Senator Pia Cayetano has criticized PhilHealth for its plan to cover just 18% of hospital costs by 2025, calling the target a “joke” that contradicts the goals of the Universal Health Care (UHC) Law, which aims to provide comprehensive health coverage to all Filipinos.

During a recent Supreme Court hearing on PhilHealth’s excess funds, Associate Justice Jhosep Lopez questioned PhilHealth Senior Vice President Renato Limsiaco about their coverage goals. Limsiaco confirmed the agency’s plan to cover 18% of hospitalization costs by 2025, with a target of 28% by 2028.

Cayetano expressed disbelief, questioning how such limited coverage could help Filipino families, especially those with lower incomes. She pointed out that between 2014 and 2024, PhilHealth received over P534 billion from sin taxes, raising further doubts about its ability to cover just 18% of hospital costs.

“How do you expect the poor, even the middle class, to afford healthcare when PhilHealth only plans to cover 18%?” she asked. “People are already struggling to make ends meet. What more when they face unexpected illness?”

She cited examples of how inadequate PhilHealth coverage can be. “Mismong si Justice Lopez, ginawa niyang halimbawa ang sarili niya. Sa sakit niya, inabot siya ng P7 million. Ang sinalo lang ni PhilHealth ay nasa 2 percent,” according to her.

“Another example. May nanay na pumunta sa opisina namin at humingi ng tulong dahil ang baby niyang three months old ay nagkasakit ng pneumonia, nasa ospital. Ang bill nila ay P1 million. Alam niyo kung magkano ang tinulong ng PhilHealth? P25,000. Even assuming na hindi inabot ng P1 million ang bill, kung P100,000 lang. Saan kukuha si nanay ng P75,000?”

Cayetano, who chaired the Senate Committee on Health for nine years, said, “”We can have a thousand hearings, but if PhilHealth doesn’t have the common sense to understand that we must aim for the least out-of-pocket expense for patients, then all these discussions are useless.”

She called on PhilHealth to reassess its coverage targets and ensure that all Filipinos, regardless of income, can access healthcare without financial hardship.IMT