The PAP Government has increased the national insurance scheme Medishield’s deductible by 50% from the current $1000 to $1500 for subsidized class C ward patients. A deductible is the payable cash variable of a medical bill which has to be borne by the patient before the rest of the bill could be claimed using Medishield.
Aside from the increase in the deductible, monthly premium of Medishield will be increased by $10 a month for those aged 64 and below, and by $5 a month for those aged 65 and above. It is unknown why the PAP government choose to increase the liabilities of average Singaporeans when there is no justification to the premium increase.
Paying more for deductible will result in patients paying exceptionally more for small medical bills below $20,000. It seems like the Medishield needs more cash from the sickly poor in subsidized wards. Did Temasek Holdings lose money again?
Unlike private insurers, the PAP government doesn’t declare the annual report of Medishield’s insurance fund. In private insurance companies, overall insurance payouts and premiums collected are openly declared so to justify any increase or decrease in benefits or premiums of the insurance policy. However the national insurance is not as transparent. The PAP government raise or decrease premiums without numbers to substantiate policy changes. While the Medishield stop short of being a Ponzi fund, the the PAP government manages it leaves a lot to be desired.
Despite Medisave being a CPF component topped up in cash from a person’s monthly salary, the PAP impose limits on the amount one can withdraw from their Medisave. When one finished using up his Medisave, the next-of-kin’s Medisave account will borne the burden. For patients who cannot pay up their medical bills, Singapore’s hospitals engage private debt-collection contractors to “follow up”.
Singapore’s high cost of medical bills is largely resulted from PAP’s anti-welfare “you-die-your-business” stance. The percentage of the GDP spent on healthcare in Singapore, is one of the lowest in the world at 4% of the GDP, or a quarter that of the United States. This has prompted former Nominated Member of Parliament Dr Kalwaljit Soin blasting the PAP government for making Singaporeans pay too high for “out-of-pocket expenses” and denouncing the “much vaunted 3M” system(Medisave, Medishield and Medifund) for only representing 10% of the patients’ total healthcare expenditures. She also criticized the PAP for misplacing their priorities in their annual Budget, especially on the record Defense Budget:
“We can afford to spend more on defence, other things, but you have to look at health. Otherwise, what are you defending? You are defending sickly people,”
An influential Opposition Party, the Singapore Democratic Party, have several heavyweight medical practitioners like Dr Paul Tambyah who also criticized the PAP for being over-defensive when it comes to helping sick Singaporeans:
“Such is the thinking of the current system-that if you have national health insurance people will go out there and get cancer just so that they can enjoy the national health insurance which doesn’t make sense. It’s part of the national psyche that assumes that everybody is going to try to milk the system just because there are a few outliers- and it is true that there are certain kinds of people who have certain types of needs who tend to use healthcare services perhaps more than we need to.”
Medishield remains a insurance policy and given that its premiums and benefits are allowed to be changed from time to time by the PAP government warrants questions if this is legal and fair to existing Medishield owners. At least with a private insurer, the premiums and benefits are contractually binded upon the day you signed it. Like the CPF with its Withdrawal Age and Minimum Sum, the Medishield shifts the goal post to their advantage. Unethical couldn’t be more appropriate for an elected government whose duty is to protect its citizens.