By Terence Lee / Youth Editor
13th DECEMBER — HEALTHCARE in Singapore is affordable as long as one is willing to accept the B2 and C-class wards without fear of losing face, said Mr Tan Kin Lian at a forum on economic rights.
He asked the audience: “Why complain about the bill when you go the the A-class ward?”
According to him, B2 and C-class wards are highly subsidised and of good quality, and a “cap on bill” exists to ensure medical fees in these wards do not escalate too much.
Held at the URA Centre on Saturday by the Society of Financial Service Professionals in conjunction with U60, the forum also saw financial consultants Leong Sze Hian and Lyndon Chew speak on different topics.
Singapore’s healthcare system enjoys a high world ranking, said Mr Tan, and this is due to the fact that responsibility for healthcare is placed on the individual. The state does not pay for everything, preventing overconsumption and keeping costs down.He also advised that Singaporeans stick with Medishield as it is adequate enough to cover medical costs in subsidised wards.
Mr Tan estimated that the lifetime cost of a private shield plan could run up to $100,000, but a Medishield plan will cost only about $40,000.
“If you are happy to contribute to the AIGs of the world, then its okay, you can go ahead,” he added.
“Some have told me: It’s better to die than to fall sick in Singapore,” said Mr Tan, citing a common refrain among lower income groups here.
“But is the situation really that bad?” he asked. “Apparently not.”
Singaporeans pay only about $800 for healthcare annually, constituting “less than 5%” of the nation’s GDP, he said.
This is in stark contrast with countries like the US and Germany, which stand at 15.3% and 10.7% respectively, he said.
A check with a World Health Organisation (WHO) report confirmed that Singapore ranked 6th in overall performance of the health system in 1997 (no later figures were available).
“The 3Ms — Medisave, Medishield, and Medifund, are there to help make healthcare services more affordable here,” he said.
He added that “healthcare costs are manageable, despite rising costs and the aging population.”
The biggest concern for Mr Tan, in fact, is that people are not educated about making the right choices when it comes to accessing and funding healthcare.
However, this is not helped by the lack of clarity about means-testing.
“If I’m a multi-millionaire, am I allowed to go to the C-class ward? The answer is still yes, just that I’ll enjoy less subsidies than someone from a lower-income household,”
“The Singapore system is so complicated — there’s too much criteria — that you are excused if you don’t know, even I myself don’t know until I found out!” he said in mock exasperation.
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It is quite true if we stayed in Classes C (discount up to 90%) or B2 (up to 75%), at least 90% of the bills are payable by medisave.
That is probably why even the rich want to stay in such classes when they are sick.
Means testing is a chore and applies more to those who are middle income. They will pay more than those who are poorer. With means testing, many will need to pay more than the current rates as it takes into account combined household income, number of household members and type of property. Obviously, those who stay in private houses are not entitled to subsidy according to means tasting procedures.
Frankly, I felt that the hospital bills are not as frightening as after-care costs.
Bills can be paid by medisave but aftercare costs can’t. Many who need to hire a maid to care for their aged loved ones when they go to work have to do so in cash. Nursing homes are even worse with charges ranging from $1000 – $1500.
As our population ages, healthcare cost will be a significant issue for all SIngaporeans. Means testing is still unsure yet for the time being. It will be unpopular as one hs to pay more when this is being implemented.
In SingaPOOR, people say you can die but don’t get sick. So it is better to buy some insurance to cover hospitalisation.
A bit strange for TKL to be saying that people not taking up subsidised health care.
The problem, to my understanding, is the lack of capacity in these subsidised wards to cope with demand. Hence, the notion of means testing to force people who can afford goes to higher grade ward.
Besides, my understanding is not just hospitalisation but post-hospitalisation cost that has to be taken into account if you want a fuller picture of the healthcare cost.
Also it is necessary to take the so-call healthcare spending as a percentage of GDP in the context of Singapore needs to be taken with a big dose of salt. The measures possibly reflect the amount of money the GOVERNMENT spends on health care and quite possibly does NOT account for Private Spending.
aiyoyo
can the subsidy information made easy for commoners understanding??
easy understand, easy to select which category to go to,
easy to pay $$ that commoners that can afford etc. etc. etc.
just make things easy la
(so many clauses, term & conditions made commoners difficult understand)
aiyoyo
I am not impressed with the care provided by our hospitals. My personal experience is that very often patients are made to pay for routine tests which they really don’t need. Our hospitals rely too much on their state of the art machines. Maybe it is a way to recover costs. I also do not think that B2 and C class patients receive the necessary appropriate care. Again, from my personal experience, they are treated as guinea pigs.
