Sunday, 24 September 2023

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Social Health: Only 1 positive out of 9 – shocking?

By Leong Sze Hian

I refer to the article “NVPC releases report on S’pore’s social health” (Channel NewsAsia, Mar 27).

I find it extremely alarming that only one of the nine areas is positive, with five negative and three neutral.

Healthcare

It states that “the bed occupancy rate in acute hospitals has been increasing (80.6% in 2010 to 84.6% in 2012)”. In this connection, I understand that although the benchmark is to have patients wait up to a maximum of five hours to be given an available hospital bed in the ward class requested by the patient, the timing of the five hours is now changed to from the time of being informed that admission is necessary, instead of from the previous time of registration upon entering the hospial to seek treatment. In other words, a patient who may have been waiting for say four hours in order to be diagnosed and then waits another five hours for a hospital bed would now be counted as meeting the “five-hour” benchmark.

“Government spending on health as a percentage of total government expenditure fell from 1.3% in FY2009 to 1.2% in FY2011.” “The private expenditure on health has increased from 55% in 2001 to 64% in 2010″ – In this connection, people have been calling for years, for the gradual decline of the share of public healthcare spending from about 75 per cent in 1965 to about 33 (a third) per cent now, to be reversed.

According to the Department of Statistics’ “Singapore, 1965 – 1995 Statistical Highlights : A Review of 30 Years’ Development”, Government Operating Expenditure on Health as a Per Cent of Total Government Operating Expenditure, declined from 9.5 per cent in 1970 to 7.8 in 1980, 6.5 in 1990, and 6.3 per cent in 2005. (“Healthcare Costs“, Nov 22, 2006) (“Healthcare: Waking up slowly from years of slumber?“, Mar 12)

“The proportion of monthly household expenditure on healthcare has increased from 5.7% in 2002-03 to 6.0% in 2007-08 for the bottom 20%. The average bills for all ward classes saw a significant increase between 2006 and 2010. The biggest jumps were in the subsidised C class bills which rose from 60% to 90%, depending on the disease condition. Considering wage stagnation in the lowest 20% of the population, increasing expenditure on healthcare could perpetuate poverty. In addition,since Medisave is an individual responsibility and not a risk-pooling mechanism, the poor may nothave sufficient savings to pay for their medical bills.”

Transport

“The average monthly spending on transport among the bottom 20% of households ($195) was 70% below the national mean ($695), suggesting that high transport costs may be a form of social exclusion for the poor, and may limit access to jobs and services.” – There were nine fare increase in the last 12 years. As it is arguable whether the 2010 change to distance-fares was actually an increase or decrease, it may actually have been ten increases.

If we can decide to spend more than $1.1 billion on buses to help the transport operators, why can’t we spend a single cent to keep fares from increasing.

HDB

“From 2001 to 2011, the resale price index (RPI) increased at 7% per annum, whereas median monthly household income rose at 3.8% per annum. In the recent five years, the cumulative increase in RPI was double that of median monthly household income.” “It (also) found that in the 2010 housing resale market, prices exceeded 30% of life time incomes for the bottom 10%”

How many HDB flat-owners are in arrears over 3 months on their HDB loans and HDB bank loans?

How many HDB flats have been foreclosed by the HDB and banks?

Income

“Gross real median wages across the common occupations listed by the Ministry of Manpower fell in all nine occupation categories from 2007 to 2011.”

“The Gini coefficient for Singapore increased from 0.473 in 2011 to 0.478 in 2012. It is the second highest in the world according to the Human Development Report among “very high human development countries” – The estimated real median wage growth per annum was about 0.4 and 6.4 per cent, from 2000 to 2012 and 1990 to 2000, respectively. (“Real wage growth p.a. in 1990s was 16 times more than last 12 years?, Mar 5)

“Consumer loans have increased from $41.7 billion in 2000 to $179.5 billion in 2011. This is largely contributed by hefty home loans. Also, the total number of main credit cards crossed six million in October 2010 and the rollover balances breached the $4 billion mark in November 2010. Rollover balances have been growing at an average annual rate of 11.5% from 2009 to 2011. If the economy performs poorly and real estate prices decline, many individuals will be unable to pay off their debts. The bankruptcy rate has shot up by 28% between 2010 and 2012.”

Retirement

“The 2012 Global Pension Index measuring the strength of retirement income systems ranked Singapore 17th out of 18 countries for the adequacy of its system and 13th in terms of its overall score. CPF alone is inadequate to meet the retirement needs of the majority of Singaporeans. According to a study, tertiary-educated Singaporeans who entered the workforce in 2010 with a pay of $2,560 and who go on to buy a five-room public housing flat worth about $560,000, would get monthly CPF payments of only 22% of their lastdrawn pay when they retire at age 65.

CPF was found to be adequate only for low income families, provided they do not withdraw money to buy property. Based on CPF’s retirement estimator, the current Minimum Sum of $139,000 is only sufficient for Singaporeans earning a gross monthly wage of $1,100 or less.

Individuals in this income bracket are most unlikely to be able to save the Minimum Sum amount. For the cohort who turned 55 in 2011, only 45% of active members attained theapplicable Minimum Sum.” – I understand that even this 45% includes about half who were only able to meet the Minimum Sum by pledging property, and as indicated in the report, it does not include inactive CPF members.

Work hours & job satisfaction

“According to The Conference Board, the average Singaporean worked 2,287 hours in 2012, the most number of hours in the world after Hong Kong. Findings from the Robert Half’s Workplace Survey in 2011 showed that 69% of Singapore employees still work when they are out of the office or on holiday, higher than the regional average of 66%.

This compares well with Jobstreet survey results which found that 88% of Singaporeans worked beyond office hours.  Singapore employees are also seemingly dissatisfied with work. A Hay Groupsurvey estimates that employee engagement stands at 62% in Singapore, marginally lower than the Asian average of 63%. Research findings from Accenture also found that Singapore ranked second lowest globally for job satisfaction. 76% of Singapore respondents are alleged to be dissatisfied with their jobs.”

 

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