Camarines Sur (CamSur) Gov. LRay Villafuerte is standing four-square behind the Department of Health (DOH)’s inclusion of hospitals managed by local government units (LGUs) in its Zero Balance Billing (ZBB) program, which is now limited to providing free hospitalization to inpatients with basic or ward accommodations in DOH-run hospitals only.
Health Secretary Teodoro Herbosa said that with its P448-billion budget for 2026, the DOH is allocating P1 billion for expanding the ZBB by piloting the inclusion in the President’s free hospitalization program of Level 2 and Level 3 provincial hospitals run by LGUs.
In a recent news briefing at Malacañan Palace, Herbosa said it is pilot-testing the ZBB expansion this year in five provinces whose LGUs are running secondary and tertiary provincial hospitals, to eliminate out-of-pocket medical expenses for eligible inpatients in these areas.
Malacañan Palace earlier announced that nearly 2 million Filipinos have benefitted thus far from the ZBB since this free hospitalization program was announced by President Marcos in his fourth State of the Nation Address (SONA) in July 2025.
“We are hoping that Sec. Ted (Herbosa) will push through with this pilot project of the DOH this 2026, and then expand its coverage soon enough to cover more provinces with hospitals managed by LGUs, so the government can provide free hospitalization to inpatients with basic or ward accommodations not only in DOH hospitals but also in many other hospitals run by LGUs,” Villafuerte said.
“Expanding the ZBB by covering indigent or low-income inpatients in LGU-run hospitals is a surefire way to expand the access of our people, especially those in the provinces, to urgent healthcare,” said Villafuerte, who is president of the National Unity Party (NUP) and senior vice chairman (for South Luzon) of the League of Provinces of the Philippines (LPP).
The former three-term congressman said that CamSur’s provincial government has been implementing ZBB since 2020 in the province, which has 13 LGU-run hospitals.
Villafuerte said, “It is fitting for the DOH to provide greater financial support for health services to LGUs by way of this ZBB expansion route, considering that it is rather costly for local governments to manage their own hospitals and hire medical professionals.”
He proposed to the DOH to relax its rules on the number of medical personnel that LGU-run hospitals should have, and, more importantly, “to refrain from pirating the medical professionals and staff of LGU hospitals.”
“Right now, DOH hospitals have been competing with LGU-run hospitals in offering higher pay to doctors, nurses and medical staff working in facilities managed by local governments,” he said.
Herbosa said at the Palace press conference that: “For the Level 1 hospitals, ang feeling namin kaya na siyang i-support noong increased benefits of PhilHealth (Philippine Health Insurance Corp.). So, alam iyon ng mga local chief executives. But for LGUs that have Level 2 and Level 3 hospitals, ito iyong mas complex procedures and higher cost of care, sila iyong gagamitin nating pilot.”
He said that DOH-run hospitals would enter into formal agreements with LGU hospitals for the latter to accept patients who could not be accommodated in the basic accommodation or wards of DOH hospitals.
Health Secretary Teodoro Herbosa said that with its P448-billion budget for 2026, the DOH is allocating P1 billion for expanding the ZBB by piloting the inclusion in the President’s free hospitalization program of Level 2 and Level 3 provincial hospitals run by LGUs.
“So, ang mangyayari dito I will ask my medical center chiefs to have a memorandum of agreement with an LGU hospital and kung puno iyong DOH hospital, papalipatin namin sila sa LGU hospital pero sasagutin namin, zero balance iyong pasyente doon,” he said.
Malacañan Palace earlier announced that nearly 2 million Filipinos have benefitted thus far from the ZBB since this free hospitalization program was announced by President Marcos in his fourth State of the Nation Address (SONA) in July 2025.
According to reports, LGU Level 3 hospitals offer comprehensive and specialized health services, while Level 2 hospitals of LGUs offer basic specialties like surgery, OB-GYN and advanced X-ray and laboratory facilities.
In a related development, Villafuerte has been pushing sweeping reforms at the DOH’s Health Facilities Enhancement Program (HFEP), which received almost ₱30 billion last year for building or improving health facilities, but which has, at this point, left this Department stuck with 300 idle or non-operational health centers out of almost 900 built thus far across the country.
Herbosa, in a report last year to the ad hoc fact-finding Independent Commission for Infrastructure (ICI), revealed that of the 878 super health centers funded under the DOH’s HFEP, only 196 were “ready for occupancy,” as 17 were partially operational, 300 inoperable and 365 still under construction.
“For the DOH to make full and immediate use of the non-operational facilities, Secretary Ted (Herbosa) should consider reforming the HFEP by (1) allowing financially-capable LGUs, including provincial governments, to immediately take over the operation of the otherwise idle super health centers,” he said.
He said the DOH should also: (2) limit HFEP beneficiaries only to municipalities that actually have the resources to hire and maintain health professionals and administrative personnel to run these facilities; and (3) invest in the medical equipment and other facilities needed by these super health centers.
“The current HFEP policy to fund the construction of super health centers even in municipalities where the LGUs don’t have the wherewithal to either pay for the doctors, nurses and administrative staff or procure and maintain the medical equipment needed for these mini-hospitals to deliver healthcare to the people does not make sense, judging from this huge number of supposedly LGU-run but unused facilities,” Villafuerte said.
Villafuerte said, “The DOH should not invest in super health centers willy-nilly in municipalities regardless of these LGUs’ financial status, as it will never stop being at risk of squandering public funds on health centers that can end up idle or useless because the LGU-beneficiaries have no capability to keep them up and running.”
