Everyone Can Play Our Part In keeping Our Healthcare System Sustainable

MOH's Reply

Lianhe Zaobao, 10 Jan 2020

Everyone can play our part in keeping our healthcare system sustainable

We thank Mr Zheng Guo Jin for his letter (医疗保费涨势可以更好地控制, 6 Jan).  

Medical insurance plans with no co-payment component can indeed result in over-charging, over-servicing or over-consumption of healthcare services. This would lead to rising healthcare costs and insurance premiums. 

All of us can play our part in keeping our healthcare system sustainable. The Ministry of Health (MOH) has been working with various stakeholders on a range of initiatives to help keep healthcare costs and insurance premiums affordable.

All Singaporeans are covered for their basic hospitalisation needs under MediShield Life, for life. The Government provides various subsidies to ensure MediShield Life premiums are always affordable.  

Many Singaporeans also hold Integrated Shield Plans (IPs) for additional coverage. Private hospitalisation insurance plans such as IPs and riders are optional, to cater to those who prefer additional coverage. Health insurance premiums tend to increase with the age of the policyholder, and with increased claims. We encourage Singaporeans to consider their decision on private insurance carefully, taking into account whether they would need private healthcare services and whether the premiums are acceptable.

Both MediShield Life and IPs have a co-payment component. Since April 2019, MOH has introduced co-payment requirements for new IP riders to prevent the proliferation of medical insurance policies with no co-payment component. This is to encourage doctors to make appropriate treatment decisions to prevent over-servicing, as well as to avoid over-consumption and encourage the prudent use of healthcare services on the part of the patients. This will help to better manage rising healthcare costs and insurance premiums to keep them more affordable and sustainable for Singaporeans in the long-term.

In addition, to moderate the rate of premium increases, MOH encourages insurers to use panel doctors and pre-authorisation arrangements to better manage claims. Insurers are also stepping up their claims scrutiny over questionable charges.

To guide private sector healthcare providers in charging appropriately, and enable patients and payers to make more informed decisions about their care and treatment, MOH published fee benchmarks for private sector professional fees for common surgical procedures in 2018. The Agency for Care Effectiveness (ACE) also publishes Appropriate Care Guides and Drug Guidances to guide healthcare professionals in making decisions that are clinically appropriate and cost effective.

At public healthcare institutions, we have made other efforts to keep costs sustainable, including the use of group procurement to get better prices, tapping on technology to improve productivity, and applying healthcare technology assessments to guide the appropriate use of services, devices and drugs.

Collectively, these initiatives will empower providers, insurers and policyholders, patients and caregivers to make better informed choices on the appropriate care and treatment that best serves their needs. Responsible pricing and use of healthcare services will help to moderate the rise in healthcare costs and claims over time, and correspondingly help to slow down the increases in insurance premiums. 

Mr Cham Dao Song
Director, Finance Policy
Ministry of Health