MOH concludes full portability of Integrated Shield Plan insurance will not be mandated

The Ministry of Health (MOH) has decided against mandating full portability of Integrated Shield Plan (IP) insurance policies, following a comprehensive feasibility study. Released on 19 November 2024, the findings highlight cost concerns, international norms, and the sustainability of Singapore’s healthcare system as key factors.

A ministry spokesman explained to local media, “In other countries, insurance is portable insofar as it is mandatory national insurance, which is what we are doing under MediShield Life. Some countries, namely Australia and Ireland, implemented portability for supplementary and private insurance, but those are done under very specific circumstances. It is also not cheap, involving spending of public monies and setting up new administrative structures.”

The study, initiated in 2021, involved consultations with insurance experts, policymakers, and stakeholders and a review of systems in other nations. It found that private insurers typically avoid competing for higher-risk policyholders with preexisting conditions, complicating efforts to achieve portability.

MOH stressed that strengthening MediShield Life, Singapore’s national health insurance scheme, is a more effective way to support policyholders.

It further emphasised that MediShield Life provides basic coverage for all residents, and recent enhancements aim to better address the needs of those with preexisting conditions.

The ministry also noted the availability of platforms like the Financial Industry Disputes Resolution Centre for policyholders facing claim disputes.

This approach aligns with international best practices, where portability is usually restricted to mandatory national health insurance schemes.

MOH concluded that mandating portability for IPs would involve high public expenditure and administrative challenges, as seen in countries like Australia and Ireland.

The ministry reaffirmed its commitment to managing healthcare costs and ensuring accessible, affordable healthcare for all Singaporeans through initiatives such as MediShield Life and MediFund.

Rahayu Mahzam defends rejection of full portability for Integrated Shield Plans

On 12 November, Minister of State for Health Rahayu Mahzam responded to questions from Dr Tan Wu Meng, Member of Parliament for Jurong GRC, about IP portability during a parliamentary session. The discussion focused on policyholder challenges and insurers’ practices.

Dr Tan highlighted feedback from constituents, particularly those in their 50s and 60s, who reported frustrations with insurers altering terms, such as restrictions on doctor selection or access to benefits.

He questioned whether insurers were upholding their social responsibility, given their privilege of deducting premiums from CPF MediSave accounts. Referring to earlier remarks by Health Minister Ong Ye Kung, Dr Tan asked if insurers knowingly sold unsustainable products.

Ms Rahayu acknowledged the difficulties faced by policyholders and explained that MOH had examined global IP portability models.

She noted that countries like the Netherlands and Switzerland ensure portability only for basic health coverage under mandatory national insurance schemes. Supplemental private insurance in these countries remains subject to underwriting, limiting portability.

She also highlighted examples from Australia and Ireland, where full portability for private insurance exists but relies on extensive mechanisms like risk equalisation funds, requiring significant public funding and administrative infrastructure.

Ms Rahayu reiterated that such an approach would not align with Singapore’s healthcare framework or international best practices.

Addressing Dr Tan’s concerns about insurers’ practices, Ms Rahayu stated that many insurers are grappling with the sustainability of their health portfolios.

Ms Rahayu explained that adjustments to policies often reflect broader efforts to maintain viability in the market. She added that while these changes can be frustrating for policyholders, MOH continues to monitor insurer practices to ensure balance and fairness.