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Dr Paul Tambyah muses about Singapore’s politics, healthcare system and the upcoming general election

Chairman of the Singapore Democratic Party (SDP) Dr Paul Ananth Tambyah was recently interviewed by The Online Citizen (TOC) regarding the history and motives behind his political career, his perspectives on Singapore’s public healthcare system, the controversy of his political donations and contributions, his opinions on the alternative parties alliance, the effect of the fake news bill on the imminent general election as well as his aspirations for SDP’s future plans and goals.

Dr Paul was an infectious disease researcher and medical doctor before he considered a political career. Although his family was very supportive about it, he faced a huge challenge when it came to his mother who was sceptical in the beginning. This was because his mother and her generation had a negative and guarded perception of Dr Chee and his political party, having been influenced by the media portrayal of the SDP in the 1990s.

Many people have wanted to join The People’s Action Party (PAP) to “try and change things from within”, claiming a “smoother” path. At one point, Dr Paul considered giving feedback as he had done so at public fora organised by the government and various ministries.

“But ultimately, I think I came to the conclusion that the system is such that it’s a bit too entrenched and it’s very difficult to change course. For one individual to try and change the course of the entire PAP machinery is just practically impossible,” he remarked.

To be a Member of Parliament was not Dr Paul’s ultimate goal. The reason he went into politics and joined the SDP is his desire to improve things in Singapore. One of them that he cited as an example is the country’s healthcare system which has been deemed as the world’s best. In spite of this, many people have not been granted access to proper healthcare and the resources are not channelled to those who need it most.

This issue requires a party with strong ideologies and this is where SDP comes in; with their clear ideology committed to people above profits, wisdom above wealth, as well as all that has been discussed in the Manifesto about the cost of living and various other policies, Dr Paul said. He quoted the second Prime Minister Goh Chok Tong who told Singaporean author Catherine Lim: ‘If you really want to change things, you’ve got to get into politics.’

“And so, I took his advice”, he said.

Next, he highlighted the complicated situation of the high-grade healthcare system in Singapore due to “extensive government subsidies” yet “significant out-of-pocket payments”. He mentioned one of the biggest major changes since 2015, which is the introduction of “universal healthcare” MediShield Life.

“However, it’s not truly universal in that the deductibles are still very high. You have to pay the first S$3000 which covers the vast majority of C-class hospital bills. In other words, most people who are admitted to C-class wards will not be able to claim a cent from MediShield Life. And this became the most apparent for this poor old man who went for the procedure at the eye centre, where MediShield Life only paid S$4.50, despite the fact that he had been contributing several hundred, or maybe more than a thousand dollars, every year to MediShield Life. And that’s the limitation of MediShield Life,” Dr Paul said.

The benefit of MediShield insurance is that it provides extensive coverage for pre-existing illnesses than other private insurance companies. The downside, though, is that it is not very generous in terms of deductibles and copayments. This has led to the increased cost of healthcare as government subsidies would result in an increase in consultation charges.

To illustrate his reference, Dr Paul alluded to the CHAS system and pioneer generation. Despite the subsidies provided for individuals going to polyclinics and general practitioner (GP) clinics, not everybody is a beneficiary of the pioneer generation thus they would not be able to afford the revised basic cost of a consultation.

A scheme was conceived with good intentions, which is to provide patients with subsidized care at GP clinics ended up contributing to the spiralling healthcare inflation in Singapore due to the variable copayment factor, Dr Paul deduced.

Dr Paul also brought up the recent data breaches that revealed the limitations of the electronic health record. It started with the input of federal resources into electronic and digital health record during the Obama administration, with the aim of reducing medical errors like allergy and dosage information through algorithms and such.

“But in reality, most electronic medical records in the United States and Singapore are designed for billing purposes. Every time I see a patient in the clinic, I cannot progress or enter my notes until I fill in a diagnosis code and the year or date in which the diagnosis is made. And the reason for that is so that the insurance company can deny the payment if the diagnosis is made before the person bought the insurance,” Dr Paul explained.

This purpose of electronic healthcare systems is emphasized over important health alerts and other features. Also, the digitisation of medical records exposes them to the risk of cyber threats and security breaches, such as the blood donor data leak, the SingHealth cyber attack and the HIV data registry leak which happened of recent in Singapore. Therefore, electronic medical systems need to improve safety and public health rather than focusing on billing.