As for payment by medisave, isn’t this our own savings? Our government is good at ensuring payment of hospital bills.
Finally, hospitals always ensure that a would be patient has funds to pay. Hospitals these days look like business centres.
I went to a B class ward for a few hours for a very minor operation when I was a SAF warrior.
OK no problem
I am in my late 60s and no problem yet.
Never been to any of the class wards for the last 30 years and so I cannot comment.
However, if the time comes and if they do not treat me in a justifiable manner I will shout, yell and break things and the doctors and others will be in such a panic that they will do a turnaround and give me the right kind of medicine and care. I swear I will do that and shout until I die or in other words protest until I kick the bucket and go to boot hill. Is that OK tankinlian?
Ronnie
From January next year onwards, all middle-class S’pore citizens will see a HUGE increase in hospitalisation bills if they were to be warded at govt hospitals. This is because 1st January would be when MEANs Testing starts. The subsidy rate would drop from 80% to 65%, depending on your income level. That means the out of pocket expense for a patient would increase from 20%-points to 35%-points…….that is a 75% increase [i.e. (35%-20%)/20%] !!!!
Our govt wants to implement MEANs Testing due to the large increase in the num,ber of PRs, who get to enjoy almost the same subsidy as S’pore citizens!!
I have visited relatives and friends in B2 and C class wards. They are satisfactory.
For people with high expectations, they can go to A class ward or private hospitals and pay the larger bills.
Is this going to be again a discussion about what the citizens deserve vs. what the PRs get?
Well, in most countries the PRs get the same as citizens, the only thing they don’t get is the right to vote.
Why in Singapore are the citizens not happy with this and want more over the PRs? why aren’t they happy with just being Singaporeans and the right to vote for their leaders?
Ask yourself that.
Mr Tan Kin Lian,
why aren’t there enough B2 and C wards for 80% of the population?
The top 20% sure can all pay a stay in ICU at full price, but what about the others?
A roof and health; these are the two necessities in life.
When one have to give up one’s roofs in order to get health, it is time to increase the Income Tax for the higher incomes and to subsidize more (and not just hospital stays).
9) Tan Kin Lian on December 14th, 2008 10.23 pm wrote:
I have visited relatives and friends in B2 and C class wards. They are satisfactory.
For people with high expectations, they can go to A class ward or private hospitals and pay the larger bills.
The issue at large according to this article and the thrust of the arguments is the affordability of the health care systems, right?
If so, the issue of whether is not how satisfactory these wards are. The problem it seemed is that either:
(a) you have confused two issues (of general affordability and an satisfactory-ness, not the same thing) of healthcare, or:
(b) you are saying, like what the PAP lot are saying, is that it is the people’s own fault for being choosy, so don’t complain.
Which is which?
Correction of my last posting:
If so, the issue of whether is not how satisfactory these wards are. The problem it seemed is that either:
should be
If so, the issue of whether these wards are satisfactory or otherwise is, well, NOT the real issue, right?
The problem for me, if I try to understand your argument, is that either:
Hi Tan Ah Kow (#12)
The issue is both affordability and satisfactory standard. Some people say that the subsidised ward is not satisfactory, so they are forced to pay for the more expensive treatment. This is not the case here, as the subsidised wards are of a good standard.
There is another argument about the lack of beds in the subsidised wards, due to the demand. I believe that this is due to the recent large increase in population, and the supply has not catched up. When more hospitals are built, we will have sufficient beds in the subsidised wards, hopefully.
The key point of my talk is: be informed about the choices. Make the right choice. You can have health care at a more affordable cost. If you prefer to spend more, it is okay – but this has to be your own choice.
I was warded for a few days for checked up on my heart. My bill was paid by my son’s Medisave. Last month, i went for two checked ups on same trouble. Had to cough out cash and not allowed to pay by Medisave as i am not warded.. Still need to go back to the hospital for other checks. Checks …checks…and who knows how more to come…but cannot charge to Medisave. Only if you are warded then you can pay by Medisave. But all the Day Visits done or forthcoming can total up to quite a sum. We are tightening our belt and really need cash to survive Recession. Why cannot related further checkups and more to come be totalled up and allowed to be charged to Medisave quarterly when the amount grows bigger. From Dec. 1 Outpatient cancer treatment (Cheotherapy and Radiography) can use Medisave. Why can’t for other type of treatments ?
