- 6/23/2025
Panayam kay Dr. Israel Francis Pargas, Senior Vice President ng Health Holicy Sector, PhilHealth kaugnay sa expanded benefits for chronic kidney diseases at datos ng dialysis claims
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NewsTranscript
00:00Expanded Benefits for Chronic Kidney Disease at Datos ng Dialysis Claims
00:05ating pag-uusapan kasama si Dr. Israel Francis Pargas,
00:10Senior Vice President ng Health Finance Policy Sector ng PhilHealth.
00:14Doc Ish, magandang tanghali po.
00:16Magandang tanghali po, Asik Quengen, Asik Joey.
00:18Magandang tanghali din po sa lahat ng ating tagapanood.
00:21Doc Ish, mula sa Expanded Benefits para sa mga pasyente ng PhilHealth
00:27na may problema sa kidney, pinalawak na ang hemodialysis sessions na dating 90 lamang
00:33at ngayon ay nasa 156 sessions na kada taon.
00:37Anong po ang layunin at epekto nito sa mga pasyente ng nangangailangan ng dialysis?
00:43Well, unang-una po ay dahil napakataas na ng porsyento ng mga tao o ng Pilipino
00:48na meron pong tinatawag na chronic kidney disease
00:51or yung tinatawag na end-stage renal diseases.
00:55At nangangailangan nito ng gamutan, unang-una either through dialysis,
01:00hemodialysis, peritoneal dialysis,
01:03or yung pong talagang treatment para sa kanya is the kidney transplant.
01:07Now, for the hemodialysis po, we expanded our benefit.
01:12Sabi nyo nga, covering 90 sessions dati.
01:15Ngayon, 156 sessions na po.
01:17At yan ay para sa buong taon na.
01:19Because ang maximum dialysis po natin is 3 times a week.
01:23And then, meron tayong 52 weeks in a year.
01:26So, 156 sessions na, buong taon na.
01:29And we also increased our benefit from 2,600 pesos per session
01:35to 6,350 pesos per session na.
01:39So, ngayon po, umaabot ng halos isang milyon na yung beneficyo natin para sa hemodialysis.
01:45Sa hemodialysis pa lamang yun.
01:47But we also expanded our benefits for peritoneal dialysis
01:52and, of course, our kidney transplantation.
01:55Yung 3 times a week, yan po ang standard, no?
01:58Yes.
01:59Actually, meron pong pwedeng twice a week.
02:02Pero ang maximum po is 3 times a week.
02:05So, ito pong peritoneal dialysis na aabot na ng 1.2 million pesos.
02:10Paano po ito naiba sa hemodialysis at sino po yung pwedeng mag-avail nito?
02:14So, yun pong hemodialysis, yan po yung dialysis, yung paglilinis ng ating dugo
02:19na gumagamit po ng machine.
02:21Yun naman pong peritoneal dialysis, ito po ay merong catheter na inilalagay
02:26dun sa ating chan, ipinapasok sa ating chan.
02:29Tapos, dun po pinapadaan yung dialysate solution.
02:33At ito po ay pwedeng gawin ng mismong pasyente.
02:36Kahit sa bahay, sa opisina, at any time of the day, pwede po niyang gawin yun.
02:42So, yun pong hemodialysis naman, yun ay through the machine at ito ay pinapadaan sa dugo.
02:48Tapos, yun pong ating dialysis ng peritoneal ngayon,
02:51para po sa ating mga adults, adult patients,
02:56ito po ay umaabot dati from 260,000.
03:00Sorry.
03:01Ngayon po, depende sa ginagamit nating ilang bags,
03:05kasi solution siya eh.
03:06So, pwedeng 2 liter solution, pwedeng 3 bags sa isang araw,
03:10or 4 na bags, sa adult po, umaabot siya ng around 500,000 na ngayon per year.
03:16At sa mga children naman po, ay umaabot na ito ng tama kayo, mga 1.2 million pesos po.
03:23Sa datos ng PhilHealth Doc-ish, gaano karami ba yung claims sa dialysis,
03:29whether hemodialysis or peritoneal?
03:30Alam nyo, yung sa first semester of 2025,
03:36tayo po ay nakapagbayad na for hemodialysis ng around 27 billion pesos
03:43for more than 2 million claims.
03:47That's 6 months pa lang.
03:49And then for peritoneal dialysis po,
03:52tayo ay nakapagbayad na ng around 121 million for 14,000 claims.
03:59Pero for 2024,
04:03ang nabayada namin for the whole year of 2024 for hemodialysis,
04:07is around 28 billion.
