Creative Accounting and Accountability Failures in the Philippine Health Sector: A Case Study of PhilHealth during COVID-19

This study investigates creative accounting practices in the Philippine Health Insurance Corporation (PhilHealth), focusing on financial manipulation and accountability breakdowns during the COVID-19 pandemic. The current paper uses a qualitative case study and document analysis of government audit reports, legislative inquiries, and media investigations (2018–2021) to reveal how procurement irregularities, unliquidated cash advances, and disguised operating losses distorted the agency’s financial position.  These practices, facilitated by weak internal controls and governance failures, undermined transparency and jeopardized the implementation of universal health care. Anchored in public sector accountability and creative accounting theories, the study concludes with actionable recommendations, including the institutionalization of forensic audits, digital transparency reforms, and stronger whistleblower protections. The findings underscore systemic weaknesses that enabled financial misreporting and highlight the pressing necessity for structural reforms in public financial management.