Aiming for sustainable health, now PhilHealth faces controversies beneficiaries complaining to its limit of cataract surgeries.
PhilHealth is created for universal health benefits covering Philippines. It aims to give sustainable health for every Filipino, providing quality services as a social insurance program in national government allocate funds to subsidize the indigent.
Currently, complaints against Philheath arose, allegedly limiting its services pointing on eye surgeries, issues involving doctors. In respond to the issues as to complaining the program, PhilHealth president Alex Padilla repeated, limit was implemented to prevent abuse in claiming benefits for cataract procedures.
The Philippine Health Insurance Corporation or PhilHealth assured to look into issues against them , as report came up that without any necessary operation, patient-beneficiaries are being “recruited” in order to avail of the clinics’ services.
In statement of Dr Raymond Evangelista, owner of Quezon City Eye Center, “We really don’t have anything against that but we do feel that it is anti-poor because if you put a cap on the several surgeries that the doctor can perform in a day for example, that doctor will necessarily choose the ones who can pay,” told reporters on Thursday, July 23.
Suspicious claims were being investigated, Sen. TG Guingona, chair of the Senate blue ribbon committee tried to emphasized as he brought up at the third hearing, claims amounting billions. This is submitted by hospitals and clinics to PhilHealth that most of cases lodged in PhilHeath’s Committee on Appealed Administrative Cases .
Alexander Padilla, PhilHealth president and chief executive officer stated, “there are 1,826 accredited private and public facilities and over 34,000 health care professionals nationwide through which our members can avail of the benefits, including cataract operations.”
Some cases were reported involving unethical practices of some eye centers and even illegal conduct of such, pointing suspension of payment of claims to two facilities in some eye center in Manila. Two doctors were under investigation for questionable PhilHealth claims. Limits of eye surgeries doctor can perform, where in fact they can actually benefit from it , asked the agency to reconsider.
As PhilHealth used to developed incentive payments to health care professionals, it offers tax-exemption, government-owned and government-controlled corporation and is attached to Department of Health.
Beneficiaries were expected to benefit on package of services, such as inpatient care, catastrophic coverage, ambulatory surgeries, deliveries, and outpatient treatment for malaria and tuberculosis.IMAGE/www.philstar.com