- - - b. sector who would only access PhilHealth at the time of need. If they pass the DSWD means-test, they would also be included in the 4P’s program immediately the year after. They decided to implement this program when coverage was still at 92% to cope with the difficulty of covering informal sector. She added that they focused the program for this sector because other sectors were already being taken care of. (poor/indigents thru the NHTS, older persons thru the expanded national health insurance program, the formal sector thru their employers) They offered coverage as well for women about to give birth even if they have not yet updated their payments at the time of childbirth, by allowing them to pay an updated 1year payment at the time of childbirth. This was included in the Millennium Development Goals. All households targeted under the NHTS program are also beneficiaries of PhilHealth. (14 million under NHTS) Is there data available on coverage of members from inherently disadvantaged and marginalized sectors? (i.e. women, persons with disabilities, indigenous peoples, older persons) and groups facing economic risks? (i.e. overseas Filipinos and their families, workers in the informal sector, indigents) - Only indigenous peoples have lacking data, but they have a partnership with NCIP in order to provide identification for our indigenous peoples so that PhilHealth can record them in the database and provide access to services. - They do have data, which is broken down to the sectors, but they do have difficulty with OFW’s which are undocumented. (data to follow) - They are part of the PDOS, PEOS, and PAOS program of POEA and OWWA so that most documented migrant workers are already members of PhilHealth - They also institutionalized coverage for Barangay Health Workers, LGU volunteers. - They also pushed for creating a unified allowance for health workers. - She goes on to detail the difficulties with the CCT program of the NHTS wherein some beneficiaries have a hard time to access benefits and there are also political issues especially with the 4Ps (i.e. households who have cement houses should not receive benefits, even the mayor sometimes receives cash transfers) - The DSWD sends them a list of NHTS targeted household every year but this list is only updated once every 3 years so every year PhilHealth receives the same list even though they have “cleaned” it. - The remaining 2% of lacking coverage probably belong to IPs, workers in the informal sector. - There is data available on number of beneficiaries versus amount of payout to beneficiaries (to follow) - Amount of benefit payments do exceed amount of collection. It is said that PhilHealth pays out benefits at the rate of 3 Billion PHP per week, their collections are 400 million lower than the benefit payments as of last year. - They are still working on the IRR of the UHCL especially when it comes to update of payments from contributing members. She reiterates that for contributing members, they can still use PhilHealth even without updated payments, but it does not mean that they will not pay. - The benefits are commensurate with the amount of premium paid. She does add that of the sectors, older persons comprise the biggest chunk of benefit payments. 59