Introduction
The Philippine Insurance Commission (IC) has made a strong appeal to insurance firms and health maintenance organizations (HMOs) to broaden their offerings to include more gender-responsive policies. This call to action is particularly timely given the anticipated surge in healthcare costs across the nation.
IC Advisory for Gender-Specific Coverage
Through Advisory No. RS-2025-009, the IC has urged providers to innovate and expand their insurance and HMO plans to encompass health risks and needs particular to different genders. These plans could involve coverage for maternal and reproductive health, gender-specific critical illnesses, and other related medical services.
Commissioner’s Statement on Inclusivity
Insurance Commissioner Reynaldo A. Regalado emphasized that the advisory is designed to inspire the creation of financial products that cater to the health and financial needs of varied demographic groups. “The commission champions initiatives that foster inclusivity, empowerment, and financial resilience through specialized insurance and HMO products that address women’s health, financial security, and general well-being,” he remarked. “Such offerings ensure comprehensive protection tailored to the diverse needs of individuals, guaranteeing that financial security and healthcare remain accessible to all.”
Encouragement for Gender-Sensitive Programs
The IC also encouraged the insurance and HMO industries to implement gender-sensitive programs and to routinely analyze sex-disaggregated data. The analysis of this data can significantly contribute to the design of more effective and targeted insurance solutions.
Healthcare Cost Projections
This policy guidance aligns with the backdrop of escalating healthcare expenses. A recent study conducted by WTW forecasts a staggering 18.3% increase in medical costs for the Philippines in 2025, marking one of the steepest hikes in the Asia-Pacific region.
Factors Driving Healthcare Inflation
The survey highlighted several factors driving this trend, including increased utilization of health services, higher hospital and professional fees, and a burgeoning prevalence of chronic diseases.
Financial Performance of HMOs
According to the IC, HMOs in the Philippines reported combined losses amounting to PHP4.3 billion in 2023, a substantial rise from PHP1.4 billion in 2022. These financial setbacks have led to annual adjustments in HMO premiums and have sparked ongoing disputes with physician groups over proposed fee hikes, some of which range from 80% to 150%.
Internal and External Cost Pressures
The WTW survey also shed light on crucial internal cost pressures, with 79% of respondents citing excessive diagnostic testing and overtreatment as key contributors to inflation. Externally, the rising cost of advanced technologies, a shortage of medical professionals, and an increasing reliance on private healthcare due to limitations in the public system were also noted.
Impact of Telehealth Services
While telehealth services have broadened access to healthcare, they have also introduced additional financial strains on the system. These challenges highlight the intricate nature of the current health financing landscape.
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