04:09Pero ngayon, half of the year pa lang, 27 billion na tayo.
04:14And then for peritoneal dialysis naman ng 2024,
04:17mga around 400 plus million na nabayada natin.
04:20So, wala naman pong delay dun sa pagbabayad,
04:22kasi diba dati, yung nire-reklamo ng mga ospital,
04:25na delay magbayad ang PhilHealth,
04:27kaya na-delay din yung pag-process nila ng benefits.
04:31Well, unang-una po,
04:32ang atin naman pong beneficyo is automatic deduction.
04:36So, pag halimbawa po tayo ay madi-discharge na,
04:39automatic na siya dapat kinakaltas.
04:41Tama po kayo,
04:42nagkaroon tayo ng issue tungkol sa pagbabayad,
04:45but we are continuously improving on it.
04:47Ngayon po, ang ating national average for payment is around 23 days,
04:53na dapat ay 60 days.
04:54At ang gusto nga po ng ating Pangulo, Dr. Edwin Mercado,
04:58is mapabilis pa ito.
04:59Kung mapapababa sa 7 days,
05:01ay mapapababa po natin.
05:02So, mas mabilis na po tayo nakakapagbayad ngayon.
05:05So, Sir, ano naman po yung naging batayan ng PhilHealth
05:08para itaas yung kidney transplant coverage
05:10mula 600,000 pesos,
05:12na ngayon ay 2 million pesos na?
05:14Um, unang-una, yun pong ating pag-expand
05:18sa dalawang klaseng expansion siya.
05:21Una is on the benefit mismo,
05:24na tama nga po kayo,
05:25ngayon ay hanggang 2.1 million,
05:27kasi dahil na rin po ito sa paglaki ng gastos
05:30ng kinakailangan sa isang kidney transplant.
05:34At ang pangalawa po nating expansion is,
05:37dati ang kinokover lang natin is yung mga living donors,
05:40pero ngayon po, pati disease organ donors,
05:43kinokover na rin po natin.
05:45So, sa mga adult patients po,
05:49ang ating pasyente po ay umaabot na ng,
05:52from dati kasi 600,000 yung pinakababa.
05:56Ngayon, ang pinakababa nating pakete is 800,000,
05:59at umaabot ito sa more than 1 million sa adults,
06:03pero sa children, umaabot po ng more than 2.1 million.
06:06Under this expanded benefit package for kidney transplant doc-ish,
06:12mga ilang Pilipino ang madadagdagan
06:15in terms of yung tulong na maibibigay sa kanila?
06:18Well, basically po,
06:19kung titignan natin,
06:20from 600,000 to 800,000 pesos,
06:23that's around almost 25% increase
06:26to more than 300% increase.
06:30Tapos nga po, yun din is,
06:33yung kasing listahan ng donors,
06:36medyo mahaba yung pila
06:39para makakuha ng donor.
06:41Kaya nga po, kinilala na rin natin ngayon
06:43yung disease organ donation
06:45at kinukover na rin natin siya
06:47para mas marami yung makakakuha
06:49ng ating kidney transplantation package.
06:52So, Doc, maanin niyo po bang ipaliwanag
06:54kung paano naman po ma-avail
06:55ng isang PhilHealth member
06:57na kailangang sumailalim sa kidney transplant?
07:00Opo. Well, unang-una,
07:02gaya po ng ating
07:03Universal Healthcare Law of 2019,
07:06ang sinasabi doon is,
07:07bawat Pilipino,
07:08automatic member ng PhilHealth.
07:10And then, bawat member,
07:12dapat mayarong immediate eligibility.
07:14Pero since ang kidney transplant po
07:17is a Z-benefit package
07:19or a package for catastrophic cases,
07:22hindi rin po lahat
07:24ng ating accredited hospital
07:26ay nakakapagbigay nito.
07:28Because not hospitals naman
07:29are capable of doing transplants.
07:32So, meron po tayong mga kinokontrata
07:35na mga hospital na may kakayanan
07:37na kayo ay maggaroon ng kidney transplant.
07:41So, unang-una,
07:42dapat po ay ma-pre-authorize muna kayo
07:45ng ating mga hospital na ito.
07:47At pagka kayo po ay na-pre-authorized,
07:49pwede na po kayong ma-subject
07:51to the kidney transplant package natin.
07:53Hmm, nabanggit nyo, Doc,
07:55is yung Z-benefits package.
07:58Ito po yung unang pagkakataon mula 2012
08:00na tinaasa ng Z-benefits
08:02para sa kidney transplant.
