Senator Sonny Angara has called on the government to make sure that all those involved in the “ghost” dialysis scandal hounding the Philippine Health Insurance Corp. (PhilHealth) will not go unpunished.

“We need some punitive measures—we need to punish those who are guilty—as well as preventive measures para hindi na maulit,” Angara said in an interview with CNN Philippines’ The Source.

Angara, one of the authors of the newly enacted Universal Health Care (UHC) Act that strengthens PhilHealth’s capacity to provide quality and affordable health care to all Filipinos, described the latest controversy surrounding the state-run health insurance firm as both “highly illegal and immoral.”

As chair of the Senate Committee on Ways and Means in the outgoing 17th Congress, Angara also sponsored the bill increasing the excise tax on tobacco products from P35 to P60 over the next four years, in a bid to raise crucial funding for the UHC program.

“Kaya natin ipinasa ‘yun (tobacco excise tax bill) para sa universal health care, so bibigyan natin ng mas maraming pera and yet merong mga anomaly,” Angara pointed out.

Aside from the usual corruption that happens in government, Angara said the issue of ghost dialysis treatments was particularly “condemnable” because it took away funds meant for sick and poor people.

“It’s a bit disturbing. Aside from being a bit political issue, it’s also a moral issue because this money is meant for very poor and sick people,” Angara said.

“These are people who are close to death. So, tinanggalan ng dialysis treatment ‘yung mga kailangan ng dialysis. These are people, who, if they don’t get their dialysis, they may die in month’s time,” he added.

Angara noted that this was not the first time PhilHealth was rocked by a scandal involving fraudulent claims.

“Every now and then, there’s a scam that pops up,” Angara said, as he recalled that PhilHealth also encountered fraudulent claims for cataract surgeries and pneumonia in the past.

Angara said institutional reforms are needed to put an end to the perennial problem of bogus claims and other irregularities in PhilHealth.

The lawmaker said it is high time PhilHealth be transformed into a “really professional insurance corporation” by bringing in more managers and fraud investigators who would ensure the company’s overall financial viability while fulfilling its obligation to provide health care protection to all Filipinos.

“What we need is a good manager who can make sure (the PhilHealth) reserve fund is intact,” Angara said.

Angara said good fraud investigators would easily determine bogus claims, as he noted that hospitals and wellness centers could not make fake claims without the help of PhilHealth insiders.

“I don’t think the hospitals and wellness centers can make these claims without knowing someone on the inside. Mukhang mahina ang safeguards kaya nagkaka-kuntsaba ‘yung private and public sector,” Angara said.

He added: “There are what you call overclaims, meaning hindi talaga nag-dialysis, binayaran for the full treatment o kaya they upgrade the disease. It’s a cough pero ginawang pneumonia. 

“So, instead of PhilHealth paying P2,000, it paid P15,000. Maybe, there’s kickback under the table.” #