Groups reject PhilHealth scheme pushed by Recto
A large number of health professionals on Thursday said they were opposing a proposal by Executive Secretary Ralph Recto to tie the type of benefit packages that Philippine Health Insurance Corp. (PhilHealth) members could get to the amount of contributions they paid.
Over 70 groups of healthcare workers are instead urging the government to increase the budget allocated for PhilHealth to prevent “polarization” between direct and indirect contributors.
In an open letter to Recto, which they presented during a press briefing on Thursday, the groups rejected his proposal which they said would lead to unequal PhilHealth benefits based on contributions—more for direct contributors, and less for indirect contributors, or those paid for by the government.
Recto made the suggestion in an interview with dzRH radio on June 19 following a viral social media post about a 47-year-old man whose family was unable to claim any benefits after his death despite being a paying PhilHealth member for over two decades.
“We understand that many working Filipinos feel they are not receiving enough benefits in return for the premiums they pay. This is not because indigent patients receive too much, or to use your own words, ‘panalo sila’ (they are winners),” the medical groups told Recto.
“This is because the government is failing to shoulder its lawful share in financing the premiums of the poor. As a result, direct contributors end up paying for a larger share of the country’s healthcare than the law intended,” they said.
Benefits for all
Instead of creating a “separate tier” for paying PhilHealth members, they said the government should stop diverting funds meant for the state health insurer so that it could improve its benefit packages for all Filipinos, not just for a few.
“As health-care professionals, we care for Filipinos from every walk of life. We do not see them as direct or indirect contributors. We see them as patients who need our care. That is why we are deeply concerned by your proposal to provide different PhilHealth benefits for direct and indirect contributors,” their letter read.
Among the signatories were the Philippine Medical Association, Philippine College of Physicians, Philippine College of Surgeons, Philippine Nurses Association, Philippine Association of Medical Technologists and Philippine League of Government and Private Midwives Inc.
According to Dr. Antonio Dans of the National Academy of Science and Technology, direct contributors are paying members of PhilHealth and indirect contributors are those who do not pay premiums since these are shouldered by the government.
He acknowledged that there was “polarization” between direct and indirect contributors because of concerns that paying members may not be getting benefits commensurate to their monthly contributions.
Equality not always justice
Dans underscored, however, that health insurance should be based on “solidarity” among all members of society.
“Is our tax the same 20 percent from the poorest to the richest? No, right? The percentage is higher for the rich, and smaller for the poor. It cannot be equal, because sometimes equality is not justice,” he said.
“The sick are helped by those who are not. The poor are helped by the rich. The elderly are helped by the youth. Those with disabilities are helped by those without,” he said. “We need to understand that because someday, you will be in need, and the ones who will help you will be the society.”
He stressed that the government should have enough fiscal capacity to increase PhilHealth’s budget so that it could provide better benefits for all from revenues earned from taxes imposed on tobacco and sweetened beverages—the so-called “sin products.”
As mandated by the sin tax law and the Universal Health Care (UHC) Act, Dans noted that 40 percent of the annual revenues from taxes on tobacco and sweetened beverages should be allocated to PhilHealth.
He showed how P69.78 billion worth of tax revenues should have gone to PhilHealth for its 2026 budget, based on data from the Bureau of Internal Revenue and the Bureau of Customs.
Instead, Dans pointed out, PhilHealth only received P53.13 billion in government subsidies for the implementation of the National Health Insurance Program (NHIP) under the General Appropriations Act (GAA), which it uses to pay for the premiums of indirect contributors.
Moreover, he noted that the subsidy received by PhilHealth was lower than its proposed budget of P172.1 billion.
“Where did the sin tax money go?” Dans asked, adding that this “diversion” of PhilHealth funds also occurred in 2023, 2024 and 2025.
Dans said PhilHealth received zero government subsidy for the NHIP under the 2025 GAA, when P69.81 billion worth of tax revenues should have been allocated for the agency.
Subsidies
In the 2024 GAA, PhilHealth got P40.28 billion worth of subsidies, when it should have received P79.02 billion from tax revenues. In the 2023 GAA, PhilHealth got P79 billion in subsidies instead of P83.9 billion.
“That is against the law in two ways: It did not provide or channel sin tax earnings to the people and the government did not add to the needs that were expressed by the PhilHealth leadership,” Dans said.
This is the second time that healthcare professionals and Recto are clashing over the allocation and use of PhilHealth funds after he directed the transfer of P60 billion worth of its “excess” funds to the national treasury in 2024 when he was finance secretary.
Medical groups petitioned against the transfer in the Supreme Court, which ordered the return of the funds to PhilHealth in 2025. The high court said the transfer was against the Universal Health Care Act and sin tax laws.
The health groups on Thursday insisted that the national government provide PhilHealth its “legally mandated” budget and not institutionalize unequal benefits among members.
Widow’s story
The Inquirer reached out to Recto for his comment, but he has yet to respond as of writing.
In his radio interview, Recto said he planned to meet PhilHealth officials in order to expand the benefits of its more than 33 million paying members.
Under the UHC Act, all Filipinos are automatically enrolled as PhilHealth members. Recto noted, however, that under Section 9 of the law, PhilHealth shall provide “additional program benefits for direct contributors, where applicable.”
He said he understood the frustrations of paying members who feel that their benefits do not match the PhilHealth premiums they had regularly paid.
“If you’re indigent, you paid zero to avail of PhilHealth benefit packages, so you’re already ahead. That’s why I believe those who are paying should receive higher PhilHealth benefits,” Recto said.
Recto was reacting to the viral story of PhilHealth member Marvin Sulit. The man’s wife said he died from a brain hematoma without being able to avail of any benefits despite being a paying member for more than 25 years.
Sulit’s widow said in a Facebook post that the hospital informed her that he was not eligible for any PhilHealth benefits because he had been hospitalized for less than 24 hours. —WITH A REPORT FROM DEXTER CABALZA
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