- - One of the sure-fire ways to ensure sustainability is if PhilHealth successfully delivers the programs and services under the UHCL. This will ensure continued support from the national government and also from the population. Off topic question: Is chemotherapy and dialysis sessions truly free? The agency pays several sessions before a member pays the rest. Dialysis – maximum of 90 sessions before member pays Chemotherapy – It will depend on the cycle Cancer – Z benefit packages (depending on type of cancer) Stroke/Infarction – there are benefit packages available as well. Coronary Artery Bypass Graft (CABG) procedures are also available but with very few hospitals that accept PhilHealth’s price of 500,000 PHP 4. What are the challenges that the agency faces in the realization of its mandates? - Proper coordination with other agencies and LGUs, especially in implementation of programs. - Very few health professionals are willing to be placed in GIDAs and so this impacts the accessibility and availability of the programs. - There are also several issues on the truthfulness of some hospitals in declaring their PhilHealth claims, and sometimes even members are part of this “modus” - There is also this issue about the concept of social solidarity and social justice and why some contributing members gripe about high premiums while there are noncontributing members who don’t pay anything while still enjoying benefits. a. Do you have data on compliant and delinquent remitters? - Yes, they do, but it comprises only a small number, mostly coming from contract agencies. (data to follow) 5. What are the upcoming plans of PhilHealth with respect to policy and program development? - The Social Health Insurance Academy is a department in PhilHealth that creates modules that will teach community leaders to be force multipliers for PhilHealth. These people will reach out to their community on the importance of health insurance. They are currently developing modules for indigenous peoples, barangay health workers, senior citizens, etc. They have plans to develop easy to understand modules of mostly pictograms, which is very useful especially for those with issues of illiteracy. - They also have plans to institutionalize CBD programs which will generate even more reach for their programs. - We will be working with private health insurance companies and HMOs, on introducing a tier system of care and where will PhilHealth be situated in the tier. This is a streamlining of services where each level of care is complimenting of each other. a. Is the agency exploring providing safety net responses that address the effects of shocks? (natural and human induced disaster, economic shocks, etc.) - The agency has always been doing some quick response programs, for example, during Typhoon Yolanda, everyone who became sick or was hospitalized was subsidized by PhilHealth. This has been institutionalized, so whenever a state of calamity is raised in an area, anyone who is hospitalized or become sick due to it will be covered by PhilHealth. 63