This week the Senate has been holding hearings about alleged corruption within PhilHealth. Many things have come to light such as the existence of a "mafia" which has been stealing billions from the taxpayers. These mafiosi have even been named.
https://www.cnnphilippines.com/news/2019/8/14/PhilHealth-mafia-members.html |
A former official of the Philippine Health Insurance Corp. (PhilHealth) on Wednesday bared the names of the members of the alleged “mafia” in the state health insurer.
On the prodding of Senate Minority Leader Franklin Drilon during a Senate probe on purported anomalies in the agency, former PhilHealth board member Roberto Salvador named five regional vice presidents and a sacked regional vice president as alleged members of the supposed mafia:
PhilHealth Vice President for Region IV-B Paolo Johann PerezPhilHealth Vice President for Region VII William ChavezPhilHealth Vice President for Region X Masiding Alonto Jr.PhilHealth Vice President for Region XII Dennis AdrePhilHealth Vice President for ARMM Khaliquzzaman MacabatoFormer PhilHealth Vice President for Region XII Miriam Grace Pamonag
PhilHealth President Morales vowed before the Senate that he would dismantle this mafia.Salvador also alleged that PhilHealth’s assistant corporate secretary, Valerie Hollero, and its legal officer, Jelbert Calicto, are part of the group, dubbed as the “Mindanao bloc.”
https://news.abs-cbn.com/news/08/26/19/philhealth-chief-vows-to-dismantle-mafia |
The head of the Philippine Health Insurance Corporation vowed Monday to "dismantle" the alleged "mafia" within the state-run health insurance firm.
PhilHealth President Ricardo Morales said executives tagged as "mafia" members have already been reshuffled and an internal investigation is also underway.
"If there is a mafia, I will dismantle that mafia. That is one of my initiatives," Morales told ANC's Headstart.
If you haven't noticed both of those articles are from last year!
What is happening in the Senate now is a repetition of an unending cycle of allegations, investigations, suspensions, everyone forgetting as time passes, and business as usual stealing billions in PhilHealth. Contrary to Morales' vow to dismantle the PhilHealth mafia every person named is STILL listed as an Executive Officer on PhilHealth's website. The mafia was never dismantled and a year later we read the following:
What is happening in the Senate now is a repetition of an unending cycle of allegations, investigations, suspensions, everyone forgetting as time passes, and business as usual stealing billions in PhilHealth. Contrary to Morales' vow to dismantle the PhilHealth mafia every person named is STILL listed as an Executive Officer on PhilHealth's website. The mafia was never dismantled and a year later we read the following:
https://newsinfo.inquirer.net/1320271/morales-tags-2-mindanao-philhealth-execs-having-inordinate-influence-within-agency-i-cant-move-them |
The two executives have “inordinate influence” and “dictate” how the agency is run, according to Morales.
Sen. Risa Hontiveros asked Morales if he could identify the officials
“At least two ma’am: Alonto and Macabato because I could not move them,” Morales said.
Is there a mafia or not? Who is in it? How are they able to continue to defraud the nation? Those are questions I am not going to answer. It appears not even those making the accusations can give a definite answer.
Obviously there is corruption happening within PhilHealth and it has been this way since 1995 when PhilHealth was founded. Those perpetrating the corruption are not just insiders but also doctors and hospitals. From 2011 we read:
https://web.archive.org/web/20111016070511/http://asiancorrespondent.com/55816/bogus-claims-haunt-philhealth/ |
For many years you’ve been paying your Philhealth dues, and so has your company. But that money may have been misused to finance bankrupt hospitals and fatten doctors’ salaries.
As early as four years ago, a scandal hit the Philippine Health Insurance Corp., which confirmed allegations that some private hospitals and doctors have been defrauding the state-run health insurer.
In her testimony before a 2007 congressional hearing, Dr. Madeleine Valera, Philhealth vice president for health finance policy, said that since 1995, Philhealth had lost as much as P4 billion due to fraudulent claims.
The anecdotes behind these claims are both tragic and true. In Iloilo, one eye doctor claimed to have performed 2, 071 eye surgeries in one year, for a total of P16 million in professional fees that he collected from Philhealth in 2006. When a Philhealth inspection team visited a hospital in Davao City, it caught janitors in hospital beds pretending to be Philhealth-accredited patients.
Today, various estimates show that Philhealth is still losing up to P500 million annually due to bogus claims. This amount can already cover additional 500,000 indigent families under a sponsored program scheme.
