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Downgrade requests assessed on case-by-case basis: MOH
14 May 2012
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4 May 2012, Straits Times - MOH and hospitals should spell out downgrading policy clearly
I AM pregnant with twins and am following up with a gynaecologist in a private hospital. Since multiple pregnancies have a higher risk of complications and premature deliveries, I wanted to find out whether I would be able to switch to a subsidised ward in a public hospital should complications arise during my delivery which necessitates neonatal care in the intensive care unit for my babies.
However, getting information about the downgrading policy of public hospitals has proven to be extremely frustrating. If I understand correctly, the Ministry of Health (MOH) introduced a downgrading policy some years ago where patients who transferred from private to public hospitals would be allowed to downgrade to the subsidised ward classes if they passed a simple means test.
Patients with a per capita family income of less than $500 per month can downgrade to Class C, while those with a per capita family income below $1,000 per month are eligible for a downgrade to Class B2.
Patients who fail the means test can also request a downgrade if their hospital bills in the public hospitals (following their transfer) exceed $15,000.
In summary, the downgrading criteria were clear and transparent.
When I wrote to MOH to ask if the policy was still in place, I received a vague reply stating thus: 'While there is a policy in effect, assessment of patients' eligibility for downgrading takes into consideration the affordability of the bill relative to the patient's unique circumstances.'
The two hospitals I wrote to with queries on choice of ward class and downgrading options offered similar, template replies.
I do not understand the secrecy behind the downgrading criteria, especially when MOH encourages data transparency to help patients make informed decisions about their health- care needs.
Many couples like my husband and I follow up with private gynaecologists because of recommendations from friends or family.
Another factor is the patient-unfriendly waiting time at public hospitals, which can be three hours or more, for a consultation lasting 15 minutes or less.
We will gladly pay private rates if everything proceeds smoothly. However, the worry is always with unforeseen complications.
Having and communicating clear policies can help minimise the stress and uncertainties that couples already face in starting a family which is costly enough.
Yap Tai Perng (Mrs)
Reply from MOH - 14 May 2012, Straits TimesDowngrade requests assessed on case-by-case basis: MOH
MRS YAP Tai Perng asked if she would be able to switch from a private hospital to a subsidised ward in a public hospital should complications arise during her delivery, necessitating neonatal intensive care for her babies ('MOH and hospitals should spell out downgrading policy clearly'; May 4).
We are gratified that Mrs Yap has confidence in the capabilities of our public hospitals in handling complicated cases. At our public hospitals, the medical social workers work closely with patients to help them if they face financial difficulty with their medical expenses.
MRS YAP Tai Perng asked if she would be able to switch from a private hospital to a subsidised ward in a public hospital should complications arise during her delivery, necessitating neonatal intensive care for her babies ('MOH and hospitals should spell out downgrading policy clearly'; May 4).
We are gratified that Mrs Yap has confidence in the capabilities of our public hospitals in handling complicated cases. At our public hospitals, the medical social workers work closely with patients to help them if they face financial difficulty with their medical expenses.
Patients can request to downgrade to a lower class ward, taking into consideration various factors - their financial means, bill sizes, medical conditions and other unique circumstances. Each request is assessed on a case-by-case basis. The same applies for private patients who seek treatment in private hospitals and wish to transfer to public hospitals.
Mrs Yap had requested a reply from the ministry and hospitals ahead of her delivery, as to whether she qualifies for the downgrade. As each case has to be assessed on its own merit, we have contacted her for a meeting to better explain and clarify her situation.