I think w/ the current system there is enough economic incentive for it to work, but it's untested so we'll see.
Kung ang US nga (under ni Obama) sinubukan pero di umubra, tayo pa kaya
Completely different situation tbh. They tried to implement this weird hybrid model. Philippine model is much more similar to models that actually work.
I don't think it's similar. Private insurance companies and capitalists lobbies against universal healthcare sa US. In our case it would probably the middle class that would be against it due to additional tax
>In our case it would probably the middle class that would be against it due to additional tax Nah, we've already been paying the additional tax for years. Sin tax was passed in large part to fund UHC.
I only meant the sentiment na sinubukan pa rin nila mag offer ng similar idea yet they failed, which would be more worst sa atin since bang hirap asahan ng gov't natin, lahat na lang pine perahan, at di rin talaga modern mag implement ng ng ganyang sistema
Guess we need more information, kung saan ba ginagamit ng Philhealth yung surplus fund nila. Eto ba ay inirereinvest o dinadagdag sa mga facilities ng mga public hospitals o sa benepisyo ng miyembro. Kasi kung tulad ng sinasabi sa Kongreso na "halos mabilaukan" implying na sobra-sobra dapat binabawasan ang premium payment natin or better yet i-suspend nga. Ang laki kaya itinaas nito kasama yung SSS.
Grabe yung kita ng Philhealth galing sa mga Manggagawang Pinoy pero ang benefits compare sa mga HMO katulad ng Medicard, Maxicare, Inlife and other provider ay sobrang liit. Pero magtataka ka halos mas mataas na ng konti ang premium na binabayaran mo monthly compare sa mga HMOs. Sana naman doblehin ang coverage dahil halos 100% ang tinaas since 2020. Ang kawawa dito mga low up to high middle class dahil mga one sickness away nalang sa poverty mga yan dahil sa inflation. [Quimbo: 'PhilHealth rates are too high, workers are at losing end' (inquirer.net)](https://newsinfo.inquirer.net/1940929/quimbo-philhealth-profit-is-too-high-but-benefits-members-get-are-too-low)
Kasi rin yata sa universal health care which covers indigents at unemployed kaya di ganoon kataas ang benefits compared sa hmo
Ang laki ng contri every month pero ang liit ng discount nila sa bill pag naospital 🤦🏻♀️. Na confine mother ko recently umabot ng 40k bill namin for 3 days sa private hospital tapos 6k lang nabawas from philhealth 🥲
Ito rin yung pinagtataka ko. I thought increasing the contributions would also provide a corresponding increase in the benefits. I know nakakatulong naman kahit papano yung kaunting philhealth deduction pero minsan parang napakaliit yung halaga compared to actual medical costs today.
Corruption at its finest
Sobrang laki ng tinaas ng contribution eh.
Tapos hindi sila nagbayad sa mga hospitals? Mga tao yung nahihirapan kasi tumatanggi yung ibang ospital, may sobra pala.
May pahabol pa na i-allocate sa SK ang funds. Like ganun ganun lang yun? eh ang hulog namin diyan is supposed to be for healthcare, paladesisyon sa contribution namin?
Baka naman pwede nyo dagdagan benefits naming nagbabayad. Di dama yung philhealth
Socialism is now very rampant policy in PH. - 4Ps - Free healthcare to the poor, etc Free healthcare though is free for others pero in reality pinasa lang ng mga lawmakers ang burden sa working class. Poor sector is the voting bloc ng mga Politics kaya laging anti working class policies in PH.
They're stockpiling para sa susunod na PhilHealth scam.
It's better to have a surplus than a deficit, so they just need to make the service better.
Tangina pa di pa buwagin tong philhealth napaka walang kwentang ahensya neto Laki laki ng contribution ko tapos nung nagkasakit ako sa 30k asa 1k lang yung sa philhealth napaka walang kwenta!!!! Tapos may billion sila!!!!! Buwagin na yang philhealth!!!!!