I am asked to pay additional Medishield premiums now and my next renewal of Incomeshield but I am not a Cancer case. The Additional Premium Payable is $61.25. Why must I now pay more for others. Next month, my age will be 79. Can I really benefit from possible cancer treatment? If negative, why must i pay for others. Has NTUC Income the approval from Ministry of Health to charge more ?
We need our cash to survive the Recession. What do other NTUC Policy Holder say ?
Is the overcrowding in C-Class beds due to the increase in population from around 2.8 million in the 80s to the now 4.6 millions but not much increase in number of hospital beds correspondingly, especially the C-Class beds.
Plus the number of people getting old in the last decade have seen a rise of people going to hospitals.
Hospitals here are also marketing their services to the rich foreign patients to milk their dollars.
All these could lead to the severe shortage of C-Class beds and we people suffer from more stringent admission and higher costs of hospitalisation.
Here is my article entitled:
Coping with rising health care cost in Singapore
http://www.tankinlian.com/articles/health.html
14) Tan Kin Lian on December 14th, 2008 11.01 pm :
The issue is both affordability and satisfactory standard. Some people say that the subsidised ward is not satisfactory, so they are forced to pay for the more expensive treatment. This is not the case here, as the subsidised wards are of a good standard.
I think there may be a bit of cross wire in my understanding of your argument.
First of all, affordability means the ability to pay. Now question: are you saying that EVERYONE who complains they can’t AFFORD to pay for treatment are really complaining they can’t get A-class treatment for C-class pricing. In other words, you are saying there are NO ONE who genuinely can’t AFFORD to pay?
If your argument is that there is NO ONE in Singapore are in a position not being able to afford to PAY than I rest my case. I may disagree with you on this point but I fully accept you believe.
If your argument is that yes, there are people who genuinely can’t afford to pay, than I suppose we can argue about how big the pool of these group of people are. And more importantly, I can then question you about your comparison with other country. For now, let’s set aside this argument until I can be clear what you are trying to say.
Secondly, you talk about satisfactory standard based on your anecdotal evidence. Whilst I am not saying that your anecdotal argument is not representative of the true state of the situation. It would be helpful if you could elaborate on what you mean by “satisfactory”. Otherwise, it would be hard to know how you come to the conclusion you did and if there is any civilised debate to be had, there is a common basis to argue from.
quote:
“If I’m a multi-millionaire, am I allowed to go to the C-class ward? The answer is still yes, just that I’ll enjoy less subsidies than someone from a lower-income household,”
unquote.
How about means testing?
We should also ask the elites why the charges for medication is so high in Singapore? Even with their so called subsidies it is still more expensive compared to our neighboring countries.
Many people who are on long term medication need to buy their drugs from across the Causeway or from Thailand because it is much cheaper there.
“If you are happy to contribute to the AIGs of the world, then its okay, you can go ahead,” he(Tan Kin Lian) added.
I am surprised that Mr Tan Kin Lian, former CEO of NTUC Income, would actually insinuate that a private health plan is less desirable than public plans. Or at least, by insinuating that getting a private health plan contributes to the ‘AIGs’ of the world, he is implying that people should rely solely on public plans. Effectively, he’s sowing distrust for insurance companies by painting them with one stroke and calling them ‘AIGs’ of the world.
There is no doubt that our public schemes such as Medishield are cheaper and are for suitable the general masses but it is equally evident that the government, by allowing private shield plan premiums to be paid via Medisave, is encouraging citizens to get into private shield plans. The rationale is obvious – we are not a welfare state(people should stop hoping) and the government does not seek to provide a public scheme which meets more than the most basic healthcare needs. Medishield covers very basic costs. The government would rather Singaporeans take responsibility for their needs by getting private shield plans which are definitely more comprehensive, despite being more expensive. In short, ‘contributing to the AIGs of the world’ by getting private shield plans is a more desirable condition than simply relying on inadequate coverage afforded by basic Medishield.
I wonder what Mr Tan meant when he made that comment or it could have possibly be a slip of the tongue, expressing distrust of larger insurance companies. Nonetheless, I am surprised that Tan Kin Lian, who should be an advocate of comprehensive coverage as opposed to scrimping costs, should make such a remark.
