Why are cancer treatments not subsidized by the government?

Deborah Choo/

Mdm Choi Lim Siew, 65, was diagnosed in 2009 with a rare blood cancer called multiple myeloma.  All the doctors she went to were perplexed over her condition and did not know how to treat her. It took almost nine months of going from polyclinic doctors to bone specialists to a blood specialist before they realized an abnormality in her blood count. Further tests then confirmed she had blood cancer. By then it was too late. Mdm Choi was already in the last stage of myeloma.

Singapore General Hospital is where Mdm Choi receives her cancer treatment now.

The hospital bills and consultation fees, especially for specialist doctors and medical reports, exhausted her savings. Unfortunately, that was only the beginning. There is no cure for her condition, and the treatments she is going through now only serve to prolong her life.

Mdm Choi has thought of giving up because the heavy medical bills were too much to bear. “I told the doctor frankly to give me the worst possible scenario if I stop treatment. He said the bones will all start to crack, I will feel pain and at most I have six months more to live,” she said.

She was told that cancer treatments are not subsidized by the government and that she was also unable to use her Medisave. After much haggling with the authorities , and with her doctor’s help, she was later allowed to tap into her Medisave which had about $29,000 then. But this was drained rapidly by the costs of the pills (about S$500 per pill) and the chemotherapy sessions (S$1,000 per treatment).

“My medicine is so expensive that the nurse doesn’t even dare to open it for me to partake. She will pass it to me to open it myself,” she said.

Mdm Choi is now tapping into her son’s Medisave account to pay for her treatment.  On the day we first met her, she had just been out of hospital for a round of chemotherapy. This was her third course of treatment and had cost about $7,000. As Medisave has a cap limit per day of $450, she could not afford to pay the entire bill. She now has about $5,000 outstanding which she needs to pay for. She has to complete another three more courses, which translates into approximately $21,000  in costs.

“I really don’t know where to find the money,” Mdm Choi said. But more importantly, she asked, “Why are cancer treatments not subsidized by the government?”

According to the Ministry of Health statistics, diseases such as cancer, ischaemic heart disease and pneumonia together accounted for approximnately 60% of the total causes of death in 2009 alone.

About three weeks ago, she sent in an appeal for financial assistance to the Singapore Leukemia Foundation. She is currently awaiting the foundation’s reply.

Here are her recent five pages medical bill (this is republished with Mdm Choi’s consent):

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During the same period in 2009, Mdm Choi’s husband Mr Cheong had a fall at home one day. He was then rushed to the hospital and told that he had to undergo surgery. He is 73.

Mr Cheong had a heart attack in his early thirties and has had to be on medication since.

When he asked the hospital for an estimate of the cost of the surgery, he was told that it would only cost him about $5,000. Thinking that he could tap into his Medisave (since he was ineligible for Medishield due to his heart condition), he went ahead with the operation. He had about $26,000 in his Medisave account. After the surgery, however, the bills came up to $31,000. The final bill, after subsidies, was $12,000. He was then told that he cannot use his Medisave to pay the bills.  “We almost died when we saw the bill,” said Mdm Choi.

In November 2009, he appealed twice to his MP Dr Lily Neo. “She saw my folder of bills and said I was already given subsidies,” he said. The meeting lasted only 15 minutes before Dr Neo said she will send a letter to the Central Provident Funds (CPF) board and the Singapore General Hospital (SGH).

 

*Note: Personal details are omitted to protect the interviewee's privacy.

On 15 December 2009 came a reply from the CPF board. The letter said, “We regret that we are unable to accede to your request to use more Medisave to pay your outstanding hospital bill at SGH as the maximum has already been withdrawn…If you have difficulties in settling your hospitalization expenses, you may wish to approach SGH Business Office …  for consideration of financial assistance or to work out an affordable payment plan.”

Slightly more than a month ago, Mr Cheong applied for financial assistance at SGH. Instead he was referred to the Medical Social Services of the National Heart Centre.

During this period, demand for payment of his bills were frequently received from a credit collection company on behalf of SGH.

“They’re like a licensed loan shark,” Mdm Choi chipped in. Mr Cheong kept holding them off by telling them he is currently appealing to his MP.

He turned to his insurance company but his claims were rejected.

Lucky for Mr Cheong, his ex-boss (he used to work in Public Utilities Board for 44 years),  who was also an ex-MP, learnt of his condition. He then made a personal call to Dr Neo after Chinese New Year in 2010 on behalf of Mr Cheong. That was when things started improving. Soon after, he received a letter from the CPF allowing him to pay off half his bills through his Medisave. At the same time, SGH also sent him a letter authorizing him to pay off his remaining payment with 23 installments of about $400 a month. “I only receive $300 a month from annuity! How am I supposed to pay $400? I don’t need to eat already,” Mr Cheong said.

He repeatedly appealed to SGH again and finally the hospital relented. It allowed him to pay $150 a month for 29 installments, which means he will have to keep paying until 2013.

Four months ago, Mr Cheong had another fall and was advised by his doctor to go for another surgery. However, he refused as he cannot afford the costs given his current predicament. He can hardly survive on the little money he has now. All he can do for now is to go for regular check-ups.

Mr Cheong also suffers from diabetes, high blood pressure and has a deteriorating eye condition. “Every week, it’s like I have to go for at least one check up,” he said.

Mdm Choi has also previously written in to The Straits Times explaining their predicament but her letter was not published.

Mr Cheong asked, “Why can’t I use Medisave when it’s my own money?”

“We’re not blaming the government for anything. We just want to get our answers,” Mdm Choisaid. 

 

This entry was posted in Current Affairs, Politics.