04 January 2008

The healthcare funding gap

Is there a healthcare safety net or not? We have all these various schemes from Medisave to Medifund, but do they provide comprehensive coverage? Full essay.


Anonymous said...

Great analysis. While the means testing is to ensure that only the poorest gets the necessary help from the government, I do not see why tax payer's money should be directed towards minister's pensions and free medical benefits. (the ministers are poor?) Is it not better to direct these millions to the citizens who wish to stretch their savings by staying in C wards? Why deny them the chance to eat porridge (C ward) and insist they eat lobster (B and A ward) when they feel they cannot afford lobsters over the long term?

Anonymous said...

This is a very good report. Thank you for sharing.

I once tried to get the help from the medifund option available only to find out from these so called "social workers" stationed at the hospital that you must reveal your bank account to them and that you had tried to begged for help from you siblings. I had also seen other people begging these "social workers" to approve their application for medifunds (yes begging).
I was even told in the face by the social worker that...I am sure you know that our government do not encourage welfare. And lastly my siblings has got nothing to do with me. They have their own problems and families to take care.

It appears to me that the government want to make sure you lose your dignity and all before you get to be considered to for the medifund option. Never fall into the trap of thinking this way........wow the government is so good offer to help us poor people...

Whatever so called 'goodies and help scheme' that the government dish out, it's all tokenism to me. The devils are all in the details of these 'help schemes'. It is more like "give them something to show that we at least appeared to be helping the people and make very very sure that it not easy to qualify for help schemes..."

Anonymous said...

I agree with anon 11.59. We tried getting some help from the social workers as my parents have seen their savings decrease substantially over the years because of illnesses. My sibling's medisave is almost at zero and they are targeting me next. I have none to begin with! As soon as one parent goes, Im dragging the other to the place Im living in now, I'd rather pay high taxes to the govt where I am now and get medical treatment covered (for myself and other citizens).

Teck Soon said...

A free press would have demanded detailed data from the government. Famed Singapore transparency at its finest here. Why does Singapore always rank so well internationally for "transparency" when you have recently highlighted so many areas where the Singapore government is not transparent at all? Is there some way these transparency ranking organizations can be made aware of these things?

Anonymous said...

organizations measuring transparency are not always transparent themselves; in fact, if they are too transparent about their formulae, the governments being measured would make a deliberate effort to up the numbers used in the formulae

to take an example from university ranking lists: if the % of foreign students is part of the formula, you can offer more scholarships to foreign students to get them to come


Anonymous said...

By now, it should ve clear that this govt is gradually cutting back on all forms of state subsidies.....from HDB conservancy fees, compulsory CPF annuity (this effectively taxes S'poreans to fund the retirement of older S'poreans) and now Mean Testing (absence of "s" in "Mean" is deliberate).

The govt often does it by making claims for subsidies (such as Medifund) difficult and troublesome.

KiWeTO said...

I seem to remember some time ago, some minister, mayhap from some health-related portfolio, or someone, made the statement or expressed the philosophy that:

The family is the FIRST line of medical cost defense for any individual.
(and addendum - the state is the last line of defence).

Now, if I comprehend the philosophical concept of insurance, it was to ensure that the greater whole help take care of those struck by the fate of randomness. From one perspective, they 'subsidize' or help defray the costs of those unlucky individuals. (who, if one believes in societal-level of karma, some must die for the majority to prosper kind of philosophy)

However, private insurance guarantees that those most likely to need fee assistance, are also those most likely to be rejected. (in the interests of profit, every payout is a loss to the bottom line).

I understand that under the SWISS level of healthcare - everyone pays a fixed fee a year (or a higher fee depending on their desire for better beds), and then to a certain level, all medical coverage is paid for by the national fund. It is complicated in its own way, but when elderly swiss prefer to live in Switzerland rather than risk expensive medical fees in Bangkok, then, there must be some real societal level of medical care for its members.

Coming back to the SG philosophy - now, as aptly described by many, the family is nuclear (stop at 2 punishing us further again), small, and unable to seriously fund medical care should illness strike more than one member of the 'family'.

If so, it then begins a negative spiral of medical un-surance, where once the family's medisave is empty due to one illness, the family cannot let any other member fall to another long-term illness.

Now, as I understand it, most nuclear families have up to 4 grandparents, who may or may not have 4 kids (or more) to support them. So, we should choose now which of the 4 grandparents should get the medical fee support in advance now? Or, amongst the four grandparents, see who gets to be the lucky one?

Also, it appears that with the family as the first line of medical fee defense, it leads that a second medical crisis will lead to the family ending up in all kinds of debt to pay for the fees. (all in all, medical care be medical care, but money does matter when determining when to carry out that potentially life-saving but not critical injury).

By saddling the family with such loans, rather than spreading the financial load out amongst the greater society, we continue to create a society of haves and have nots.

and sadly, no one can predict when a medical crisis can strike a 'family'. Our system guarantees that not only the individual and immediate family's financial defense is consumed, but that the family must now pray that no other illnesses ever strike them again.

Its a wonder that we claim to have a swiss-standard of living. I dread the day when my remaining parent's medical bill becomes a reality.


Anonymous said...

Would just like to point out a small error: "Singapore spent about S$6.8 billion (approx US$10.5 billion in 2004 exchange rates) on healthcare in 2004." Clearly there is something wrong in the exchange rate calculation.

Yawning Bread Sampler said...

Ooops! Corrected.