By Ng E-Jay
French virologist Professor Francoise Barre-Sinoussi was one of the co-discoverers of the Human Immunodeficiency Virus (HIV) some 27 years ago. Today, she has taken Singapore to task for failing to provide free treatment for HIV sufferers, who form one of the most stigmatized groups in our country.
Prof Barre-Sinoussi, who was at the Biopolis last week to share her latest research findings on Aids, said that although she was initially impressed by Singapore’s healthcare infrastructure, she found Singapore’s lack of free HIV treatment difficult to accept. [1]
In response, the Ministry of Health (MOH) pointed out that unlike France’s state-sponsored healthcare system which requires that a heavy tax burden be imposed on the population, Singapore’s approach of co-payments and subsidies allow for an affordable healthcare system without high taxes.
It is time to question whether Singapore really provides affordable healthcare to the needy, especially in light of rapidly rising healthcare costs and the absence of a comprehensive social safety net for those who have fallen through the cracks. The introduction of means testing also means that the middle class is being saddled disproportionately with increasing costs.
Given that treatment for critical illnesses like cancer as well as terminal illnesses can run into the hundreds of thousands of dollars, is it humane for the government to continue to insist that taxes be kept at an ultra low rate and to deny Singaporeans increased subsidies for such expensive treatments that have the potential to cause financial ruin to families?
The burden on HIV sufferers in Singapore is perhaps one of the most acute, not just because they know they face certain death, but also because of the prevailing social stigma that they have to endure, as well as the fact that treatment costs in Singapore for them is very high.
HIV treatment in our country is much more expensive than in many other developed countries because generic versions of commonly prescribed anti-retrovirals are not available, forcing HIV patients to purchase branded originals. This is compounded by the fact that many HIV drugs are not approved for government subsidies, leading to a double whammy for HIV patients. There is a serious need for a better system of subsidies for HIV treatment in Singapore.
Initiatives launched by the MOH to promote early detection and treatment of Aids such as public awareness campaigns and anonymous HIV testing, while commendable, are by themselves insufficient at addressing the issue of humane treatment of HIV sufferers. Public awareness campaigns need to be more proactive in debunking myths about Aids and in erasing the stigma attached to Aids victims. The government also has to remove the insidious discrimination against HIV patients in the form of incomplete subsidies.
Taxes in Singapore are already very low and there is ample scope for taxes to be increased to provide greater financial assistance to HIV, cancer as well as terminally ill patients.
Taxes can easily be raised without affecting our level of economic competitiveness because the latter is actually being stifled not by taxes but by obsessive micromanagement of the economy by the government and entrenchment of GLCs which are unproductive.
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References:
[1] Channel NewsAsia, “HIV testing, treatment in S’pore should be free: Nobel laureate“, 08 March 2010
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It’s a given that such welfare for the sons and daughters of Singapore , who contributed to nation building, pay taxes like everyone, be taken care of, in times of sickness or poor health. Every citizen is equal. Every citizen deserves equal respect & treatment.
Unfortunately, given this blatant discriminatory dictatorship running the system, caring for Singaporeans is like telling the Myanmar junta to honor democracy and instal the rightful democratically elected leader Aung San Suu Kyi, back in power. Dream on.
The problem with Singapore’s healthcare system is very much like our economic situation; both are run with the bottom dollar in mind.
Economic-wise, we are clamouring for the world-wide dollar in order to place ourselves at the forefront of economic developments and have a bite of the same world-wide economic pie. By so doing, all other things become irrelevant if they do not help to support this drive. That’s why we are seeing so much effort and energy to promote the Singapore Economic Model where every citizen is forced to embraced without exception.
In the long run, every citizen is going to be just digit serving this Economic ship and helping it steer into the waters of wealth. The more we whine, the more foreigners we will see. The model just have to work – at all cost!
What then do you think our healthcare infrastructure will be like in the future? Very much the same. As it is now, our hospitals have been gearing up to compete for the regional medical dollar – welcoming the rich and willing-to-pay sick neighbours who thinks Singapore’s healthcare institution provides the better care compared to those like Malaysia and Indonesia.
Walk into any of the government-subsidized hospitals – the restructured hospitals – and you will see the mad rush to convert subsidized clinics to private ones. Isn’t it clear that the private dollar has a better value than the subsidized dollar?
With no solution to help the poor sick Singaporean in his time of medical distress, our multi-million dollar health minister suggests that these sickly poor Singaporeans are better of being taken care by neighbouring hospitals. What’s more, he was so quick to release the medisave dollar so that Singaporeans would flood over to these neighbouring hospitals – and thus saving the government from subsidizing these poor sickly Singaporeans – keeping to the wise adage of not being penny-wise and pound-foolish.