On 16) Tan Kin Lian on December 14th, 2008 11.21 pm
Mr Tan,
Having look at your so-called statistics on international comparison , I am getting the impression that you have somehow collected a whole lot of numbers to justify your conclusions without knowing what those numbers means.
Let’s take the UK case where I am most familiar with. Based on your statistics, uk 8.3% of GDP, a dollar cost per head of 2,732. Did you know that the NHS here is free for virtually EVERYONE who has been residing in the UK for more than three months? Also for this cost, it covers virtually every illness known on the face of this earth (from Breast implants to Cancer to Aids, from hospitalisation to outpatient care)? My understanding is that medishield only cover some illness?
All this, based on your statistics cost the National 8.3%? and You quote Singapore case as 5% or maybe less say 4%. Now are:
(a) If the statistics was to be believe than clearly, Singapore’s health care cost is hardly cheap is it? I mean for 8.3% covering a population of 60 million where a population of 4million and consuming 5% of GDP?
(b) If you are going to make such comparison than clearly it is not only cost but also the value of get from the healthcare. Otherwise, you are not make like-with-like comparison are you? In which case, how did you come to the conclusion that Singapore health care is cheap?
(c) Do you know the source of the numbers? Is the number a reflection of government heath care budget (Singapore government typically inject less money from taxation on health care than other country except US) or the actual cost of health care (government spending plus additional spending by people)?
Again as you have not responded to my earlier query, I can’t really tell what you are trying to say so I shall leave this argument as it is. So I at this juncture I have to take your argument with a heavy dose of salt and lots of scepticism.
hope the government can let us use more medisave money to buy more insurance and protection.
Sorry:
this:
Let’s take the UK case where I am most familiar with. Based on your statistics, uk 8.3% of GDP, a dollar cost per head of 2,732. Did you know that the NHS here is free for virtually EVERYONE who has been residing in the UK for more than three months?
should read:
Let’s take the UK case where I am most familiar with. Based on your statistics, uk 8.3% of GDP, a dollar cost per head of 2,732. Did you know that the NHS here is free AT POINT OF USE for virtually EVERYONE who has been residing in the UK for more than three months?
The CPF system is even more complicated given the following:
1. potentially variable rates of return (pegged to the 10-year Singapore bond),
2. changing rates of contribution (pegged to age range, and subjected to further cuts in recessions)
3. withdrawals for HDB loans and educational loans
4. investment losses (how many gaining?)
5. increasing amount locked under the Minimum Sum Scheme (subject to increases due to inflation and policy changes)
6. delayed withdrawal age (subject to further delays due to inflation, increased retirement age and other policy changes)
7. forced expenditure (buying of CPF Life, annuity or whatever it is now called)
So how to plan for retirement? Not enough CPF have to top up with cash.
No longer our ministers have to be paid so much to oversee such complicated schemes.
I would like to recommend TKL and friends here to study on the health care system in Taiwan, which is rarely introduced or made known to Sinaporeans .
My surprise is that, ALL Taiwanese people regardless working or not are covered under the scheme, secondly, the covering include common FLU and fever which mean minor illness, and with a healthcare card, you can go to ANY clinic or hospital thruout Taiwan to pay only a little amount of co-payment,ie: less than S$10 and get treated !!! for serious illnesses, MOST of them are covered under the scheme, FEW are not covered and have to pay yourselves.
The MOST important part : Taiwanese pays a healthcare fee of a couple of tens of SG dollars per month whinch I think is very WORTH it. And you can pay for your family members who are not working.
MY QUESTION IS : WHY IS THIS WORLD CLASS SG GOV CANNOT COME OUT WITH POLICY LIKE THAT IN TAIWAN?—-WHICH REALLY CAN COVER EVERY SINGLE PEOPLE WITH LOW PAIN?
I support the future elect president candidate, Mr. Tan’s, call for people to opt for C-class ward whenever they are hospitalised.
I am thankful that after selling Incomeshield to the masses for the last 10 years before he retired, now Mr. Tan has seen the light and came out to proclaimed that actually the CPF Medishield is all you need. It’s a full circle. Thank you for your clarification.
Do not worry about not having enough C-class wards. When there is demand, the supply will increase. That’s how the free market work. With more hospitals built, there will be more C-class wards. If hospitals cannot give you C-class ward, just kick up a fuss and the hospitals will accede to your needs.
As Mr Tan has mentioned, it’s time that people be educated about the 3 Ms policies that we have in place – this is the foresight of the PAP government.
