by Leong Sze Hian
I refer to the article “More uses for Medisave, greater subsidies” (Today, Mar 5), the Ministry of Health’s (MOH) advertorial “Healthcare made affordable” (Sunday Times and Zao Bao, Mar 6) and MOH’s response which is on its web site, to media queries about the increase in Class C wards’ hospitalisation bills.
The former states that :
“Wider Medisave coverage, a bigger Medifund budget and a doubling of the Medication Assistance Fund to pay for expensive drugs. These were part of several measures Health Minister Khaw Boon Wan announced on Friday to keep healthcare costs affordable”.
The Health Minister went on to claim that since March last year, Singaporeans have been able to use their funds for non-urgent treatments overseas. Since then, only 58 patients have used it for overseas treatment, withdrawing S$125,000 in total. The low utilisation “signals confidence in Singapore’s healthcare system”, he added.
The low utilisation may be due to the issue that Medishield and all the CPF-approved private insurers’ medical insurance plans do not cover overseas treatment. So, why would anyone choose to be treated overseas at perhaps less than half the cost compared to Singapore, when his or her insurance does not cover the medical fees?
Patients ask for it?
The MOH’s response that many subsidised patients are now well-read and often come with internet printouts about alternative treatment options, does not answer the question raised as to whether non-subsidised drugs and implants are in the treatment guidelines of hospitals, which doctors are duty-bound to inform their patients.
Most Class C patients not poor?
As to more than 42 per cent of all admissions to restructured hospitals opting for Class C wards, with many clearly not from low-income families, the reason why many Singaporeans may be opting for Class C may be the fear that only about one per cent of those who apply for down-grading to a lower class ward were successful.
Instead of just citing the average household income vis-a-vis the average Class C bill size as evidence that Class C wards are highly affordable, we should also look at the lower-income statistics.
In this connection, the bottom and second decile of employed households had an average monthly income per household member of only $354 and $675, respectively in 2010, and there are 400,100 residents earning $1,200 or less, about 1 in 8 resident workers earn less than $1,000, 64,400 unemployed and 10,900 discouraged unemployed.
More non-subsidised drugs?
I think the question as to whether the number and proportion of non-subsidised items in Class C has been increasing over the years, remains unanswered.
According to the MOH’s web site:
“In 2008, Singapore spent about S$10.2 billion or 3.9% of GDP on healthcare. Out of this the Government expended S$2.7 billion or 1.0% of GDP on health services”.
According to the Budget, our public healthcare spending dropped by 0.6 per cent to remain at about one per cent of GDP, which is one of the lowest in the world.
Recently, the Health Minister wrote on his blog “Confronting hard truths” (Mar 6):
“I meet Health Ministers regularly. They are often intrigued by our healthcare system, delivering first world standards at only 4% of our GDP. Many OECD countries spend more than 10%. The US is the biggest spender, with 18% of their GDP spent on healthcare.”
Perhaps we should spend more on healthcare, instead of allowing Class C hospital average bills to almost double in the last four years, and having more drugs and treatments as non-subsidised.
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