The continued abuse of the funds is also behind the limited coverage for new entrants to the labor force, since a new employee will have to contribute for at least nine months within the year of confinement before he or she could be entitled to benefits.
The problem persists because of government’s failure to prosecute any of the players involved in the scam.
While some hospitals, such as the Our Lady of Mercy Specialty Hospital in Bacolod and the General Santos Doctors Hospital in General Santos City, had been fined or suspended, the truth is no one has been jailed for the crime. Weighed down by manpower problems and lack of political will, Philhealth could only implement stop-gap measures to stop the bleeding, such as random inspections and a stricter evaluation of claims.
Lack of political will and only implementing stop-gap measures to stop the bleeding rather then aggressive prosecuting those who commit fraud. Why not? Could it be because some PhilHealth executives are colluding with doctors and hospitals to commit fraud? The DOJ says that is exactly the case.
https://newsinfo.inquirer.net/1322072/2-resource-persons-reveal-fraudulent-schemes-inside-philhealth-by-its-employees-in-collusion-with-doctors-banks |
“The individuals (who requested anonymity) informed the Task Force of the different fraudulent schemes allegedly employed through the years by PhilHealth officers and employees, both at its main office and regional offices, in collusion with some doctors and hospitals, and even banks which act as remittance centers,” DOJ Undersecretary and spokesman Markk Perete said in a statement on Saturday.
Such schemes include the payment of false or fraudulent claims against PhilHealth, the malversation of premiums, as well as the exploitation of “some unscrupulous personalities” of the case rate system and the interim reimbursement mechanism, among others.
The resource persons, Perete added, also exposed the “abuses and flaws” in PhilHealth’s legal department and information technology (IT) office which allegedly made the proliferation of the schemes possible.
Enter Duterte in 2016 and his strong political will. Surely he will not allow corruption to flourish within PhilHealth. So said former PhilHealth President Roy Ferrer.
https://www.philhealth.gov.ph/news/2019/no_mafia.php#gsc.tab=0 |
"No mafia can survive in the Philippine Health Insurance Corporation (PhilHealth) under the watch of Philippine President Rodrigo Roa Duterte." Thus declared PhilHealth acting president and CEO Dr. Roy Ferrer, laughing off the imagined fears of a former PhilHealth staff working with the past administration.
Dr. Ferrer scored a certain Minguita Padilla, erstwhile head executive staff of a former Health Secretary under the government of former President Benigno Simeon C. Aquino. "The loser's mind and defeatist attitude of Ms. Padilla cite ‘a culture of fear' in PhilHealth, but that was the PhilHealth of the past," Ferrer pointed out, "and such fear and trembling no longer exist in the present PhilHealth and under the strong government of President Duterte."
In a fast-breaking development, President Duterte was quoted by a television network saying, "I do not have the slightest doubt on the integrity and honesty of PhilHealth President Roy Ferrer," in the midst of this controversy particularly related to the wrongdoing of a health center that had abused and misused PhilHealth benefits.
"Ms. Padilla, who served a former Health Secretary (who figured prominently in the Dengvaxia mess), harks back to a weak-kneed and feeble government before the robust Presidency of my Boss, Rody Duterte," Ferrer said. "So when Ms Padilla spoke about the impotence and helplessness of the earlier PhilHealth leadership, she is referring to a thing of the past," Ferrer added.
Acting PhilHealth President Ferrer said that the present PhilHealth Board members were appointed by President Duterte, and our President's principled stand and courageous stance have rubbed off on every Board member and, added Ferrer, "No members shrinks from the challenge to cleanse PhilHealth of shenanigans.
"Our top management executives who are directly under me are loyal to the higher ground principles and policies of a PhilHealth, and no villainous mafia member can survive within their ranks," Ferrer emphasized.
This statement reads like a bad joke in the light of all the corruption which continues to come to light. Roy Ferrer himself was accused of corruption and forced to resign in order to give PhilHealth a clean slate and new start!
https://www.pna.gov.ph/articles/1071990 |
He said that although Duterte still believes in the integrity of PhilHealth Acting President and Chief Executive Officer Roy Ferrer and members of the Board, he felt that their resignation would give the state-run social health insurance firm a clean slate.
“While the Chief Executive reiterated his trust to - and has no doubt about - the integrity of PhilHealth Acting President and CEO Dr. Roy Ferrer, as well as the members of the board, he however demanded for their courtesy resignation in order for the corporation to have a clean slate absent any taint of irregularity in rendering services as well as implementing pertinent policies on health, including the Universal Health Care Act,” Panelo said in a statement.