We should also be environmental friendly and support the government’s call to use more public transport. Why need to drive? The government has provided for cost-efficient means for transportation for the masses already. Using more public transport would allow you to get in touch with the masses and create a communal spirit – since everyone will be on the same train/bus.
Like what Mr. Tan has mentioned, live simply and you can enjoy a good life. If cost of living is high, just stay at home and cook frozen food. Cut back on air-cons, heaters and TVs, this will help save electricity costs.
Nothing beats living simply.
Thank you, Mr Tan, for showing us the right way to live.
I think TKL in his article is simply advocating that if Singaporeans what to have a fuss-free affordable health care facility go to stay in C or B2 wards. If you have the means, go to private healthcare hospitals. That is the crux of his message.
I believe moving on, healthcare cost will go up due mainly to means testing.
Means testing basically use the combined income of people staying within the same household and divide it by the number of dependents in your family. They must stay within the same household.
For example, you have three dependents namely two kids and a grandparent staying with you. Your combined income (spouse and yours) is $4000 a month. Thus, your means testing amount is $1,300 – $4,000/3 dependents. However, if you have other siblings working but they stay outside of the household, their income amount is also used for the determinant of means testing if you want to claim healthcare discount for your parents. Siblings are deem to have a share in the cost for the ageing parent so their income is targetted for means testing equation.
There are a few discount variants here. For example, for those having at least a means testing figure of $1,000, they will probably get less than 20 percent discount. Those with range from $700 – $1,000 may get up to 35% discount. Those with means testing range from $500 – $700 may get up to 50% discount. The middle income will get another whack in their pocket again.
The one main adovcatee of means testing is to fairly spread the healthcare discount so that the poor/needy gets more discount and the middle income gets less discount. In theory it works but the devil is in the details.
One can see that means testing is terribly unfair and also difficult to gauge. Some people are self employed and siblings with their own families have their own expenses and obligations. So, it can be said that aged parent probably has little healthcare discount if the person has several children who are grown up and doing well career wise. Some siblings may also not want to reveal too much of their financial detials to the social worker and for families with dysfunctional family ties, means testing is also impossible to fulfill.
It is not surprising that MOH finds little support for the means testing programme to be rolled out in Jan 09. Unless they can find a fair and comprehensive means testing programme, Singaporeans may find the whole implementation frustrating and a pain in the wallet.
In SIngapore, there are basically three public affordable healthcare programme – medisave, medishield and medifund.
Medisave – a comprehensive nation wide healthcare self funding programme. Deducted from your monthly CPF contribution, depending on your age, at least 5-7% of your monthly contribution is channelled to this facility. I find this programme fantastic as it is a good self funding facility and can be tapped into even for all your loved ones including siblings and parents. One of the govt solid programmes.
Medishield – this is another self paying healthcare insurance programme meaning it works exactly the same as any private insurer (AIA/NTUC Income). It pays when you are hospitalised. However, as I looked through the details I got swamped with a maze of information. I find that it is more a co-payment programme than anything else . This mean that the insurer will pay something and you still need to pay your part. It also only pays after a certain hospitalisation bill amount is breached. For example, you need to have a bill of more than $10,000 before the insurer will come in to pay their part. I find that this insurance scheme is good for those with long drawn chronic sickness with long hosital stay e.g. heart attack, cancer, stroke, etc. As premium is relatively affordable (less than $300 a year on average payable from CPF) it is a good scheme nevertheless to have for any emergency. This programme may not work well for those who stay in hospitals for a few days with minor illnesses.
Medifund – medifund is more for the poor and needy. The poor has nothing to pay and no CPF funds in their medisave. So medifund is more for the underpriviledged and is a good scheme to have as we see more of the poor getting hospitalised as they aged. A good programme for the needy. Such fund is tapped from the MOH coffers.
I recommend that Singaporeans buy some insurance for critical illnesses available from most major insurance companies. Most are tied to a life insurance plan and pays on diagnosis of at least 30 major illnesses e.g. cancer, heart attack, stroke, etc. A lump sum is payable depending on how much you have insured yourself.
Singaporeans can also buy an insurance product whereby if you are sick due to a dreaded disease your income is insured depending on your insurance amount. Most major insurers will have this facility.
Hope this help.
Hi Tan Ah Koh (#17)
My point is that the subsidised wards (B2 and C) are affordable and the standard is satisfactory. It is available to everyone, including the well-off (who enjoys a lower level of subsidy when means-testing is implemented). There is no suggestion that they expect A class treatment.
