Health consultant criticises Gan for taking another 2 years to review Medishield Life claim limits

Four years ago in Jan 2015 when Health Minister Gan Kim Yong introduced the MediShield Life Scheme Bill in Parliament, he said that MediShield Life would enable all Singaporeans to “come together as a nation to build this healthcare safety net, so that no one is left behind”. It would extend help to the vulnerable and the needy, he said.

“I would like to reiterate that this Bill goes beyond providing the legislative framework for the operation of a national Scheme. It is a Bill that provides many firsts in the Government’s efforts to help Singaporeans fulfil their aspiration,” he said.

“Like many first steps, there will be lessons to learn from and things to improve on. We will work with Singaporeans to bring the Scheme closer to our vision as we move forward.”

“If there are hiccups along the way, I’m sure there will be, please bear with us as we do our best to fix them as quickly as we can,” he added.

20 per cent of medical subsidised bills were above Medishield Life claim limits

However, recently, cases have surfaced that some public hospitals are charging certain medical procedures more than what MediShield Life is allowed to cover. In a recent story which shocked many Singaporeans, Mr Seow Ban Yam, 82, was asked to fork out most of his $4,477 post-subsidy bill for an eye operation when MediShield Life was only allowed to pay $4.50 for the bill.

In light of the public furor over the case, MOH replied on ST Forum on Tues (8 Jan) that eight in 10 subsidised bills were within the Medishield Life claim limits. That means to say, 20% of the subsidised bills, like the one billed to Mr Seow, were not.

MOH explained that in Mr Seow’s case, the procedure he had to undergo is uncommon and complex, and was performed by a senior consultant. However, it shared that there is an ongoing review of claim limits to ensure that MediShield Life’s coverage remains broad-based and sustainable.

“The review will be completed by end 2020. In the meantime, patients who face financial difficulties can apply for assistance such as Medifund to ensure that healthcare remains affordable,” it added.

Health consultant: Public confidence in MediShield Life shaken

With regard to Mr Seow’s case, Dr Jeremy Lim, a health consultant with Oliver Wyman wrote an opinion piece which was published on ST today (‘MediShield Life payouts: For true peace of mind, limit patients’ exposure to big bills‘, 10 Jan).

Dr Lim opined that the fracas involving Mr Seow’s negligible insurance payout for a complex eye operation has shone the spotlight on the adequacy of Singapore’s MediShield Life scheme.

He argued that while claim limits protect MediShield Life from excessive claims, he would like to see the policy enhanced to also protect patients from making excessive cash outlay, like in Mr Seow’s case. In addition, he proposed also capping the patient’s co-payment instead of leaving it “open-ended”.

In particular, he was critical of MOH not fixing the issue fast enough. “MOH has said it would conduct a review by the end of next year, but with more than $1.5 billion already paid out to over 200,000 Singaporeans, surely there is enough experience to start identifying gaps and improving the scheme?” Dr Lim asked.

“Health Minister Gan Kim Yong previously assured Singaporeans that while ‘hiccups’ were unavoidable, MOH would ‘do our best to fix them as quickly as we can’. Asking the public to wait two years may not be palatable,” he added.

“Like it or not, public confidence in MediShield Life has been shaken by this episode (of Mr Seow’s case).”

He hopes the government would move decisively to restore confidence in the public with regard to the MediShield Life scheme.