08:04Bakit paliwanag po ang layunin ng Z-benefits
08:07at paano ito naiiba
08:08sa regular PhilHealth packages?
08:10Well, unang-una nga po,
08:11gaya ng nabanggit ko,
08:13the Z-benefits is really
08:14for the catastrophic cases.
08:16So, ito po ay nag-coover
08:17sa mga transplants,
08:19dun po sa ating mga cancer patients,
08:22ganoon din po yung mga operasyon
08:24para sa puso,
08:25yung sa mga valve surgeries,
08:28sa mga orthopedic surgeries.
08:30At ito po,
08:31ang layunin po nito is
08:33maibigay yung kabuoan
08:35ng treatment from diagnostic
08:37up to the rehabilitation
08:39ay mako-cover po ng PhilHealth
08:41yung kabuoan.
08:42Ito, Doc,
08:43nabanggit nyo kanina, no,
08:44na yung post-cadney transplant,
08:46eh, kukover na rin yung mga donors.
08:48So, ano po yung coverage nito?
08:50Opo, well,
08:51isa po sa ating expansion
08:53sa kidney transplant,
08:55ngayon po,
08:56kino-cover na natin
08:57yung post-cadney transplant.
09:00So, ito naman pong post-cadney,
09:01kasi po pag ikaw ay nagkaroon
09:03ng kidney transplantation,
09:05after po nun,
09:07habang buhay kang iinom ng gamot
09:09para po sa anti-rejection,
09:11immunosuppressants,
09:12tapos may mga laboratorio
09:14na kinakailangan gawin
09:15to monitor the function of the kidney.
09:17So, ngayon po,
09:18kinu-cover na po natin siya ngayon.
09:21At para sa mga adults,
09:23ang ating pong pakete nito
09:24on the first year
09:25is around
09:26660 plus thousand.
09:29Sa succeeding years,
09:31it will be
09:31600,000.
09:33Sa mga children naman,
09:35sa mga kabataan po,
09:37is ang ating
09:38coverage for the first year
09:40ng post-cadney
09:41is around
09:421.7 million.
09:43And then,
09:45succeeding years,
09:45around
09:46800 million na.
09:48And then,
09:49kinu-cover na rin po natin
09:51yun pong ating
09:52deceased organ
09:53ay yun pong
09:54doon naman siya natin
09:56ngayon
09:57kinu-cover
09:57sa
09:58kidney transplant
10:01package mismo.
10:02Nakasama po doon
10:03yung pag-harvest
10:04ng organ
10:06doon po sa
10:07pasyente na
10:08patay
10:10or sa
10:10deceased organ.
10:11And then,
10:13pagdating po sa
10:13post-cadney transplant,
10:15yun ang ating
10:15mga donors
10:16kasama rin po
10:18yung kanilang
10:19mga monitoring
10:20and laboratories
10:21kung kinakailangan.
10:22Doc Ish,
10:23alinsunod sa
10:24tagubili ni
10:25Pangulong Ferdinand
10:26R. Marcos Jr.,
10:27ano pa po yung
10:28mga benefits
10:29na i-increase
10:30o i-expect
10:31natin from
10:32PhilHealth this year?
10:33Well,
10:35ayon nga po
10:35sa utos
10:37ng ating
10:37Pangulo Bongbong
10:38Marcos,
10:39ay dapat
10:39ang ating
10:40mga beneficyo
10:41ay patuloy
10:41na pinapalawak.
10:43Hindi lang po
10:44ang ating beneficyo
10:44but even
10:45our
10:45serbisyo
10:47ay pinapaganda.
10:48So,
10:48sa ating pong
10:49mga
10:49nakalinya pa
10:52na
10:53mga beneficyo
10:54na ipapalawakin
10:55natin,
10:56nandiyan po
10:57yung sa
10:57cancer.
10:58Unang-una po,
10:59kami po ay
10:59nag-aaral ngayon
11:00para doon sa
11:01liver cancer
11:03natin,
11:04sa lung cancer.
11:05Ito expand
11:06also our
11:07current prostate,
11:08cervical,
11:09and ovarian
11:10cancers.
11:10and our
11:11colorectal
11:13cancer.
11:14At ang isa po
11:15sa malaking
11:16utos din
11:18ng ating
11:18Pangulo
11:19is dapat
11:19pinapalawak
11:20natin
11:21yung ating
11:22tinatawag
11:22na primary care.