There are people who has to pay a high bill for treatment in A class or private hospitals, and the bill is beyond their means. If these people had been more careful about their choice, they would not have to face the heavy bill.
Reply to QuestionEverying (#20)
You should read my written article and listen to my talk, to get my message. Do not put words in my mouth and attack me.
My key points are:
1. Medishield and subsidised wards is the best value for money
2. For people who want to pay more for a private Shield, go ahead. Be aware about the lifetime cost and the large portion that is taken away as expenses. After paying so much, be ready to have your claim rejected due to non-disclosure or various reasons.
When I introduced the private Shield for a company that I worked previously, the premium rates were lower than today, and there is a no-claims discount after three years.
I am not responsible for the increase in the premium rates for this private Shield plan in recent years – which has now made it unattractive. I have also decided to terminate my personal coverage of this Shield plan, and move back to Medishield.
Actually, it is not hard to understand what TKL is saying.
The best option we have in having affordable healthcare in Singapore is to go for the cheapest healthcare plan available in Singapore and insist on the cheapest hospital wards despite all the administrative barriers.
Even if you qualify for less subsidy at a C-class ward, the price you pay at a C-class ward is still much less than that at an A-class ward.
I have been using C-class wards in our public hospitals. No major issues other than noise and toilets. Sometimes some families treat hospital visits as picnics and bring three generations to the hospitals. The adults hog the TV seats and the children run up and down the corridors. I do not know if the hospitals still impose the “2 per patient” rule that was in place during the SARS epidemic; I was in KK at that time and the ward was so quiet and peaceful.
As for the lack of choice of your doctor, I think that’s what many people are concerned with. I too am concerned at the quality of the doctors. They’re mostly MOs and some of them do tend to be a bit inexperienced. So you have to be pro-active and don’t just lay there and let the doctors or nurses do what they want with you. Do some research on your own condition and be alert. Ask questions if needed.
If I’m not wrong, if there are not enough C-class beds when you are admitted, the hospitals will put you in a higher class at C-class prices until a bed opens up.
Choosing lower over higher class will reap great savings. My mom stayed at B1 once (at my insistence). She didn’t enjoy the stay (she preferred an open ward) and for all subsequent consultations, she had to pay private rates.
when i was hospitalised
ps
i am a good client to the top 3 general hospitals
tantockseng
(no not aids dept)
singapore changi south
(guinea pig tester)
singapore general hospital
(radiated guinea pig 1st class)
alway checkin on ward C 3rd class
whos cared if some ah peks sleep liked pigs on daytime
and coughed liked shit on night time
when i have 60 roomates to keep me company
heck we can even played a football match with so many reserved plus spectators
the main reasons
WHY
i stayed in class C is simple
upon discharged
whenever you go outpatient
you pay subsidised rates
somewhere liked 30% ratio:100
\onced when we went outpatient
radiation treatment
there was around 20 of us awaiting for the same nuclear drink
same size as the yakut
the lady in front paid $100
i paid $30
she demand to know
WHY?
am i having a great discount
when we are having the same nuclear yukut drink
before the poor lass @ the counter could answer
(as though she know the answer)
i asked the in front lady
when you were checkin in general hospital
you stayed ward A
right?
fully private
fully aircon
heck even your meals is alacart
do you know what class i was?
have you ever tried to sleep with 60 sick people around you?
well beside my army daze…?
she the lanlaned kept quiet….
when my belated papa was hospitalised during a diabetic attack
even the A&E doctor was askin if my pap prefer to be in class B ward
(i believed thay earned an incentive for ^upgrading^ skills)
i asked the A & E doctor
would class A or B
make him well again?
he couldn’t answer
as though my unconcious belated papa
would have the feeling of class A/B treatment
by monday
he passed on….
father
may you rest in peace
26) partisan on December 15th, 2008 2.24 am
Another very interesting piece…
Just to add on to what PArtisan Proclaimed.
“I am thankful that after selling Incomeshield to the masses for the last 10 years before he retired, now Mr. Tan has seen the light and came out to proclaimed that actually the CPF Medishield is all you need. It’s a full circle. Thank you for your clarification.”
I have been covered under Incomeshield close to 10 years. I chose Incomeshield over Medishield and Medishield Plus because for similar costs, it simply beat the latter two. I also enjoyed 20% no claim bonus under the scheme.
