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WP’s Gerald Giam urges govt to release full actuarial report on MediShield Life scheme

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The Workers’ Party (WP)’s Gerald Giam has urged the Government to release the full actuarial report of the MediShield Life scheme to enable independent actuarians to accurately calculate its premiums and benefits.

The Aljunied GRC Member of Parliament (MP) in a Facebook post on Tuesday (3 November) gave a recap on how he had asked Senior Minister of State for Health Koh Poh Koon for the report in Parliament during the debate on the proposed hikes of MediShield Life premiums on Monday.

Dr Koh, however, replied that the Government may release more actuarial calculations to external consultants and academicians for further analysis.

Mr Giam in his Facebook post highlighted that other jurisdictions such as Taiwan have already released actuarial reports for their national insurance schemes.

“For example, Taiwan’s National Health Insurance Administration is required by law to release an actuarial report every 5 years, and their latest report is available on their website.

“I urged the Government release a report like this so that independent actuaries can analyse it. This will go a long way in improving transparency and helping Singaporeans understand the calculations behind MediShield Life’s premiums and benefits, instead of being asked to take the Government’s word for it,” said Mr Giam.

The Government had earlier announced that MediShield Life premiums may rise by up to 35 per cent next year, making the first increase in premiums for compulsory health insurance since its launch in 2015.

Dr Koh told the House yesterday that the number of MediShield claimants has increased by about 30 per cent over the last four years, while annual payouts have increased by about 40 per cent.

He added that the size of the average hospitalisation bills for public healthcare institutions had increased by about 6 per cent a year on average, between 2001 and 2019.

“They need to be adjusted to ensure that the MediShield Life Fund remains solvent and sustainable so that it can meet its obligations to all policyholders,” said Dr Koh, emphasising that premiums have been kept unchanged for the first five years of the scheme.

Progress Singapore Party’s (PSP) Non-Constituency Member of Parliament (NCMP) Leong Mun Wai asked whether it is unusual by international standards for a health insurance scheme to increase its premiums by 35 per cent in a single adjustment.

Dr Koh responded that it would not be appropriate to compare MediShield Life’s premium increases with other schemes as premiums are priced based on multiple factors “which inevitably vary from country to country”.

Mr Leong also asked the Senior Minister on the total MediShield premium that will be paid by an individual in a lifetime, assuming that the premiums are compounded at 2.5 per cent and four per cent interest respectively.

Dr Koh replied: “It would also not be meaningful to compute how much premiums a Singaporean will need to pay over his lifetime simply by assuming a fixed compounding factor each year.”

He explained that future premiums depend on how underlying drivers evolve and this depends on many factors, adding that the amount of premium subsidies an individual receive will also vary over his lifetime, depending on the person’s financial circumstances.

Dr Koh also pointed out that financial support schemes are provided to all Singaporeans in order to ensure that they can continue to pay their premiums.

“Taken together, about 35 per cent of the total premiums collected were paid for by the Government through various subsidies and support schemes in 2019. For the elderly aged 65 and above, the contribution from the Government is even higher, at about 50 per cent of their premiums,” he noted.

The Government had considered deferring the MediShield Life review and premium increases following the current economic situation brought by the global pandemic, but Dr Koh emphasised that it has to remain “solvent and sustainable” so that it can meet “its obligations in time to come when policyholders make claims”.

“Its coverage also has to be updated and enhanced to remain relevant to the healthcare needs of Singaporeans,” he added.

Dr Koh revealed that a total of S$7.5 billion in premiums was collected between 2016 and 2019, comprising S$4.4 billion collected from policyholders and S$3.1 billion from the Government in terms of subsidies and other forms of premium support.

He added that S$3.5 billion in claims were paid out in the same period, while S$3 billion was set aside for future premium rebates.

Dr Koh also noted that the Incurred Loss Ratio of the fund was an average of 104 per cent from 2016 to 2019, which means that the total premiums collected were “slightly less than the total monies required to ensure that the fund is able to meet current claims and future commitments”.

He went on to emphasize that the fund has to be “self-sustaining” and based on “sound actuarial principles”.

