12/07/2025
Statement of Petitioners on the Negative Impact of Dependence on Ayuda and Guarantee Letters on Health Services
We, the group of petitioners who challenged the constitutionality of the transfer of the PhP89.9 billion Philippine Health Insurance Corporation (PhilHealth) funds to the national treasury in 2024, are alarmed by the recent statement from the Private Hospitals Association of the Philippines Inc. (PHAPI) that delays in payments of receivables from the Department of Health’s (DOH) Medical Assistance to Indigent and Financially Incapacitated Patients (MAIFIP) Program have made private hospitals hesitant to accept Guarantee Letters (GLs) from indigent patients.
In the Philippines, financially incapable patients have two primary processes to seek coverage for health expenses using government funds. First, they can access PhilHealth, mandated by the Universal Health Care (UHC) Act as the state health insurer. Second, patients seek medical assistance from various government agencies, including the DOH’s MAIFIP Program, which provides additional financial support to those in need.
Social health insurance is readily available at the point of care, accessible to all, and reduces the social cost to households, such as transportation and proximity to the health facility. On the other hand, accessing MAIFIP is complex, adds a burden to the patients and their families, and is subject to political patronage, with assistance given to patients frequently appearing arbitrary.
The central role of PhilHealth is to serve as the national purchaser of individual-based health services intended to provide the benefits entitled to every Filipino and prevent the fragmentation of funds. This prevents patients from relying on “pagmamakaawa” (begging) for medical assistance.
Moreover, DOH Administrative Order No. 2023-0016 and the Guidelines for the Implementation of the MAIFIP Program do not specify the requirement for GLs for patients to avail themselves of assistance.
To address the issues stemming from patronage-driven and fragmented healthcare financing, we call on Congress to ensure proper allocation of PhilHealth funds, as mandated by the UHC Act. Over the years, MAIFIP has become one of the most heavily funded programs of the Department of Health. Particularly for both 2024 and 2025, allocations for MAIFIP were higher than those for PhilHealth, with PHP 41.160 billion allocated for MAIFIP in 2025 compared to a zero budget allocation for PhilHealth.
Additionally, allowing the MAIFIP budget to grow continuously will perpetuate and normalize the use of public funds for patronage politics. Indigents may feel indebted to politicians for the GLs they receive. PhilHealth should be able to cover such costs and be accessed by patients in a dignified manner.
Ensuring that PhilHealth receives the mandated allocations to cover vulnerable populations and expand benefits is critical to protecting patients from catastrophic, out-of-pocket health expenditures.
We also emphasize that simply urging patients to go to public hospitals instead of private facilities, as noted in DOH Assistant Secretary Albert Domingo’s response to PHAPI’s statement, does not address the long-standing problem of the public health system. Currently, 65% of health services are provided by privately owned facilities, while only 35% are provided by public hospitals. Defunding PhilHealth and prioritizing funding for MAIFIP will drive patients to public facilities, leading to overcrowding in already understaffed hospitals that also lack adequate facilities and equipment. There is an even greater need to strengthen the capacity of public health facilities, including ensuring sufficient funds to support and sustain health human resources.
Finally, we trust that the Supreme Court will decide in favor of the right to health of 100 million Filipinos. As the budget legislation process approaches, we hope that the High Court will soon render its decision on the PhilHealth fund transfer case. We must prevent the possible repetition of the government’s unlawful practice of defunding PhilHealth. The Executive and Congress have been withholding funds for UHC that would have helped ease the healthcare burden of Filipinos, protect them from seeking GLs from politicians, and ensure the right of every citizen to health benefits.
Signed:
Cielo Magno
Dante Gatmaytan
Ernesto Ofracio
Ibarra Gutierrez
Minguita Padilla
Philippine Medical Association (PMA)
Public Services Independent Labor Confederation (PSLINK)
Sentro ng mga Nagkakaisa at Progresibong Manggagawa (SENTRO)