Another aspect of healthcare in Singapore that affects doctors on a daily basis is the recent medical council rulings, especially in the case of defensive medicine. According to Dr Paul, the Ministry of Health does not guarantee their support or defence for those who practise good medicine in the best interest of the patient. This was made clear in an episode whereby a psychiatrist acted in what he thought was the best interest of the patient during a potentially life-threatening situation but ended up paying the price for it. This has created a tremendous knock-on effect, Dr Paul asserted, which would require clear communication and strong leadership from the top guns to resolve.

Then, there is also the issue of Internet surfing separation which was implemented to curb data breaches. The problem is that it also prevents medical professionals from being able to acquire essential information easily because the computers at the hospitals are barred from online access. Placing in-house resources within the intranet of the system proved to be “scrambling” and “reactive”, making you wonder if it could have been done in a better way, Dr Paul said.

Around the year 2015, Dr Paul who had just turned 50, stirred up a bit of news when he made a donation of a considerable amount to TOC around the Bukit Batok by-election period which he addressed at one of the rallies. In fact, Dr Paul proclaimed to have made significant contributions to organisations for causes he championed, including his church, Action for AIDS, autism and migrant workers charities. He added that the donations are transparent and clear with “nothing to hide”.

He also mentioned that the reason he contributed to TOC was that he believed in freedom of speech, expression and the press. “I think TOC are amongst the last remaining bastions of the free media in Singapore”, he added. He stated that as long as the donations are public knowledge and politicians have the right to give to whichever organisations they support and charities in need. “There is no reason why a politician who believes in a democratic society should not be giving to that”, he said.

As for the topic of alternative party supporters calling for an alliance akin to Malaysia and Thailand, Dr Paul reasoned that “Thailand’s alliance is yet to be formalised” and it illustrates some of the problems in trying to “form a coalition from very different groups of individuals, different parties with different agendas”.

Nevertheless, he also observed some encouraging signs that the alternative parties in Singapore may be able to cooperate. He recollected the photography session he had with Dr Tan Cheng Bock, head of newly formed party, Progress Singapore Party, Pritam Singh, head of Workers’ Party and SDP’s chief, Dr Chee Soon Juan in which they shared a meaningful discussion during the Chinese New Year open house event earlier this year.

“There had been informal and formal discussions about working together and basically, it’s the kind of situation where we have individuals who may have different ways of reaching the same goal but we ultimately have the same goal, which is a more democratic Singapore based on justice and equality,” he said.

However, political parties working together in the future might have to take a back seat to the impending fake news law which would have a chilling effect on the response from commentators and members of the public during the election period. The unintended consequences from this bill would not only publicize the less important voices into prominence but it is also a tool of desperation for leaders such as US President Donald Trump and former Malaysian Prime Minister, Najib Razak to use when their backs are against the wall.

Back in the 1960s, the credibility of the PAP was based on a solid track of achievements which made them unafraid of any public opinions or claims. They used the Internal Security Act to oppress competition and the Newspaper and Printing Presses Act to suppress free media so they saw no real need for the fake news legislation. Dr Paul believed that fake stories have no credibility as people can see the reality of their lives in Singapore. To resort to this sort of law displays insecurity and uncertainty about the future, which is “sort of encouraging in a paradoxical way for the alternative parties”.

As the chairman of SDP, Dr Paul hopes that this “party of ideas” will be able to move beyond their reputation of being able to absorb blows and bounce back from difficult situations, especially through Dr Chee who has been a source of inspiration to many for his ability to recover from his past bankruptcy and losses.

He also spoke of SDP’s comprehensive agenda and the policies they have in place to be revamped and relaunched. There would be events held in the months to come, which were some of the plans discussed during the campaign launch. In spite of PAP’s stronghold with the mainstream media and grassroots bodies presently, Dr Paul is confident that SDP would be able to “chip at the edifice” with the help of social media, dedicated volunteers and a good strategy.

Through dedication and commitment, denying PAP a two-thirds majority during the upcoming general election would be a realistic and reasonable goal for SDP to aim for, indeed.

Disclaimer: The views and opinions expressed here are personal and do not represent those of people, institutions or organisations that the owner may or may not be affiliated with.