I was exhausted, cranky, in need of a long, warm bath and some chocolate bars to perk up my mood. Worrying about someone in the family who is sick, especially if that person is a baby, does that to you.
But the voice of the man near the admission counter of the hospital where my son was admitted pierced the cloud of selfishness around me. He was obviously in pain. And he could not get a room at the hospital.
“I’m sorry, sir. We don’t have a room for you. You can wait in the ER until we have a room that fits your card,” the clerk said.
“Why, what’s wrong with my card?” the man said.
“We need to double check if you can get a private room just as you requested. I know that the maximum for your card is P1,900 per night, but we will have to check again,” the attendant said.
In the end, he decided to go home while waiting for a room. He was seventh on the list and it was already 4 p.m.
Sickness is a financial planning wild card. Even if you stock up on vitamins, eat lots of fruits and vegetables, swear by the benefits of eating wheat bread, there’s no telling if or when you will get sick. There are just too many factors when it comes to health – including genes. It’s a probability that each family needs to prepare for.
Are you prepared for the cost of getting sick? Is there room in your finances right now for sickness in the family?
I have long wanted to do a comparative study on HMOs in the Philippines, but my son’s condition prompted me not to put the topic in the backburner any longer. However, instead of presenting you with data, I will have to throw questions at you, hoping that you will share your experiences so that we can have an initial data scan of what options Filipinos have out there when doing emergency planning.
What HMO do you have?
How much are you paying?
What are your benefits?
How would you rate the delivery of these benefits?
How would you rate the quality of their service?
Let me be the first to answer:
My family’s HMO is Intellicare. We pay P1,484.40 per month for five cards, one of which is for a 1.6-year old baby, which I understand is the most expensive one. We have dental benefits, annual executive check-ups, check-ups with doctors affiliated with their network. The HMO covers room rates up to big private room for my husband who is the main cardholder and small private room for his beneficiaries. Whenever someone is hospitalized, they give P1,000 per day in cash, I suppose to cover other expenses during hospitalization. Ours is a corporate plan. The service is excellent.
What about serious illnesses? Are you prepared for them? Last week, I attended a press conference organized by Stryker Corp., one of the biggest orthopedic implant maker in the world, which has entered into a tie-up with HSBC and BPI Credit Cards so that Filipinos can avail of an operate-now-pay-later plan.
Orthopedic implants cost around P80,000 to P150,000. The entire operation can reach up to half a million. Under this scheme, if you have been recommended to have an operation, you can use your card to pay for the implant at zero percent interest and in so doing defray the cost.
Using our litmus test for those zero-percent advertisements, I asked them what would happen if the patient wanted to pay in cash. Same price, they said. I was able to have a good talk with their Finance guy (they are my favorite people in every company) and he said that Stryker was charged one percent per month by the card companies, totaling 12 percent per annum, but the company decided to shoulder the cost for the first year of the program.
I guess, a good deal, all in all, as long as you don’t default on your payments. One-month default would lose that zero percent deal and trap you into paying a 42 percent per annum interest on a huge amount of debt. That would give you a headache to go with your new bone transplant. Not a nice combination.
The best strategy is still to have an emergency plan in place. Make sure you have three to six months worth of expenses as emergency buffer, and a good HMO to back you up. Medical insurance companies, are in general, cheaper than HMOs. But they operate by reimbursement, so you need that cash for this to work.
Let the HMO story sharing begin :).
November 6th, 2007 at 9:32 pm
[...] I know more or less how this author must’ve felt when I saw how the couple reacted when they were told of the amount they had to [...]
October 13th, 2007 at 6:23 am
Hi-I am working on a research paper about the Philippines for a class I am taking for my Masters in Nursing. Your article is very interesting and it sounds as if healthcare has negative aspects everywhere. Do you have any PPOs in your country? Again, great article!–Kathy
October 3rd, 2007 at 8:58 am
i am a doctor and this is my experience with HMOs. it can be exasperating at times because we accredited doctors may require tests or meds for the patient which we deem is best to help diagnose or treat the patient, yet the HMO has final say in these. say, we need a CT scan to better determine problem, but HMO would only approve an ultrasound; same case for meds - we would recommend a better antibiotic, HMO would change and use an inferior one. of course, all these is for HMO to scrimp on expenses. also, sometimes the HMO coordinators manage the patient even if the patient’s case is not their specialty, again so they don’t have to pay other doctors. there is a danger then of patient not getting the proper medical care, e.g. a surgeon treating the patient’s diabetes or hypertension problem.
the reason why many doctors don’t accept HMO patients is because accredited doctors are underpaid. a cardiologist friend related her experience. an HMO patient had a heart attack and was referred to her. patient was at ICU for 1 wk, then about 8 days in regular room before discharge. she would do visits 3-4x a day, sometimes at wee hours of the morning. when cardiologist’s professional fee was paid - about 8-9 months later - she got a measly P1500.00!
so, i hope patients would understand why many physicians are averse to HMO. watch michael moore’s SICKO!
October 2nd, 2007 at 12:57 pm
I believe that we really need an HMO, this is because PhilHealth Insurance will only cover 20% of the medical costs. Therefore, you have to pay the remaining 80%. Or if you have your HMO, most of the plans covered the remaining 80% of the bill.
I really dont know what could be the “best” HMO provider today - well at least for the individual plans/non-corporate.
September 22nd, 2007 at 12:07 am
any suggestion for old people age 60?