By Leong Sze Hian
I refer to the article “Majority of public hospital patients settle bills within 2 months: Gan Kim Yong” (Channel NewsAsia, Nov 12).
5% couldn’t pay?
It states that “Health Minister Gan Kim Yong said more than 95 per cent of patients in public hospitals settle their hospital bills within two months of discharge.”
Why not tell how many couldn’t pay?
When I read the above reply, I sensed that it may be rather strange to give a percentage instead of the number who couldn’t pay.
So, I began my quest to try to find the number.
According to the Ministry of Health’s (MOH) web site, the number of admissions in public hospitals in 2012 was 362,458.
5 per cent of this number is about 18,123 – who couldn’t pay their medical bills?
As this figure only refers to those who couldn’t settle their hospital bills within two months, does it include those who had difficulty paying for their medical treatment pre and post-hospitalisation or out-patient medical fees (for those who did not require hospitalisation or opted not to be hospitalised or treated because they couldn’t afford it)?
In any case, isn’t 18,000 plus who couldn’t pay an indication that healthcare in Singapore is not as affordable as we have repeatedly been told?
I believe the number may be more than 18,000 plus because public hospitals have out-patients too – and my figure is only based on hospital admissions.
500,000 successful Medifund applications?
Since Medifund paid fully or partially the medical bills of 500,000 successful Medifund applications, isn’t this, arguably another indication of how “unaffordable” healthcare may be in Singapore?
Lowest public healthcare spending in the world?
How can healthcare in public healthcare institutions be “affordable” when our public healthcare spending as a percentage of GDP, at 1.4 per cent, is the lowest among developed and developing countries in the world?
Arrears was 2.5% of hospitals’ total operating expenses?
The report writes that at end-2012, the total arrears due from patients that exceeded two months amounted to about 2.5 per cent of the public hospitals’ total operating expenses which include arrears brought forward from prior years.
This also include patients who are paying outstanding bills by instalments, or are awaiting assessment for financial assistance by the hospitals.
“Mr Gan said a significant part of the arrears are eventually recovered or paid up over time, leaving a smaller portion amounting to about one per cent of total operating expenses that becomes bad debt and have to be written off eventually.
In some instances, this could be due to the patient remaining uncontactable despite repeated attempts, or even due to disputes regarding the treatment”
Hospitals owed $110 million
The last available statistics given in a Parliamentary reply was that public hospitals were owed about $110 million, after writing off about $90 million in FY 2008, FY 2009 and FY 2010.
Aiyah, just tell us how much couldn’t pay lah?
So, how come this time round the reply just gives the arrears as a percentage of the public hospitals’ total operating expenses, instead of the amount?
So, once again I began my quest to try to find the numbers.
According to the annual reports of the Singhealth and the National Healthcare Group, their last reported total operating expenses were $2.331 and $1.565 billion, respectively, making a total of $3.896 billion.
2.5 per cent of this $3.896 billion is about $97.4 million. As the above figure is only for the two major healthcare groups, what is the total operating expenses of all the public healthcare institutions?
So, how much are the public hospitals being owed and how much more has been written off?
21% in debt due to healthcare?
The last available statistic on credit counseling was that about 21 per cent of Singaporeans who sought help from Credit Counseling Singapore cited healthcare costs as one of the reasons for getting into debt.
Trend shows not “unaffordable”?
With regard to “Mr Gan said the trend of arrears has remained similar over the last five years and does not suggest increasing un-affordability of healthcare bills” – since the public hospitals’ total operating expenses has been increasing over the last five years – why not give us the statistics on the number and quantum who couldn’t pay?
Trend of strange Parliamentary replies?
The only trend that may be obvious is the kind of incomplete, strange replies that we seem to be getting increasingly in Parliament.