11:23Kung kaya't
11:24yung ating
11:24konsulta
11:25program,
11:26yung ating
11:27tinatawag
11:27na primary care,
11:28ay unti-unti
11:29po natin
11:29pinapalawak
11:30to include
11:31more benefits
11:32for preventive
11:34and promotive.
11:35Balikan ko lang,
11:36sir,
11:36yung
11:36pag-donate
11:38ng internal organs.
11:39Paano kung
11:40kailangan pa po
11:41dyan?
11:41Nung dati kasi
11:42parang may
11:42donor's ID,
11:43di ba?
11:44So,
11:44paano kung yung mauna
11:45hindi naman alam
11:46ng kamag-anak
11:46na donor pala siya
11:48ganito,
11:49or hindi naman
11:49natin inaasahan,
11:50kunyari,
11:51nasa ospital,
11:51or na aksidente,
11:52hindi natin inaasahan
11:53na mangyayari yun,
11:54mawawala na sa isip mo
11:55na gustong
11:57i-donate
11:57nung namatay
11:58sa likod pa ng
11:59lisensya,
12:00meron pa rin ganun?
12:02Meron pa rin po,
12:03tapos meron din talaga
12:04yung parang
12:04kulay yellow
12:05na card,
12:07na organ donor,
12:08something.
12:09So,
12:10unang-una,
12:10kinoconsider po yun.
12:12Pero syempre,
12:13kinoconsider din po
12:14yung mga
12:16opinion
12:18at pagpayag
12:19nung mga naiwan.
12:21So,
12:21talagang kinukuha pa rin po
12:22yung consent nila
12:23para po
12:24doon sa pagbibigay
12:26nung mga ganitong
12:27organ
12:29para po ma-donate.
12:30So,
12:30doon po yun sa ospital?
12:31Yes.
12:32Kung sa ospital
12:32or doon sa...
12:33Sa ospital na po
12:34sya mangyayari
12:35or kasi kuminsan
12:36ang kalimitan na
12:37pinagmumula
12:38ng mga disease organ donors
12:39are coming from
12:40accidents.
12:41Yes.
12:42So,
12:42pagkupagkuhan ng pasyente
12:44sa streets
12:45and all
12:46pagdating po sa
12:47sa ospital,
12:49tatanungin
12:49kung sya ay
12:50organ donor cardholder
12:52or kung gusto ng
12:53pamilya
12:54na ma-donate
12:54yung pong organ
12:55na functioning pa
12:57para po doon
12:58sa mga nangangailangan.
12:59Sir,
13:00tanong po ng karamihan
13:01paano po tinitiyak
13:02ng PhilHealth
13:03na sapat
13:04ang pondo
13:04para masuportahan
13:05itong bagong
13:06beneficiyong ito
13:07ng mahabang panahon?
13:09Well,
13:10kasama po
13:12sa pag-aaral
13:13at paggawa ng
13:14beneficyo
13:15kaakibat po
13:16yung tinatawag na
13:17actuarial financial
13:19impact analysis.
13:21So,
13:21every time po
13:22na mag-a-approve
13:23ang ating board
13:24of directors
13:25ng PhilHealth
13:26ng isang beneficyo
13:27kasama po
13:28sa ipinipresent
13:29kung ano
13:30ang magiging
13:30epekto niya
13:31sa ating finances
13:32kung ito po
13:33ay sustainable
13:34at matutustusan
13:36yung pagpapatupad.
13:37Kaya po,
13:38nakakasiguro tayo
13:39na once
13:40naglabas tayo
13:41ng beneficyo,
13:42ito po
13:42is sustainable
13:43at masusuportahan
13:45ng pondo
13:46ng ating PhilHealth.
13:47So,
13:47sa ngayon po,
13:48lahat ng ating
13:48inilalabas
13:49ay talagang
13:50masusustain
13:50na natin
13:51at kung makikita
13:53magpunin nyo,
13:54patuloy pa rin tayo
13:55na nag-expand.
13:56So,
13:57ibig sabihin po
13:57ay may sapat na pondo
13:59ang PhilHealth
13:59to support
14:00all its benefit
14:01expansion.
14:02Kaya lang,
14:03syempre,
14:03sasabihin ko rin po,
14:05ba't kinakailangan
14:06din natin
14:06later on
14:07to really sustain
14:09all the programs
14:10and all the plans
14:11na kailangan din
14:12na talaga una,
14:13patuloy tayo
14:14nagbabayad
14:14ang premium contribution
14:16and second
14:17is yung pong
14:18subsidiyan
14:18na nanggagaling
14:19sa gobyerno
14:20patuloy din
14:20natin matatanggap.