Why the government
with its economies of scale
was not as competitive as the private company? Our best Health minister looked into the system and proclaimed that was because the company picked all the cherries. Hmm… he never explained how it was able to do so…
Well, our best Health Minister forced all the cherries back under one roof. Since then, my premium has increased by a third and the no claim bonus has been halved to 10%. Next year, under the means testing, citizens can conceivably see a 75% increase in medical bills.
“As Mr Tan has mentioned, it’s time that people be educated about the 3 Ms policies that we have in place – this is the foresight of the PAP government.”
“We should also be environmental friendly and support the government’s call to use more public transport. Why need to drive? The government has provided for cost-efficient means for transportation for the masses already. Using more public transport would allow you to get in touch with the masses and create a communal spirit – since everyone will be on the same train/bus.”
My great regret is that our PAP ministers and MPs do not take the public transport which would have helped them “get in touch with the masses and create a communal spirit”.
“Like what Mr. Tan has mentioned, live simply and you can enjoy a good life. If cost of living is high, just stay at home and cook frozen food. Cut back on air-cons, heaters and TVs, this will help save electricity costs.”
“Nothing beats living simply.”
Just to give further credit to the PAP government – they have a similar philosphy as Mr Tan. Some examples:
1. Switching to cheaper products can reduce the cost of living despite a rise in the CPI.
2. Switch to (cheaper) house brands.
3. Switch to (cheaper) frozen meat.
4. Save on one hairdo and use the money for breast screening
.
Thank you, PAP government, for showing us the right way to live. :)
I am surprise that the topic on Singapore’s healthcare system is limited to ward classifications only. Healthcare comes with many parts and as described by #14) Obamaosama, he had to find out that there are other areas in healthcare that do not allow the patient to tap into his Medisave accounts.
Medisave, Medishield and medifund are mainly for inpatient admission payments only. Once you are discharged, your subsequent follow up visits have to be paid in cash. This is where the killer lies in wait.
And if you need a medical report for whatever claims, you need to fork out extra cash for something as easy as a printout from the hospital’s regular medical information database. These amounts can go into hundreds of dollars which again must be paid in cash.
Most patients do not have problems paying their Inpatient bills as these are deducted directly from one of their Medisave accounts but when it comes to paying out in cash for follow ups and tests and x-rays, then they eat into the pocket money that you have set aside for feeding your family.
Let’s not limit healthcare to just paying of bills in inpatient settings only. The net is bigger than this.
gem!
I heard medisave can also be used for dental surgery and last year I went for my tooth surgery at Alexandra Hospital and on completion, they present me with a bill amounting to some $600/+ of which I still have to foot out $80++ in cash as this is for the X-ray stuff . . . .??? why I don’t understand the logic here. The hospital out sourced their X-ray thingy? or what? oh…btw, they gave me back my tooth and I told them to keep it as souveniors. . . .lol
Hi tiredsingaporean,
There are a few other things we have been asking the management over here to no avail. We have even suggested that follow up visits become part of the Inpatient process so that these visits can be paid for by the patient’s Medisave accounts; we have recommended that patients be given a general medical report upon discharge so that the report can be used for medical claims etc but all these have fallen on deaf ears.
Bottomline is, if what we have suggested are adopted, it would mean a lower annual profit margin for the hospital which is anathema to the management whose competency is measured in terms of dollars and cents. Our perm sec on healthcare makes regular visits to see that the subsidised money given by the govt is well-spent.
There is as much money in continued treatments & consultations as with inpatient admissions.
It all depends upon a patient’s financial mean. If a patient can afford and prefer better Class of hospitalisation service, someone can always opt for it.
However, if it is a chronic disease, then obviously a patient may require long-term medication and healthcare, his/her medical expenditure could be skyhigh, so the patient needs to consider carefully what sort of hospitalisation is more suitable and affordable to him/her.
Hi Gem,
Yes, and I believe alot of questions has been written to all these organisations but to no avail. As long as their answers would cost damage to their profit margins, then they will not answer you to avoid confrontation later on.
Dear all
Let me share my experience. Being a middle class (on the high side), and warded in my life time on 2 occasions. One in a motorcycle accident and the other in the domestic accident. I choose C and B2 respectively although I am covered by the insurance.
Rationale is simple, most of the time follow-up consultation and medicine is much cheaper in case it reaches the cap of the insurance coverage. At the same time, I am afraid once the record of me going into the A class is logged, future admission to the hospital might force me to go to the A class due to my record. Another recent case where I was referred by my company private doctor to go for a scope. I actually bring the referer letter to a polyclinic first and they write me another referer letter to the hospital for a scope.
