MY 85-YEAR-OLD mother, who has asthma and lupus, was just discharged from the hospital last Friday after being treated for pneumonia. When I was processing her clearance, there was a step I first had to take — answer a questionnaire about our PhilHealth experience during confinement.
I tried really hard not to express my agitation and despair. On a scale of one to five, with five being the highest, how would you rate PhilHealth services? My true answer is more complicated than a scale of numbers. I have so many feelings and thoughts about our country’s social health insurance program and how it is currently implemented. And the news of PhilHealth’s zero-subsidy in 2025 is making me extremely anxious.
Because I was in a hurry to get out of the hospital, I answered 3. When the interviewer asked why, instead of citing a long list of reasons, I just said: “It could be better, give more benefits.” The interviewer smiled, visibly relieved by my diplomatic answer. I call it the spirit of Christmas.
My mom is retired so she is living off her pension, which is barely enough to cover her monthly needs. She lives with me, her only child. She is a widow so I am all she’s got. I am not yet a senior citizen but I have been semi-retired since I was 40. I just do consulting and volunteer work now so I can have flexibility since I am a full-time caregiver of two loved ones. With that flexibility of time comes flexibility of income. Sometimes there is, sometimes there isn’t.
Our unique situation means we need government assistance from time to time, especially when one of us needs to be hospitalized (and there were times when all of us were sick at the same time). So even if we do not fit the profile of what the government considers “indigent,” our income is not enough to cover hospital bills.
I have worked in government for many years and dedicated my prime productive years to public service so I know how to navigate the bureaucracy. But the system for accessing government assistance is honestly very challenging even for a veteran in government like me.
First of all, they keep changing the rules. I do this almost twice a year and the rules are never the same. The annoying part of it is they change the rules after every major scam or scandal involving violations of the system is exposed.
They changed the rules and made the process more complicated because of the few people who were caught violating them. Meanwhile, the majority of the people who followed the old rules have to suffer the consequences of additional new rules. Is this really the only way to respond to system breaches — make things harder for everyone?
Processing government assistance takes quite a long time. Even when you start reasonably early in the patient’s confinement. This is because you need to comply with several documentary requirements.
First, there is the barangay certification that proves you are a resident (and a legitimate voter of the politician who will endorse your subsidy to DSWD, but that’s just my guess) of this country eligible for support from public funds. We are fortunate to belong to a barangay that is responsive and has a good system in place for things like this. It always takes me only a few minutes to secure this requirement. Shout out to Barangay Ma-a, Davao City!
Then, if the assistance you need is quite substantial, you need to go to the hospital’s social worker and ask to be registered for the Medical Assistance for Indigent and Financially Incapacitated Patients (MAIFIP) program under the Department of Health (DOH). There is a different set of requirements for that, too, depending on your life situation.
You have to attach an original copy of the hospital bill duly signed by the billing manager and an original medical certificate or medical abstract or certificate of confinement signed by your attending physician with his/her professional license number indicated.
The above requirements are kind of tricky to comply with early. The government requires a copy of the final hospital bill with the senior or PWD discount and PhilHealth deductions already reflected. That can be provided only at the time when the doctor has given the discharge order, meaning on the very day you are expected to settle your bill. Same thing with the medical certificate. The hospital issues that on the day when the patient is discharged.
And here is the fun part. If you are going to ask for assistance from various government sources like your congressional district representative, your party-list representative, your favorite senator, or your local government chief executive, you will need different sets of supporting documents for each request. You will also run from one office to another, line up in each one, and hope you do not get cut off and asked to return the next day. You better pray your day of discharge does not fall on a weekend.
Since my mother’s day of discharge was Friday the 13th — payday (could not relate, haha), Christmas parties, holiday rush, traffic, name all the challenges you can think of — I knew it would be impossible to get the government guarantee letter in time, even with a lot of help from our friends in high places.
We had three choices — (a) pay the full amount indicated on the final bill (and incur debts throughout the new year) or (b) extend the hospital stay until Monday and add to the already growing hospital bill or (c) sign a promissory note with the hospital.
Letter C was our best option. But that also entailed a new set of requirements that included a Notary Public and a post-dated check that we did not have but were able to borrow. Yes, the Christmas spirit is alive and well, thank God.
I am sharing our story not only because it is a good Christmas story — my mother overcoming another hospitalization in time to celebrate her 85th birthday on December 23, the eve of Christmas Eve, and her only daughter surviving yet another round of accessing government assistance and benefitting from the kindness and generosity of family, friends, and even strangers.
I am sharing our story to show that our current system is not designed for the poor Filipinos who do not have influential friends and expert navigators of the government bureaucracy. And we need to do a lot better than asking our citizens to answer PhilHealth questionnaires rating its service by indicating a number from one to five. It is an essay question, Mr. Chair, not answerable by “yes” or “no” or by simply picking a number. Our healthcare system is so broken it requires a very long answer.
But my short answer is let’s seriously overhaul our healthcare system with equity, equality, justice, and human rights embedded in our structures, processes, and institutions. We can’t all survive on Christmas spirit alone.
