A government research body is raising alarms over a widening gap between what Filipino patients pay for hospital care and what their national health insurer covers.
Hospital bills climbed 70% between 2018 and 2024, while PhilHealth reimbursement rates rose by only 31.75% over the same period, according to a study released last week by the Philippine Institute for Development Studies. The disparity has left patients shouldering a growing share of medical expenses out of their own pockets.
The research, conducted with support from the Department of Health, PhilHealth, and the Philippine Business for Social Progress, also found that a large portion of healthcare spending is concentrated in inpatient services — and that many of those hospitalizations stem from conditions that could have been prevented with timely and adequate primary care.
When community-level health services fall short, the study noted, people are pushed toward hospital admission, which is far more costly for both patients and the health system.
PIDS framed its findings as a challenge to policymakers, asking: “As the country advances Universal Health Care, what do health insurance data reveal both progress and persistent gaps? How can these insights guide reforms to strengthen primary care, improve public spending, cost control, and reduce preventable hospitalizations and inequities in healthcare?”
The institute stressed that meaningful reform and proper implementation remain central to building a fairer and more functional healthcare system for all Filipinos.
