PhilHealth: Isang walang-pusong kabiguan

FIRING LINE
ni Robert B. Roque, Jr.

MAY mga trahedyang hindi na kayang pagaanin ng kahit gaano karaming komentaryo. Isa ito sa mga pinakamasakit na maaaring maranasan. Sa paglipas ng mga taon, paulit-ulit na pinuna ng Firing Line ang Philippine Health Insurance Corp. (PhilHealth), at maging ang Department of Health, dahil sa korupsiyon, maling mga prayoridad, bilyon-bilyong pisong pondong hindi nagagamit, at isang burukrasya na tila mas abala sa pagprotekta sa ipon nito kaysa pagprotekta sa buhay ng mga tao.

Ngunit walang mas malinaw na nagpapakita ng kalupitan ng isang sistemang naligaw ng landas kaysa kuwentong ibinahagi ni Maria Lourdes Sulit sa Facebook matapos mawala ang asawa — si Marvin.

Isa itong nakalulungkot na pag-aaral ng kaso ng isang ordinaryong pamilyang Filipino na natuklasang walang garantiya ang dalawampu’t limang taong tapat na paghuhulog sa PhilHealth kapag tinamaan ng isang nakamamatay na medikal na emerhensiya.

Sa halip na ibuod ang dalamhati ni Gng. Sulit, hinahayaan ng Firing Line na magsalita ang kanyang sariling mga salita:

“On June 4, 2026, my husband, Marvin, died from a brain hematoma.

“We became part of the unfortunate families forced to choose between life and death because we simply did not have millions of pesos for a life-saving operation.

“Initially, we were told that the surgery would cost around ₱4 million at #ManilaDoctorsHospital Hospital. We were then advised by his attending Nuero Surgeon that if we don’t have that amount we can transfer Marvin to #UERM to reduce the cost by almost ₱2 million. Desperate to save him, I agreed to that option.

“However, before #UERM could admit him, we were informed that a ₱1 million deposit was required. With time running out and no way to raise that amount immediately, we had no choice but to wait for Marvin to die. It was heartbreaking and devastating. We are an ordinary family living only from #HandToMouth.

“At 12:29 AM on June 4, Marvin passed away, he was admitted at around 5:59 am.

“A few hours later after Marvin was brought to the morgue, I went to the billing section at around 6:00 AM to request a copy of our hospital bill. In less than 24 hours, the charges had already reached approximately ₱200,000. I then went to #PhilHealth hoping to receive assistance and reduce the burden of the bill.

“To my shock, I was told that my husband was not eligible for #PhilHealth benefits because he had been hospitalized for less than 24 hours. My husband had just died. How could he not be eligible?

“Even the #ResuscitationPackage was denied because it was claimed that we did not authorize resuscitation (ambubag was present in the bill). But how could resuscitation save him when the surgery he urgently needed was never performed? What was the point of reviving him only for him to suffer and die again without access to the treatment that could have helped him?

“Dear #PhilHealth, I was only asking for the benefits that my husband spent more than 25 years contributing to. He was a lifelong member. He paid faithfully throughout his working years. The hospital denied him treatment because we could not immediately produce the required amount. Then, after his death, #PhilHealth denied him benefits because he had been confined for less than 24 hours.

“When I sought consideration and raised my concerns, I was repeatedly told that the policy was based on a #PhilHealth circular that had to be followed or else #ManilaDoctors cannot collect from #PhilHealth. It was money all along.”

Kung ang sagot sa isang nagdadalamhating biyuda ay isang circular, marahil ang dapat nang mawala ay ang circular na iyon—hindi ang mga karapatan ng mga miyembrong ilang dekadang naghulog sa sistema.

Napakasimple ngunit napakalalim ng panawagan ni Gng. Sulit, at mahirap itong balewalain: Kung hindi kayang burahin ng kamatayan ang mga obligasyon ng pagiging miyembro, hindi rin dapat burahin ng kamatayan ang mga benepisyong kaakibat nito.

Kung hindi, milyon-milyong Filipino ang nagbabayad hindi para sa segurong pangkalusugan mula sa pamahalaan, kundi para lamang sa ilusyon nito.

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