14:22Doc H,
14:23may in-expect ba tayong
14:24additional programs
14:25para sa
14:26outpatient emergency care
14:28at acute
14:29myocardial infarction
14:30at paano po
14:31maa-avail ito
14:32ng ating mga miyembro?
14:33Well,
14:34as if,
14:34Joey,
14:34actually po,
14:36nakapaglungsad na kami
14:37ng bagong beneficyo
14:38yun pong tinatawag
14:40na outpatient
14:40emergency care
14:41benefit package.
14:43Dati kasi
14:43ang ating kinukover lang
14:44primary care
14:45and then
14:46inpatient.
14:48Pero kapag
14:48nadala ka
14:49sa ER
14:49at hindi ka na-admit
14:51wala tayong
14:51beneficyo nun.
14:52Pero meron na po tayo
14:54niyan
14:54starting February 14
14:55of this year
14:57kinukover na po natin
14:59yung mga pasyente
14:59na nadadala
15:00sa emergency room
15:02nag-stay
15:03ng 2 hours,
15:043 hours,
15:045 hours,
15:06less than 24 hours
15:07hindi na-admit
15:07covered na po yan
15:08ng PhilHealth.
15:09Pagdating naman po
15:10doon sa MI,
15:12meron po tayong
15:13in-expand
15:14na beneficyo.
15:15Ito po yung
15:16ating tinatawag
15:16na acute
15:17myocardial infarction,
15:19ischemic heart disease.
15:21So ngayon po
15:21yung ating
15:22beneficyo diyan
15:23unang-una.
15:25Kung ang pangangailangan po
15:26nagkaroon kayo
15:27ng atake sa puso,
15:29cardiovascular attack
15:30or yung MI
15:31na tinatawag
15:32or myocardial infarction,
15:34yun pong kapag
15:36ang gamutan
15:36ay kinakailangan
15:38kayong turukan
15:39ng gamot
15:40na medikal,
15:42yung pong
15:42fibrinolytic agent
15:43na tinatawag,
15:44dati po
15:45ang beneficyo natin
15:46dyan is around
15:4630,000.
15:48Ngayon po
15:48nung in-expand natin,
15:51ito ay
15:51umaabot na sa
15:52130,000.
15:54Kung ang kinakailangan
15:55naman pong gamutan
15:56sa nagkaroon ng
15:57myocardial infarction
15:58or heart attack
15:59ay operasyon
16:01katulad po
16:02ng angioplasty,
16:03dati po
16:04ang coverage
16:05natin dyan
16:06is 30,000.
16:07Ngayon po
16:08ang coverage
16:08na natin
16:09is 530,000 pesos.
16:12Tapos
16:13kasama na rin
16:14po ngayon
16:14dyan
16:15sa
16:15myocardial infarction
16:17yung cardiac
16:18rehabilitation
16:19na
16:20umaabot
16:21sa 66,000
16:22at
16:23kinocover na rin
16:24po natin
16:25yung ambulance
16:26transfer.
16:27Halimbawa
16:27ikaw ay nadala
16:28sa isang ospital
16:29na walang
16:29kakayanan
16:30na gamutin
16:31ang inyong
16:31heart attack,
16:32ililipat ka
16:33to another
16:34hospital.
16:35Yun pong
16:35paggamit
16:36ng ambulansya
16:36kinocover
16:37na rin po
16:37natin
16:38sa around
16:3822,000
16:40pesos package.
16:41Parang hindi
16:42lahat ng
16:43Pilipino
16:43alam yan
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16:54natin
16:55informing
16:56almost
16:57the
16:57116
16:58million
16:58Filipinos.
17:00Pero
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17:20mga
17:20miyembro
17:21you can
17:22always
17:22check
17:23our
17:23website
17:24at
17:24www.philhealth.gov.ph
17:27or
17:27sa
17:28e-gov
17:28app
17:28po
17:29natin
17:29or
17:30you can
17:30call
17:30the
17:3124x7
17:32hotline
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17:34028-622-2588
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18:02health
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18:48chronic
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18:54dialysis
18:55o sa
18:55kidney
18:56transplant
18:56salamat po
18:57Asik Wang
18:58and of course
18:59Asik Joey
18:59sa pagkakataon
19:00but
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19:49Dr. Ish
19:50Fargas
19:50Senior Vice
19:51President
19:51ng Health
19:52Finance
19:53Policy
19:53Sektor
19:54ng PhilHealth