By Howard Lee
“Hello sir, I’m calling from MCI.”
Uh oh. My mind scrambled. What did I write recently that might have offended the Ministry of Communication and Information? Can’t be this piece on LGBT issues, right? Did I say gays should kiss in concerts, or that the Christians should start a political party?
“We are doing a survey on Medishield Life. Would you be able to spare some time to answer a few questions?”
The immediately sigh of relief was followed just as quickly by puzzlement. Why was MCI doing a job that should belong to the Ministry of Health?
On a scale of one to five, one being strongly disagree, five strongly agree, please rate the following statements:
1. The government is managing Singapore well.
2. The government does the right thing for Singaporeans.
3. Singapore is heading in the right direction.
4. The government made my life better compared to five years ago.
5. The Prime Minister is doing a good job running the country.
Hang on, wasn’t this supposed to be a survey on Medishield Life? Why is MCI conducting a report card assessment on the government, and better yet, a popularity poll for the Prime Minister? Of course, it is his government, his Ministries, his Medishield Life scheme to sell. But to barge into a survey with this as an opening – a little too desperate, perhaps?
6. Singapore has a good healthcare system.
7. Healthcare in Singapore is affordable.
Already one-third through the survey, and still no questions about Medishield Life. No doubt, the scheme is part of the national healthcare plan, but why ask the public about their perceptions on the general health of the healthcare system? Should the survey not focus on the new scheme? Like the first five, these two questions appear to do nothing more than seek affirmation for their subject.
And finally, the actual questions about Medishield Life:
8. Have you heard of the Medishield Life scheme? (Yes/No)
9. How much do you know about Medishield Life? (1: Not at all, 2: A little, 3: A lot)
10. Medishield Life makes healthcare more affordable.
11. Medishield Life gives you peace of mind.
12. Medishield Life makes healthcare affordable for the low income, the middle income and the elderly.
13. Medishield Life premiums are affordable given the coverage it provides.
14. Do you feel that Medishield Life premiums will be affordable down the road?
15. Are you confident that you have sufficient funds in your Medisave account?
16. Are you aware of the costs involved for Medishield Life?
17. Are you currently paying for the healthcare cost of any family members?
18. Are you confident that you an afford healthcare for your family through Medishield Life?
19. Are you confident that you have sufficient funds for your family’s healthcare needs?
The exact wording of the survey is about as accurate as I can remember, with all the noise of a telephone survey to contend with. But clearly the push was to discover the affordable quotient of Medishield Life. This excessive focus on one issue is quite telling – has this been flagged as a concern by citizens?
More significantly, the affordability of Medishield Life is really a matter of individual capability. The less you earn, the more significant the contribution, and hence the less affordable the scheme, even if the premium quantum currently favour low-income households.
In addition, the premiums are now subsidised by the government over the next four years for what appears to be the bulk of the population, and Health Minister Gan Kim Yong has also promised that premiums will not increase in the first five years. What happens after the initial years? Will the government continue to subsidise the scheme to keep it affordable, and will premiums increase thereafter?
The answers are unclear, and hence affordability still remains a big question mark, particularly since healthcare costs will continue to increase. Affordability should not just be an issue with premiums, but with total costs associated with it.
As such, it is difficult to understand what the survey was really trying to discover.
Moreover, what the survey fails to address is the issue of coverage. Question 13, in particular, seems to imply that the increase in coverage, most significantly for the elderly and those with pre-existing illnesses, is taken for granted as sufficient. Has any effort been taken to understand if citizens might have grouses about what it the scheme covers? If not, why the certainty that coverage is sufficient?
Despite its short-comings, this survey is currently being conducted, very likely using tax-payers money. A proper and open evaluation of the results is needed, to properly critique all aspects of Medishield Life. Indeed, while the first five questions are completely different in nature to the rest of the survey, there would be many a Singaporean keen to know the results.