Once this is done, he can then go forward to think up ways to earn the foreign medical dollar – the private ones.
That’s all there is to it really.
Poor you if you are one of the unfortunate ones to contract HIV. You are caught in between aren’t you? Do you think the government would lift a finger to help you now that you know the ultimate plan for Singapore’s healthcare system?
Michael Moore’s show “Sicko” gave me a new set of eyes to see the shortcomings of the healthcare in Singapore.
Good watch it. It asks the fundamental question of Government’s role in looking after her citizens….
The numbers are staggering. If everyone who expects to live to a ripe old age (and we all do) eventually needs to pay for chronic illness (and we all will) of say, $200,000, that means the average person has to save enough over his working life to buy a 3 room flat in order to cover his chronic illness. There’s no way a poor person can do that. But then the amount of re-distribution that may need to be done to get everyone access will be pretty dramatic.
I would support giving free or subsidized treatment to children who are infected with HIV from their mother at birth, or people who unfortunately infected with the virus unwittedly, ie through blood transfusion, or wives who got infected from their irresponsible husbands.
As for those who choose to live a promiscuous lifestyles and got the disease from one of the many sex partners, you bear your own treatment cost. Why should the state pay for your agony when you are the one who choose to put yourself in risk?
Must listen to our caring PM….sick and dying. It’s better to DIE then to be a burden to the country!
So people who smoke and get lung cancer, people who drink and get liver damage…oh and people who don’t eat vegetables and get colon cancer, people who don’t exercise and get heart disease / hypertension, people who walk around in the sun without sunscreen and get skin cancer… heck, even people who walk around in crowded shopping centres and get H1N1, should bear the cost of their own treatment, because it’s their own fault they put themselves in risk.
Or what you’re saying is because you judge some people’s actions as immoral, you think they should be punished? Isn’t getting a terminal illness and having to go through all the medical treatment punishment enough? Or you want them to suffer more huh? You think you’ve never done anything wrong, never taken an unwise risk in your life? You’re a saint is it?
Go and eat your egg roti pratas, then next time if you get heart disease don’t expect the State to subsidise your medical fees!
Not just HIV victims, but I think the whole healthcare system in general needs to be looked at. When my mother was in hospital staying in a B class ward (6 beds with no aircon and sharing 2 toilets for the WHOLE WARD) at NUH and even after government subsidy it was over $100 a night (can you imagine how much it must cost before the subsidy?) She was very uncomfortable there but was told that if she moved to an A class ward they would backdate her bill and charge her as if she spent the entire stay at the hospital in an A class ward, and there would be no government subsidy. At one point when we thought that my mother had something in her brain and needed brain surgery, she told me that she’d rather die, because otherwise we’d have to spend pretty much all our family’s money just to pay for the hospital bills, and then she wouldn’t even be able to go back to her job after. It is the common “it is cheaper to die than to get well again” mentality in Singapore, which unfortunately seems to be rather true. Luckily she was fine in the end without surgery, otherwise I can’t imagine what would have happened.
It is horrific that anyone has to think it is cheaper to die than to live, and it should be the country’s responsibility to make sure that people are protected and provided for. After all, we all work hard and pay taxes, why should we have to pay through the nose just to get good health?
Taxes will have to increase.
If people can accept the rationale that healthy people pay taxes to support not so healthy people.. then it is workable.. This is how france and uk does it, i think. Health care is a right of a citizen not a privilege of only the rich
Ultimately, the beneficary of the high taxes would be you yourself in the form of free or highly subsidised health care .
Then you won’t have situation where people rather die cheap than seek costly treatment
I think the best safeguard of health is to exercise and keep fit.
The bottom line is that relationships are extremely important, and money is not a bottomless pit. Chronic healthcare expenses can only rise if lifespans increase. With a limitation to the tax base and what can (should) be put into healthcare, it is contingent on EVERY person to take care of one’s health, and to make all efforts to be productive and wise in deploying one’s resources to ensure that one’s health can be funded into the future. Expecting the government to pay, merely means that someone else pays for me, and there is a limit to that. Take responsibility over one’s life, health and finances.
in singapoor..when you are sicked..you are a liabilities..even if you hav adequate medicsaves in your cpf savins…in which you will never get to ulitilize it…the government will keep remindin you your cpf savins is meant for your ole aged after 62… whether you survived your present illness no matter how serious or how youn you are is not in their books for considerations
~period~
The logic of some the postings baffle me. Of course, one’s health is one’s responsibility. I am not saying that it is the responsibility of the government. We all ll know the good habits of staying healthy - eat well, exercise regularly, sleep well, etc, etc. and we should all do that.
