Medisave use for patients over 75

by: Gerald Giam/

Ms Sangeetha Bysheim wrote in to the TODAY newspaper on 7 July appealing for her 75-year old diabetic father to be allowed to use his Medisave to pay his full bills for his regular check-ups and medication. Currently only about 20 per cent of his bill can be charged to Medisave and the rest has to be paid in cash. She explained that her father has a lifetime’s worth of savings in his Medisave and argued that this was a perfect age to start tapping fully on the funds.

In their reply today (July 9th), the Ministry of Health reiterated the government’s long-standing position that they want to “manage the extended use of Medisave funds carefully to prevent the premature depletion of members’ funds”.

The Workers’ Party (WP) had in fact proposed in its 2011 Manifesto that “Medisave withdrawals for outpatient medical treatment should be further facilitated (e.g., for specialist and major outpatient services), subject to a cap on usage” and that “patients above 75 years old should be allowed to use Medisave for medical treatment without restriction” (Healthcare chapter, pg 37).

I had also raised this proposal during my General Election Rally speech on May 2nd at Moulmein-Kallang GRC. The proposal came at the tail end of a long list of other proposals on public housing and healthcare that I had expounded on in my speech.

At the time, I thought that it might have been a more niche issue that wouldn’t find much resonance with the crowd. To my surprise, when I read out that line, there was a huge cheer from the crowd (even though I didn’t exactly deliver it with much emotion or emphasis).

I believe the liberalisation of the use of Medisave for elderly folks is an important issue to many Singaporeans. I share Ms Sangeetha’s sentiments that 75 is a perfect age to start fully tapping on Medisave funds.

The life expectancy at birth in Singapore is now 79 years for males. How much longer does the government want to “extend the use of Medisave funds” for these elderly folks? Until they die?

In my opinion, a 75-year old drawing down on his Medisave funds is in no way “depleting it prematurely”. Even if a 75-year old were to live until 85 and deplete all his Medisave funds, there are other sources of funding like family support or Medifund that can kick in.

However, if an elderly person were to pass away before using up all his Medisave funds, what could have been used to relieve his financial burden and that of his children would effectively be wasted. Ironically, it is even possible to tap on Medifund if the expense doesn’t meet the Medisave withdrawal criteria, and one is destitute enough to qualify. This puts an unnecessary burden on the State, which is exactly what the government is trying to avoid — not that I don’t think the State should pick up a bigger tab for healthcare, but I’ll leave that for another debate.

Even though the balance is passed to his family (or whoever he nominates), the Medisave still has not served its intended purpose at the time when it was most needed. Therefore, restricting the use of Medisave for people over 75 years not just burdens the patient and his family, but is a poor allocation of resources.

This article first appeared on Gerald Giam‘s blog. We thank him for allowing us to reproduce it in full here.

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