“Premiums collected have to cover potential current and future payouts, including amounts set aside to support future commitments as well as provide a buffer against unforeseen contingencies such as unexpected spikes in hospitalizations due to disease outbreaks,” Dr Koh asserted.

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Survey reveals one-third of Singaporean youth struggle with severe mental health issues

A national study by the Institute of Mental Health reveals that 30.6% of Singaporean youth suffer from severe symptoms of depression, anxiety, or stress, driven by factors like excessive social media use, body image concerns, and cyberbullying. The findings emphasize the need for early intervention and targeted mental health strategies.

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A significant portion of Singapore’s youth are experiencing severe mental health challenges, according to a comprehensive national survey conducted by the Institute of Mental Health (IMH).

The National Youth Mental Health Study (NYMHS), released on 19 September 2023, found that 30.6% of individuals aged 15 to 35 reported severe or extremely severe symptoms of depression, anxiety, or stress, with key risk factors including excessive social media use, body shape concerns, and experiences of cyberbullying.

The study, which surveyed 2,600 Singaporean citizens and permanent residents, highlights the growing mental health concerns among Singaporean youth and suggests the need for more targeted interventions and support systems.

Mental Health Issues Prevalent Among Youth

Anxiety was the most common mental health issue, with 27% of respondents reporting severe or extremely severe symptoms, followed by depression (14.9%) and stress (12.9%).

These findings underscore the high prevalence of mental health issues among young people, particularly in those aged 15 to 24, who were more likely to report severe symptoms compared to older participants.

According to the IMH, young people who were female, single, unemployed, or had lower levels of education or household income were more prone to severe mental health symptoms.

For example, youth with monthly household incomes below S$5,000 were more likely to experience severe anxiety​.

Key Risk Factors: Social Media, Body Image, and Cyberbullying

The study identified three major factors linked to severe mental health symptoms:

  1. Excessive Social Media Use: Around 27% of respondents reported using social media for more than three hours daily, which was associated with a significantly higher likelihood of severe mental health issues. Youth with excessive social media use were 1.5 to 1.6 times more likely to experience severe symptoms of depression, anxiety, or stress​.
  2. Body Shape Concerns: About 20.2% of youth had moderate to severe concerns about their body image. These individuals were 4.9 times more likely to experience severe depression, 4.3 times more likely to experience severe anxiety, and 4.5 times more likely to suffer from severe stress​. Such concerns were often linked to social media exposure, which can perpetuate unrealistic beauty standards and increase dissatisfaction with one’s body.
  3. Cyberbullying: One in five youth (21%) reported being victims of cyberbullying. These individuals were approximately twice as likely to report severe mental health symptoms compared to those who had not experienced such harassment​. The anonymity and pervasive nature of online bullying exacerbates the mental health toll on young people, according to the study.

Demographics at Higher Risk

The study found that specific demographics were more vulnerable to mental health issues. Young people aged 15 to 24 were more likely to experience anxiety, depression, and stress, particularly females, those who were single, and those with lower levels of education, such as junior college or vocational qualifications​.

The Malay ethnic group was also found to have a higher prevalence of severe mental health symptoms compared to other ethnic groups​.

Barriers to Seeking Help and Sources of Support

Although about 69.1% of those with severe mental health symptoms sought help—primarily from family and friends—a significant portion of young people hesitated to seek professional support.

The top reasons included concerns about privacy, fear of judgment, and doubts about the effectiveness of professional services​.

Among those who sought help, family and friends were the most common sources of support (57.9%), followed by self-help measures (31.1%) and medical services (20.1%)​.

However, the reluctance to seek professional help highlights the need for continued efforts to destigmatize mental health treatment and increase awareness of available services.

Protective Factors: Resilience, Social Support, and Self-Esteem

The study also identified factors that helped mitigate mental health challenges. Youth who reported higher levels of resilience, perceived social support, and self-esteem were significantly less likely to experience severe symptoms of depression, anxiety, or stress.

This suggests that fostering strong support networks and building resilience in youth could play a critical role in improving their mental well-being​.

Government Response and Preventive Measures

The findings of the NYMHS support Singapore’s broader National Mental Health and Well-Being Strategy, launched in October 2023, which adopts a whole-of-government and whole-of-society approach to addressing mental health concerns. Schools have already begun integrating mental health education into their curricula, equipping students with the knowledge and skills to manage their well-being.

