Parl Committee on health vs PM's “acts of faith”

Quick Summary

  • Comparing PM's National Day Rally healthcare announcements with Dr Lam led GPC's 16 recommendations.
  • The major areas comparison points include CHAS, affordability, Medisave and MediShield.
  •  What the GPC said

    CHAS

     Singapore Parliament

    Singapore Parliament

    • Optimise utilisation of private resources and see CHAS GPs as part of the public healthcare node. More GPs should be encouraged to sign up for the scheme. Referrals from GPs (even for non- CHAS patients) can be considered for subsidised care as long as patient requests and is willing to be under the subsidy scheme.

    Affordability

    • Fixed rates for consultation and treatment for low-income Singaporeans at primary healthcare institutions, like polyclinics and CHAS GPs.

    • Expand the standard drug list by including more essential drugs used in the treatment of common conditions as this will minimise the out-of-pocket costs.

    • To survey and make public information on professional and medical fees across the healthcare industry. This would serve as a check and balance on medical costs, and allow the public to make better informed choices. While hospitals in Singapore publish their fees, GPs and private practitioners are not required to do so.
    • As the current Eldershield payout, meant for severely disabled elderly Singaporeans, is insufficient to even cover nursing home fees, its coverage should be strengthened to make it more relevant.

    • Ministry should rationalise the current schemes in the healthcare system today, ranging from social-related schemes to medical-related schemes, and collapse these into one unified funding assistance scheme, possibly called “Medifund – Universal”. 

    Medisave

    • Allow Medisave use in health screening, essential dental procedures, physiotherapy and occupational therapy up to a certain cap to prevent excessive utilisation.
    • The cap on Medisave limits should be increased for the CDMP and tagged to an inflation index.
    • Medisave limits should be raised, be tiered according to different age groups and subsequently pegged to medical inflation rates to be in line with the higher medical costs. 
    • Prevent premature depletion of Medisave through inter-generational use by imposing some form of limitations on the quantum used, after which government support will kick in.
    •  Medisave curbs across the continuum of care that over encourages the use of the acute health care system should be reduced and minimised. This could be done by levelling restrictions evenly across the board. As of now, the restrictions on the use of Medisave in the areas of community and social healthcare leads to cases where patients voluntarily choose to admit themselves or extend their stays in the hospitals, so that they could utilize their Medisave for treatment.

    MediShield

    • As a general principle, the government step in to guarantee the continuity of MediShield coverage for those Singaporeans who cannot afford to pay. This is especially when high premiums or low Medisave balances makes it unaffordable or unsustainable for Singaporeans to continue their MediShield coverage even after years of payment. Another possibility would be to use Medifund to pay for MediShield coverage of needy Singaporeans.
    • A reversed premium structure, where one pays more during one’s younger years and less during one’s old age, was amendable to the young and could reduce the burden on maintaining MediShield coverage for the future elderly.

      MediShield coverage should also be enhanced and extended to cover social and community care costs. The co-payments and deductibles for basic plans, though essential, should be lowered to make it more affordable for Singaporeans.

      MediShield age limit should be removed. Older Singaporeans have maintained their Medishield coverage despite the hefty premiums in their older age and deserve to have the insurance cover when they need it most.

    What the PM did

    CHAS

     PM Lee

    PM Lee

    • Extension of the Community Health Assist Scheme (CHAS) to younger low-income Singaporeans by removing the minimum age limit of 40 years so that they enjoy subsidised rates at private GPs and dental clinics.

    Affordability

    • The current 50 percent subsidies to be enhanced for lower- and middle-income patients at Special Outpatient Clinics.

    Medisave

    • Medisave – the national medical savings scheme will cover more outpatient treatments in future as contributions go up. 

    MediShield

    • Relaunching MediShield as MediShield Life to cover all Singaporeans regardless of pre-existing illnesses for life; No opting out will be allowed; Premiums will go up but subsidises will be given to those who cannot afford.

    • A special Pioneer Generation Package for the elderly to pay their MediShield Life premiums. 

    As Singapore ages, healthcare would be the most important concern for Singaporeans in the next decade. The GPC, which comprised of eight MPs led by Dr Lam Pin Min, submitted it's report to the Ministry of Health (MOH), acknowledged this. It further added “the old adage 'it is better to die than to fall sick' resonates with many Singaporeans, especially those from the lower and middle income families. This leaves many Singaporeans worried and apprehensive about their current and future medical needs”.

    Thus under the mandate of improving healthcare affordability for Singaporeans, the GPC took a “person-centric perspective” and concluded that “the government needs to constant review the healthcare financing framework to ensure healthcare remains affordable and also to provide a peace of mind to Singaporeans, especially those from the low and middle families”.