PhilHealth: the people as contributors should have been consulted

Every month, workers like Jose watch a small but significant portion of their salary go to PhilHealth. They do not complain; they understand that these mandatory contributions form the bedrock of the country’s national health insurance system. For the poor and vulnerable, the government pays premiums using taxes and sin-tax revenues — also people’s money. In principle, this shared pool is meant to guarantee that every Filipino can access healthcare when illness strikes.

PhilHealth contributions have a clear purpose. They fund hospitalization benefits — room and board, medicines, procedures — so no patient is left entirely at the mercy of rising medical costs. They support outpatient services such as dialysis, chemotherapy, and laboratory tests. Through the Konsulta Package, contributions should ensure that preventive and primary care, including checkups and maintenance medicines, becomes a routine right rather than a privilege. PhilHealth reserves also function as an emergency buffer, allowing the system to respond swiftly to pandemics, disasters, and sudden surges in healthcare demand.

In other words, contributions are not arbitrary deductions. They are investments Filipinos make for their health and for the collective security of all members. PhilHealth is not a business enterprise; it manages public funds under the principles of social insurance.

This is precisely why the Supreme Court ruled that PhilHealth’s “excess funds” cannot be redirected to unrelated government programs. Under the Universal Health Care (UHC) Act, PhilHealth resources must be used strictly for health services and benefit payments. Anything less violates the mandate of the law — and the trust of contributors.

Despite these clear principles, however, the issue of how PhilHealth’s excess funds would be utilized proceeded without meaningful consultation with those who pay into the system. Workers, employers, self-employed members, senior citizens — the very people whose money sustains the fund — were left unheard. This absence of consultation is alarming. It reflects deeper problems in transparency, accountability, and the recognition of stakeholder rights.

Public consultation is a democratic process. It enables agencies to seek the views, concerns, and priorities of people who may be affected by policy decisions. Consultation ensures that government actions are informed not only by technical considerations but also by the lived realities of citizens. When done properly, it makes policies more just, responsive, and sustainable.

For PhilHealth, consultation should have been non-negotiable.

First, because the money comes from the people. PhilHealth is financed by mandatory contributions and public revenues — not discretionary funds. Contributors have every right to know, question, and influence how their money is used. Discussing excess funds without their input is not merely a procedural lapse; it is a denial of ownership.

Second, contributors are the primary stakeholders. PhilHealth exists to serve its members. Any action affecting benefits, reserves, or long-term fund viability should involve them. Excluding contributors from these discussions undermines the basic principle of stakeholder participation found in all reputable social health insurance systems.

Third, the lack of consultation further erodes public trust. PhilHealth has faced repeated controversies — overpriced IT projects, questionable claims payments, delayed reimbursements to hospitals, and persistent governance concerns. When contributors are kept in the dark, suspicion naturally deepens. The question “Is our money being misused?” becomes increasingly difficult to dismiss.

Fourth, the UHC Act promotes transparency and participatory governance. While it may not outline a specific process for consulting contributors on excess funds, it clearly upholds the spirit of openness and shared decision-making.

Global best practices reflect this approach. Countries with strong social health insurance systems — such as Germany, Japan, Thailand, and South Korea — involve contributors through public hearings, member representation on governing boards, open publication of fund-use plans, and structured consultations before reforms are implemented.

PhilHealth could have taken the same path. It could have held stakeholder forums, opened online consultation platforms, presented financial scenarios, and explained clearly how much of the reserve would be used and for what purpose. These steps are not optional burdens; they are responsibilities.

At the heart of this issue is a simple truth: people deserve a say in what happens to their money. Public consultation is not a bureaucratic formality — it is a democratic right. Until institutions like PhilHealth fully embrace it, the gap between people and public agencies will continue to widen, along with the mistrust that fills it.