Additionally, the government introduced the Parenting for Wellness toolbox in September 2023 to help parents manage their children’s screen time and promote healthy social media usage.

A guide on responsible social media use, expected to be released by mid-2025, will offer further strategies to mitigate the negative impacts of excessive screen time and online harassment​.

Future Implications and Policy Development

Associate Professor Swapna Verma, chairman of IMH’s medical board and co-principal investigator of the study, emphasized the importance of early intervention.

“Not all individuals with severe or extremely severe symptoms of depression or anxiety have a clinical condition, but being in such states for a prolonged period of time can be detrimental to their well-being,” she said​.

The study’s data will help policymakers and healthcare providers develop more targeted approaches to address the mental health needs of Singapore’s youth, especially those most at risk.

Associate Professor Mythily Subramaniam, IMH’s assistant chairman of medical board (research), stressed the need to pay attention to issues like excessive social media use and cyberbullying, noting their “tremendous impact on youth mental health” and the importance of preventive measures​.

Support for Youth Facing Mental Health Challenges

Young people dealing with mental health challenges in Singapore have access to various resources:

  • CHAT (Centre of Excellence for Youth Mental Health): CHAT offers a safe and confidential space for youth to seek help through online and face-to-face mental health assessments and support.
  • Institute of Mental Health (IMH): IMH provides a comprehensive range of mental health services, including outpatient consultations and inpatient care. Youth in crisis can also seek immediate assistance from the 24-hour Mental Health Helpline at 6389 2222.
  • Samaritans of Singapore (SOS): SOS offers emotional support for those feeling distressed or experiencing suicidal thoughts. Their 24-hour hotline is 1767.
  • Health Promotion Board’s National Care Hotline: This hotline provides immediate emotional support for those in need and can be reached at 1800-202-6868.
  • Counselling Services: School-based counsellors, as well as community-based services such as TOUCH Youth, provide further avenues of support for young people grappling with mental health issues.
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Malaysia reports new mpox case in man without recent international travel

Malaysia has confirmed its first mpox case of 2024 in a male patient, the Health Ministry reported. The patient is in isolation and stable, with authorities monitoring his contacts. This brings the total confirmed cases since July 2023 to ten, all from clade II.

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MALAYSIA: The Malaysian Health Ministry confirmed a new case of monkeypox (mpox) in a male citizen, marking the country’s first confirmed case of 2024.

The patient, who began showing symptoms on 11 September, is currently in isolation and in stable condition.

The ministry, in a statement issued Tuesday (17 September), revealed that the patient first experienced fever, sore throat, and cough, followed by the appearance of rashes on 12 September.

He has no recent history of international travel within the past 21 days, and authorities are in the process of identifying and monitoring his close contacts, following strict standard operating procedures (SOPs).

“Out of the 58 suspected mpox cases referred to the ministry this year, one case has been confirmed positive for mpox clade II as of 16 September,” the ministry stated.

“All 10 cases reported in Malaysia since July 2023 have been from clade II.”

The Health Ministry had earlier reported that Malaysia recorded a total of nine mpox cases since the first detection on 26 July 2023, with the most recent case reported in November 2023.

All previous cases had links to high-risk activities, but no deaths were reported.

Global Context and National Preparedness

Mpox was declared a Public Health Emergency of International Concern (PHEIC) for the second time on 14 August this year, due to the rapid spread of the clade Ib variant, particularly from the Democratic Republic of Congo (DRC) and neighboring African nations.

In response, Malaysia’s Health Ministry activated its national crisis response centre on 16 August to enhance readiness and coordinate preventive measures.

The ministry advised the public to take precautions, including maintaining personal hygiene and avoiding direct contact with individuals suspected or confirmed to be infected with mpox.

High-risk individuals experiencing symptoms such as fever, swollen lymph nodes, and rashes are urged to seek immediate medical attention.

Mpox is caused by the monkeypox virus (MPVX) and spreads through close contact with symptomatic individuals.

The incubation period is typically between 5 and 21 days, and patients remain contagious until all lesions have dried up and fallen off.

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