Help is there for the needy

27 Jun 2006, Business Times

Question

Name of the Person: Leong Sze Hian

Help is there for the needy

ACCORDING to the Ministry of Health's website, subsidies for subsidised patients have been rising from $560 million in 1997 to $1.39 billion in 2005. 

Particularly for the poor, increases in subsidies may need to be viewed in the context of rising healthcare costs. For example, if healthcare costs rise by 10 per cent, and subsidies also increase by the same amount, the net impact on the poor is zero. 

Notwithstanding rising subsidies, the poor were most affected as healthcare spending of the lowest 20 per cent of households by income, had the highest increase of 81 per cent among all items of expenditure from 1998 to 2004. This increase is further compounded by the decline in average monthly household income of this group by 3.2 per cent a year from 1998 to 2003. A statistic that may need to be looked at is whether the poor's co-payment for every incremental dollar of healthcare costs vis-a-vis the government's share has risen over the years. 

A slew of changes in healthcare policies in recent years may have contributed to rising healthcare costs for the poor, such as the 9 per cent increase in polyclinic fees to cover renovation work; no more free treatment for infectious diseases like dengue fever and chicken pox at the CommunicableDisease Centre; increase in MediShield deductible and premiums; maximum waiver of only up to 60 per cent for non-air-conditioned 6-bedded ward under Medifund; means testing for disabled care; means testing for community hospitals elderly care, etc. 

For example, means testing since 2000 for community hospitals elderly care, starts at $301 per capita income. How can a family with a per capita monthly income of $301 be considered not poor? 

With over three per cent of Gross Domestic Product (GDP) spent on healthcare, I understand that Singapore's healthcare spending over GDP is one of the lowest in the world. 

The poor is perhaps not interested in the debate or statistics on healthcare, but rather the issue of affordability and whether healthcare will continue to be a rising financial burden.

Reply

Reply from MOH 

In "More healthcare subsidies needed" (BT, June 27), Mr Leong postulated that the poor had not benefited despite increased government subsidies. He built his case on his assumption that subsidies had not kept pace with rising healthcare cost. But the evidence proves otherwise. Between 1997 and 2005, health consumer price index rose by 2.6 per cent per annum. Over that period, government subsidies grew by 12 per cent per annum. Mr Leong added that the means test applied at the community hospitals was too stringent and could only benefit a tiny portion of the population. Again the evidence proves otherwise. In community hospitals, government subsidises reach out to all patients up to $1,000 per capita family monthly income. This would cover about half of all families in Singapore. We share Mr Leong's concerns on affordability of healthcare. Indeed, our misson is to ensure that basic healthcare remains affordable to all Singaporeans. Our system is not perfect and we will continue to improve on it. Last year, we reformed MediShield to cover bigger bills more adequately. And we will continue to build up the Medifund so that it can remain an effective safety net for the needy patients. 

In addition, the government has spent millions of dollars to top up the Medisave accounts of Singaporeans, with larger top-ups for those in greater need. This year, the Medisave accounts of older Singaporeans and low-wage workers will be topped up by a total of $290 million.