Yes, my personal experience is that C or B class is packed and as a matter better business than the hotel 81. However, the service is not really that bad. Frankly, if the doctor allow early release from the hospital, I do recommend that you get out and save the ward charge to minmise medical bill.
Can someone clarify if all our hospitals are now privatised? And if they are, do you think that making profit is not their priority?
My relative went to Singapore Dental Centre to fix her denture and implants. The work was shoddy and the wait long. The temporary dentures broke so often that she finally gave up and went to the private dental clinic. Do you know that the private clinic will charge her less than the government clinic?
One of the writers said, if you are housed in C ward, make sure you ask questions. But how do you ask if you are not educated or insistent or brave? Most of us will just be guinea pigs and let the doctors treat us the way they think is appropriate. The common saying that we can afford to die but we cannot afford to be sick is very true to me.
I think the concern is more of those with critical illiness. Where you really want a good specialist to attend to. If you take B2 or C, I am afraid you can’t choose your doctor. That is a real concern for people who can’t afford because on many occasion, critical illiness need professional specialist rather the half past six “specialist” to get the treatment right due to their experience.
Most of the time, these half past six specialist are experimental and it is a matter of life and death if they make the wrong decision. Worst still, prolong the suffering together with your pocket libility!
#41
Dental is very different from normal illiness, the charge are unusually high most of the time. Only difference is that you go to the public or private one. I think this is so because it is not consider as a illiness at all, rather a welfare.
Therefore cannot compared with normal medical health care.
That’s the reason why you don’t see every company provide dental coverage.
Beaware also that once you check into the higher class ward ie. B1 or A class it is more difficult for you to downgrade to a B2 or a C class ward. The opposite is of course a no problem. So should a patient now be able to afford A-class ward since he is holding a good-income job, he may face difficulty should he loose that job and no longer able to afford A-class and decide to downgrade later on.
I know someone who recently went for a major op at NUH. The doctor was quite against the idea of C-class wards, because apparently the class letters do indicate their cleanliness and sterility. Substandardly sterile environments will obviously hamper patients’ recovery. In a more personal capacity the doctor advised that he would personally trust A and B1 wards’ standards, but could still accept B2.
There are conceivably patients less fortunate, to have doctors that would advise thus, or to have sufficient money to freely choose their ward class. Is their health any less important?
Not all hospitals are ‘equal’…so how can the wards be…does the one in the ‘c’ wards get the kind of treatment the ones in the ‘b1′ gets???
The article merely suggest the author’s view that based on the current healthcare system, the medishield and subsidized wards are the best value for money as compared to the more exclusive wards or private healthcare plan.
I believe he have done his due diligence and is best entitled to his opinion.
However, the views are based on the choices that exist in the current healthcare system.
What Singaporeans want to hear is healthcare reforms like that mentioned by some of the readers here of the UK healthcare system and Taiwan Healthcare system.
I do know there is limitations to a single person effort to propose any comprehensive or holistic approach to healthcare reform.
This should be the focus of the government as they are able and have always gone overseas on “Study trips” to world-class countries to study the various aspect of operations.
On the other hand, I do think teams in the alternative camps need to show people that they are capable of proposing world-class solutions.
Show people that you are able to propose “new’ systems that can compete with the current healthcare system.
Show people that they truly have a choice between current and new systems, not choices within the current system.
My sister-in-law has cancer and recently the doctor wants to put her on a drug cocktail to combat her condition. The cocktail costs $5000 per treatment and since she has a private plan, she paid $1500 per treatment. She needs 3 treatments per month – $4500 per month.
She was told that the drug cocktail is an experimental drug and not available for subsidized medication and hospitalisation.
She is wondering how long can she keep up with paying the medicine.
Any comments
I DO NOT agree with means test. This is probably the least any govt shld provide for her citizen.
If the govt is always talking abt planning ahead, wht the hell is wrong if I choose ward C to lower my medical bill so as to enable me to reserve more medisave for my old age.
Not to mention everyone nw dun even know how long one can keep his/her job.
With this financial crisis, it is both not logical & insensitive to introduce means testing now!!!
#49) Enlightened on December 15th, 2008 9.46 pm
Maybe you can try to source for the medication in Malaysia or Thailand. It should be cheaper in those places.
Many people who require long term medication buy from such places because it is cheaper there.