Funny that Duterte demanded Ferrer's resignation while all the executives named as part of the mafia remain in their positions at PhilHealth. Also funny that Ferrer, along with several others tagged in the WellMed dialysis center scandal, are back in their positions of power as if nothing happened. Ferrer was appointed as Assistant Secretary of the DOH.
http://archive.is/KwFKR |
The former acting President of Philippine Health Insurance Corporation (PhilHealth) was appointed by President Rodrigo Duterte as one of the assistant secretaries of the Department of Health (DOH).
Roy Ferrer was included in the list of presidential appointees released on Monday.
He, along with other PhilHealth board members, was asked by Duterte to submit his courtesy resignation in June 2019, in the wake of alleged fraudulent insurance claims involving nonexistent kidney treatments.
Ferrer was asked to resign due to command responsibility. Duterte, however, vouched for his integrity and honesty.
Four others who were charged in the scam but not forced to resign were recently given promotions.
https://cebudailynews.inquirer.net/319717/4-officials-tagged-in-alleged-philhealth-scam-get-promotion |
At least four officials of Philippine Health Insurance Corp. (PhilHealth) were promoted less than a year after being implicated in the WellMed dialysis scam, according to a document obtained by the Inquirer on Friday.
Based on PhilHealth Corporate Memorandum No. 2020-0037, Cheryl Peña, Dr. Rizza Majella Herrera, Dr. Bernadette Lico and lawyer Recto Panti were promoted to department manager III on May 18. Their promotion, along with four other officials, was approved by the state insurance firm’s board of directors on May 14.
All this is to say that the cycle continues at PhilHealth. Allegations, charges, nothing. And that is how it has been for 25 years! Again from 2011:
https://web.archive.org/web/20111009083140/http://asiancorrespondent.com/55886/philippines-how-to-cure-philhealth’s-woes/ |
Philhealth officials in Region 12 said their conviction rate in administrative complaints has been minimal compared to the volume of cases that they have investigated. Not a single criminal case has been filed against any health care provider in the region or any of the doctors involved in fraudulent claims.
Connections with the powerful, lack of witnesses, safety concerns, and conniving Philhealth officers—all these contribute to the continued plundering of Philhealth.
Philhealth officials in Region 12 said their conviction rate in administrative complaints has been minimal compared to the volume of cases that they have investigated. Not a single criminal case has been filed against any health care provider in the region or any of the doctors involved in fraudulent claims.
That article goes more in depth into some of the problems within PhilHealth. The corruption runs deep and there are many and various reasons. From political intervention to lack of manpower there are many things wrong with PhilHealth and contrary to the PACC six months will not be enough to fix 25 years of corruption.
https://newsinfo.inquirer.net/1320572/only-6-months-needed-to-rid-philhealth-of-corruption-pacc-commissioner |
(That is possible. I don’t believe it cannot be done in six months. You put the right system, the right people, and do the right thing, in six months it will be improved.)
Belgica reiterated that some government and private institutions have been offering their information technology solutions to PhilHealth for free, even as PhilHealth seeks a proposed P2.1-billion IT project to stem fraud and scams devised by some corrupt personnel.
(They should use the IT solutions being offered for free and the IT system will be cleansed. There will be a validation mechanism, and there will be no upcasing, fake documents, and fake claims. In six months, they can fix that at no expense.)
The anti-corruption official made this remark after PhilHealth president and chief executive officer Ricardo Morales admitted during a Senate hearing Tuesday that “fraud has always been in the system as it has always been in all similar health systems in the world.”
Morales added that the problem in PhilHealth can take at least three years to solve.
Six months, three years, new IT system, fire all the corrupt executives, it all seems so simple but it's not. At this late date PhilHealth is an unwieldily monster. It is out of control. And this is the bureaucracy tasked with implementing universal healthcare!
Strangely enough some actually put faith in the government to investigate this mess. As if their investigations will bear any fruit and end in prosecutions and jail time.
Joke's on this guy! The cycle of corruption at PhilHealth will continue. How many government bodies need to be investigating PhilHealth anyway?
Strangely enough some actually put faith in the government to investigate this mess. As if their investigations will bear any fruit and end in prosecutions and jail time.
https://twitter.com/iskonglasalista/status/1293141697111527424 |