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终身健保只赔四元五角 揭示现有健保给付复杂 民众困惑

by Yee Loon
07/01/2019
in 健康, 报道, 时事
Reading Time: 1 min read
0

早前,《海峡时报》报导,一名82岁老翁萧万延(译音),到新加坡眼科中心进行白内障手术后,4477元的医药费,其终身健保仅赔4元5角,再次让民众留意到整体医疗保健的索赔程序过于繁琐,在一些手术和费用的高免赔额,也让保户自行承担大部分的费用。

萧万延是名退休商人,去年到眼科中心(SNEC)进行白内障手术,全额费用高达1万2000多元, 在扣除政府津贴后,最后的医药费为4477元。

萧万延动用自己的保健储蓄(Medisave)存款来支付其中的3000元自付额/免赔额(annual deductible)。

按理说,终身健保(MediShield Life)可承担医疗费首5000元的90巴仙,若超过1万元则承担97巴仙,然而,萧万延申诉最终终身健保只帮他支付4元5角。

报导出街后,卫生部发言人解释,终身健保的索赔限额是医疗账单的十分之九,但是作为国家转诊和高等眼科专科中心,其费用和成本会高于其他的医疗机构。

手术索赔上限2800元

再者,终身健保对特定手术的索赔上限为2800元。至于萧万延先生留院一晚和医疗消耗品的费用则是205元。在终身健保可以索赔的限额,是3005元。

《海时》在本月4日的跟进报导,分析萧先生的医疗费用和终身健保索赔的运作方式:

萧万延从保健储蓄掏出3000元支付上述可索赔限额后,事实上终身健保可索赔额就只剩5元。五元的十巴仙还是保户“共同承担”(copayment),所以最终终身健保只赔四元五角。余下的1472元,还得萧万延自己承担。

这使得萧万延先生不免申诉,终身健保的功能理应是减轻保户的医疗重担,不解为何不是以整体医疗费来计算,反之硬性规定索赔上限仅2800。

“如果不能减轻负担,就失去了保险的意义。”

医生批评太复杂  高免赔额致保户承担更多费用

一名不愿具名的高级医生,在本月2日接受本报采访时称,萧万延的个案,再再显示我国医疗保障系统过于复杂。

他直言保险中的高免赔额,意味着往往保户很难在一些昂贵和复杂的手术中,得到保障。

他认为这样的系统急需改革,减少其繁琐程度。

职总英康前总裁陈钦亮也参与到有关个案的论战,指出医保索赔的繁琐程序反而让保户感到混淆。

“政府希望病患为自己的医疗费用负起责任,但实际上很多患者都感到困惑,他们根本没办法去预算和控制医疗费用。”

“他们唯一能选择的,就是要去哪家医疗机构,然后治疗期间的各种消耗和附加费用,都会加诸在患者身上。”

陈钦亮建议,如果政府要鼓励民众使用健保储蓄和终身健保,就应为规范、为各类医疗费用定价,并且让公立医院和诊所依据定价,一口价收费,且吸纳其余费用,不允许对每项服务另外计费,斤斤计较。

“医院应控制自身开支”

他认为,医院应该考量控制自身的开支,因为现今国家花在基础设施、昂贵系统和薪资的开销太高了。

此外,他批评终身健保设定的免赔额过高,至少需减少至500元或更低;同时移除健保储蓄的顶额,这不会让病患随意索赔开销,因为病患始终还是需前往指定的医院来接受治疗。

“政府以为病患能有效控制开支的想法很幼稚。他们任由病患在商业化的医疗系统中被摆布。”

 

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