PhilHealth listed 105,683 cataract surgeries claims in 2019. EYE hEAR Foundation together with our partners did a total of 8,333 of which 4,464 are non-PhilHealth or did not utilize their PhilHealth.
In the pie below, it shows that 7% of the total cataract surgeries done was done by us and partners
Whereas, in the pie chart illustrated below, of our total cataract surgeries output, more than half (56%) did not claim PhilHealth. It does not necessarily mean they are not members of the national health insurance but they could be members but cannot file reimbursement due to the standing circular of PhilHealth that when it's done in an outreach or what they call a 'mission' setup, the doctors or the hospitals cannot claim. May pre-approval po kasi ang cataract surgery na niri-release ng PhilHealth bago mai-skedyul ang operasyon at hindi natin ito magagawa o maaasikaso sa setup ng Outreach. Ang circular na ito at ang isa pang circular na nagsasabing ang ophthalmologist ay maari lamang gumawa ng limampung (50) surgeries sa isang buwan ay halimbawa ng pagkokontrol na nakikita nating hindi makatao at hindi patient-centered na desisyon ng PHilHealth. Para sa amin, isa itong balakid para matamo o maabot natin ang ating hangarin na wala sanang Pilipino na nabubulag na hindi naman dapat.
Sana marinig at maaksyonan na ang ating matagal ng adbokasiya sa Department of Health at PhilHealth.
No Filipino should go needlessly blind.
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