What i am saying is that there is a responsibility by the government to provide health care to those who are unfortunate enough to be ill. Following the stories of people who lament on the high cost of treatment, i am simply saying that perahps one way is to increase taxes so that health care can be further subsidised or even provided free.
The tax structure can be further tweaked to make sure that the rich contributes a bigger share of a “health” tax. We can educate the public that utlimately this “health” tax translates to cheaper (or free health care) that ultimately benefits them.
Why is this model so unworkable in Singapore when it has been working in UK, in France and Canada ? I have yet to get a convincing answer.
@ JJ Mar 10, 2010 10:03
You wrote : ” As for those who choose to live a promiscuous lifestyles and got the disease from one of the many sex partners, you bear your own treatment cost. Why should the state pay for your agony when you are the one who choose to put yourself in risk?”
What about (a) OBESITY (b) Obese-DIABETICS (c) Obese-HYPERTENSIVES
if they get Stroke, heart attack, kidney failure, blindness, or legs-chop off because of obesity and poor circulation, it is their irresponsible lifestyle of over-indulgence in eating and laziness in exercise,
What about Drink-Driving, and subsequently caught an accident ?
What about smokers who have COPD (Chronic obstructive Pulmonary Disease) as a result of prolonged smoking ??
Do you think they deserve subsidy ???
To bring the analogy further, there are always students who are lazy and do not want to study hard….. so they become school drop out, and cannot find meaningful employment or cannot make enough money to keep their family, you think they deserve help??? (afterall, they are also irresponsible for their laziness in studies, rather enjoy their life and put themselves in risk of not earning money ??
What about those , who lost employment because they are not willing to be CHEAPER, FASTER and BETTER, they are irresponsible too, because they dont UPGRADE themselves.
who wants to get sicked in the 1st place? when diseases start attackin singapoor peasants..what happenned?..lauLEE and his famiLLEE as usual turned tils and illan into anther country on the falsh pretemtious of states visits…which part of our history LIED?
laulee would grumbled @ our ahkongs N ahpohs for visitin china and brin in the SARs viruses..he retailate those who are ole shouldn’t be goin overseas @ all..yet he himself brin his not so ole young mrs harry lee to united kingdom as though the british government invited him for an offcial visits..we all knew he was siamin the birdflu contagious diseases..
and he further siamed the pigflu diseases by visitin a smaller middle east muslim country..
in the end what happenned? mrs harrylee kanna strucked by don’t know what attacks hav to be flown home in a 72 hours converted sia 747 flyin ambulance with doctors and staffnurse accompanied..who paid for all these expenses? till today no 1s knew the answers..if this happenned to our ahkongs/ahpohs..we cannot even dipped our enough medicsaves/medicshields insurances to cover such unforseen events… till now we are bein penalised as irresponsible.. @ this present moments..so many of our aged parents who are already retired and exceed the 55 years aged limits hav yet to enjoy their meaniFOOL retirements with their cpf savin$…yet here the pap mongrols still growl @ us the peasants for bein a liabilities N homeless… and worst of all..the same breed of untamed mongrols expect us the older folks to shape up or shipped out to johore or bataam to rot till death do us part…
~zhee~ hopeFOOLEE when this mongrols time comes i prayed hard that they sit on wheelchairs with a plastic urinal bag strapped to their bodies..onLEE than would they think what they says or did when they were earnin their $13,500 iron ricebowls…
With a potential Pandemic in H1N1 & H1N5 the health Minister insists Singaporean to pay for a Tamiflu jab knowing its expiry is due ignoring the elderly POOR.
I recollect when the Asian flu was sweeping Singapore in the Fifties when we were than 3rd world still struggling, jabs or inoculation were given free.
How ironical,life was better when we were poor and the govt. than were more compassionate.What Happened???
For heaven’s sakes…no one ask to be sick. Cancer etc…who wants to get them? Our citizens have and are still doing their part in making S;pore a thriving economy. At the very least, let them have basic and cheap medical care. Fine…if some of the treatment are way to expensive for the poorer amongst us…but at least treat them with dignity and let them die with dignity. Instead the poor are encouraged to seek help outside the country whilst foreigners with $$ are welcomed into 5-star type rooms n treatments….Is this also to be our fate then? God help us…