Evaluation of Medicare I: Administrative Issues

Page 140

126 also shown in Table 45. Except in the years 1982-83 when both systems provided the same amount to ECC. SSS has shouldered considerably more of ECC's operational budget. The ECC cost per claim again reverses the picture, much like the system-based per capita expenses. ECC is absorbing more than twice of the costs originating from GSIS. On average, ECC operational costs per claim for GSIS have added up to P123.76, compared with ECC expenses per claim for SSS, which was lower at P53.64. How did the two systems fare with respect to the 12 percent ceil_._ on operating costs? Adding the portion of the ECC operating budget contributed by a particular system to the a_nhaistrative expenses of that system gives the total operating costs borne bt_ that system. total ECP income, the outcome is, as portrayed in Figure 70. For

Figure 70

,_':P_P_T_._ ._>'.F_-b._$_ A_.' _ OP TOTAL !NCO_J5

"_째r-:'._ /_, ,,.[ / _ -_

0._ _,,.vL

I A /

,

1

GSIS. they have come up to 6 "=[ _ _ - I percent across the 1980-90 ---__-_"_ period. Thus, neither of the two o _ j,,_ jj,_ & ,-,. j,, _. systems has gone near the 12 _ ,,% ,,. percent cap im terms of administrative expense. SSS has managed likewise to reduce the fluctuations in administrative costs. The same is not true of GSIS. which came precariously close to the lhnit, once in 1981 when costs reached 1]..7percent of total income, and in 1984, when costs climbed to 10.7 percent of gross income. Containing both benefits expense and acAministr, ative costs is clearly a maSor problem of GSIS.

'-L-

=-<D_

H. ECC operations The ECC operates as a government-owned and -controlled corporation. That makes it quite unlike PMCC, which operates like a regular gove.rnment agency. But ECC's statutory functions in relation with the ECP are similar to that of PMCC in relation with Medicare. The ECC performs the tasks of accreditation, monitoring, policy formulation, review of appealed cases. research (including actuarial studies) and public information. ECC is substantially dependent on the two systems for its operating budget, and it is a matter of judgment whether ECC has a harder time dealing with its corporate financiers (that is, SSS and GSIS) than PMCC dealing with DBM. Such financial dependence is widely perceived as giving the two systems unwarranted policy influence over ECC. Yet as a GOCC, the ECC has been able to generate earnings distinct from its SIF-based revenues. Its profit ,and loss statement shows that in 1991, it earned a net income of PI.34 million.'In 1990, its net earning was much higher, P7.82 million._[_ese came mostly from


Issuu converts static files into: digital portfolios, online yearbooks, online catalogs, digital photo albums and more. Sign up and create your flipbook.