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PhilHealth taking over OWWA Medicare
    Last Nov. 6, the Overseas Workers Welfare Administration (OWWA) launched its outpatient clinic at the lobby of the Philippine Overseas Employment Adminis-tration (POEA) building in Mandaluyong City. The clinic, which is the second of its kind, is OWWA’s way of enhancing its health care services for OFWs and their dependents. It is also OWWA’s pamasko for OFWs.
    OWWA Deputy Administrator and Medicare Manager Delmer R. Cruz, who led the launching ceremony, also disclosed that the agency would open up similar clinics in Cebu and Davao in January 2003. But sooner or later, these clinics may no longer be under OWWA but under the Philippine Health Insurance Corp. (PhilHealth), a government corporation administering the government’s medical care program for all Filipinos. PhilHealth is taking over the function of providing health and medical service to OFWs from OWWA by virtue of its mandate. But OWWA wants to keep the function.
    “We made a comparative matrix of the package of benefits under PhilHealth and OWWA Medicare.
OWWA Deputy Administrator and Medicare Manager Delmer R. Cruz samples the service of Dr. Remy Magno-Tahil, head of the OWWA outpatient clinic at the lobby of the POEA headquarters. MedTech Elma Ligason and RadTech Vic Jumarang look on.
The matrix indicated that mas superior ang package of benefits and services ng OWWA Medicare,” said Cruz, citing one of the reasons OFW Medicare should be retained under OWWA. Cruz cited other advantages of the OWWA Medicare.
    Members of the OWWA Medicare and their dependents may start availing of health and medical benefits immediately after paying the P900 annual premium.
    In contrast, availing PhilHealth benefits is subject to a three-month waiting period. PhilHealth members pay three regular monthly premiums of P100 within six months prior to availment of benefits. The annual premium in PhilHealth is P1,200 or P300 per quarter
    OWWA Medicare also gives a 200% increase in benefits for catastrophic cases such as injury from accident and sickness.
Aside from superior benefits and services, Cruz noted that with the presence of OWWA in countries where there is a heavy concentration of OFWs, collection of membership contributions and availments of medical benefits can be done with dispatch. OWWA’s computer system, which is already in place, facilitates the provision of Medicare services to OFWs.
    PhilHealth had invoked its mandate under Republic Act 7875 or the National Health Insurance Act of 1995 to justify its takeover of the OWWA Medicare. RA 7875 provides for universal and compulsory health insurance coverage of all Filipinos.
    “Tama ‘yon, dapat ma-cover lahat ng Pilipino. Pero di nangangahulugan na isang entity lang ang magko-cover. Pwedeng ibang agency,” Cruz said.
    It is also OWWA’s position that PhilHealth covers only indigent Filipinos or those who cannot afford such health services.
Cruz added that RA 7875 has not expressly repealed Executive Order 95, which creates the OWWA Medicare and authorizes OWWA to collect, administer and disburse the funds of its Medical Care Program for OFWs and their dependents.
    In its position paper recommending the retention by OWWA of the administration of the Medical Care Program Fund for OFWs, the agency cited that RA 7875 and EO 95 are not inconsistent with each other and can co-exist together.
    OWWA added that RA 7875 did not expressly provide for the transfer of the Medical Care Program Fund for OFWs to PhilHealth.
For its part, PhilHealth promised OFWs and their dependents that they will enjoy the same Medicare benefits as what they are currently getting from OWWA after the transfer.
    “Nananawagan kami sa mga OFW na wala silang dapat ipangamba. Sisiguraduhin namin sa PhilHealth na ang mga natatangagap nila sa OWWA ay pareho din na matatanggap nila sa PhilHealth,” declared Dr. Francisco T. Duque III, president and CEO of PhilHealth, over the radio program Radyo OFW aired over DZMM every Sunday.
    “We will maintain the current hospitalization and out-patient benefits that OFWs are currently enjoying under OWWA, including the contribution rate,” said Duque.
    He also cited an advantage of PhilHealth over OWWA Medicare.
“Ang lamang namin sa OWWA Medicare ay ang mga OFW na naging member ng PhilHealth, pag naabot nila ang retirement age, magiging lifetime member sila. Di na nila kailangang magbayad pa pero tuloy-tuloy ang kanilang benepisyo,” Duque told Radyo OFW host Rod Hizon.
    Under PhilHealth rules, any OFWs who retire at the age of 60 and have 120 monthly contributions can qualify under PhilHealth’s Non-Paying Program and enjoy Medicare benefits for life without having to pay any contribution.
    The earlier an OFW becomes a member of PhilHealth, the more they are assured of qualifying in the non-paying program, said Duque.
OFWs who eventually return for good in the country can continue their Medicare coverage through PhilHealth’s Individually Paying Program.
    While it may not have offices abroad, PhilHealth has 16 regional offices and 71 service offices nationwide with 1,512 accredited hospitals, 289 rural health units and 17,555 doctors all over the Philippines.
    As of September 30, 2002, PhilHealth covers at least 40 million beneficiaries, six million of whom are individual payees. Some 20 million are workers, five million are indigents and almost 30,000 are non-paying members.
    Duque assured that PhilHealth would properly main tain the P3 billion worth of Medicare contributions of OFWs to OWWA.
“Maganda ang aming pamamalakad sa PhilHealth. Ang President ng Pilipinas mismo ang nagsasabi na isa sa mga top performing agencies ang PhilHealth sa taong ito. Maganda ang aming ginagawa,” he said.
“Di namin papayagan na magamit ang pondo ng PhilHealth sa iba. Hahanap pa tayo ng paraan para mas mapaganda ang serbiosyo natin sa mga OFWs,” he added.
    Congress wants to make sure that the transfer of the OWWA Medicare to PhilHealth will be for the best interest of OFWs. Sen. Loren Legarda Leviste, the Senate Committee on Labor had set an inquiry on the transfer after OWWA said such move would be detrimental to the welfare of OFWs.
    While the Senate may have a say on the issue, an OWWA official believes that the President can have her way by just signing an order. But if there is anyone who must decide on this matter, it should be the OFWs themselves because it is their money anyway.
Sound fund

    OWWA Medicare Manager Delmer R. Cruz said that the OWWA Medicare finances stand on very solid footing. “It can even further enhance the Medicare package for OFWs,” he said.
    The fund’s projected net worth by yearend of 2002 is approximately P3 billion, proof that the money is in good hands under OWWA.
    The accumulated fund balance within a span of only seven years was brought about by the sustained high revenue generation capacity of the system. Revenues generated by the Medical Program increased from P339.87 million in 1995 to P714.56 million in 2001 posting an average annual increase of 18%.
    The OWWA Medicare revenue exhibited an increasing trend from 1995 to 1998, remained relatively stable for the next two years and bounced back in

2001 attaining the highest annual increase of 25.6 %. The total revenue generated amounted to P3.57 billion in seven years or average annual revenue of P509.89 million.
    The collected premiums accounted for 72% of rev enue while investment income contributed 28%.
    The total expenses increased from P19.85 million in 1995 to P261.01 million in 2001 or an average annual expenditure of P117.17 million. About 70% of the total expenses went to direct benefits and services to members. This percentage accounted for only 23% of the total revenue generated.
    The efficiency of the OWWA Medicare program operation is clearly shown by the small proportion (7%) of the operating costs to revenue generated.
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