Let MediShield cover the mentally ill; MediShield doesn't help the mentally ill; Ease burden of those stricken and their family

23 Jun 2005, The Straits Times

Question

Let MediShield cover the mentally ill; MediShield doesn't help the mentally ill; Ease burden of those stricken and their family

Let MediShield cover the mentally ill20 June 2005 

THE Ministry of Health (MOH) has raised premiums for the new MediShield to protect Singaporeans against the financial burden of large hospital bills in Class B2 and C wards. My wife is stricken with schizophrenia and she has battled this terrifying illness for more than 30 years. I have paid her MediShield premiums faithfully for more than 20 years.I have been told the new MediShield does not cover mental illness. Granted that mental illness requires long-term medical care, MOH should provide some protection for the mentally ill and their caregivers.Separately, I have noticed that Mandarin programmes on Channel 8 use the word sern chin ping 'crazy' freely in both dramas and variety shows. Chinese dramas during prime time use the word in practically every episode. Comedy shows have to resort to the word to raise a laugh.This word is so common, my Chinese neighbour uses it to discipline her daughters, aged three and two.Last month, I noticed three Primary 3 pupils engaged in conversation on a bus. One chided the other by saying: 'You crazy! You better go to the Institute of Mental Health.'What kind of values are we promoting here? How is it that such insensitive language is used so frequently on national television, where prime-time shows reach more than one million viewers? It is little wonder that the mentally ill continue to be stigmatised and shunned. We should build a gracious society, not one that divides and segregates.I wrote a novel, Loving A Schizophrenic, to help demystify mental illness with the hope that society will give love, understanding and support to psychiatric patients and their caregivers as they struggle against tremendous odds to create a safe world for themselves. It was painful to write. My efforts will go down the drain if people continue to be prejudiced against the mentally ill.The Prime Minister has called on Singaporeans repeatedly to put on their track shoes and complete the race with him. The mentally ill and their caregivers want to compete that race as well. Give us the track shoes, and we will not just complete the race but do so in record time. 

MediShield doesn't help the mentally ill23 June 2005 

I REFER to the letter, 'Let MediShield cover the mentally ill' (ST, June 20), and would like to voice my concern for I am in a similar situation. I have a younger sister who has suffered from mental illness for more than 10 years. She has not been working all these years and therefore does not have CPF funds, let alone Medisave contributions.I have been paying her MediShield premiums to provide her with the minimum medical-insurance coverage.Sometime back, she had a relapse and had to be admitted to hospital. She had to be confined for a period of time to prevent any suicidal or violent acts.I was surprised then that I had to pay cash for all her medical expenses. This was because, firstly, she did not have Medisave; secondly, MediShield does not cover mental illness; and, lastly, she could not use her siblings' Medisave. My sister is single and thus does not have access to spouse or children's Medisave. She is not getting any younger and I don't think she will be spared major illnesses. Hence, essential medical coverage is extremely important for her. But all the insurance companies that we approached to apply for life and medical insurance for her turned us down. Family, spiritual and financial support is very important for such patients.I hope I will outlast her. If I were to leave this world before her, I am not sure who will take care of her medical expenses. I hope that the Ministry of Health will look into dilemmas such as mine. As the Government is plugging MediShield and Medisave as basic insurance coverage for most Singaporeans, it should reach out to all needy patients. Why leave out those who are mentally ill? 

Ease burden on those stricken and their family23 June 2005 

THE Singapore Association for Mental Health fully supports Mr Raymond Anthony Fernando's appeal to the Ministry of Health for the MediShield scheme to cover persons with mental illness ('Let MediShield cover the mentally ill'; ST, June 20). Mental illness is treatable but persons stricken with severe mental illness may require long-term medication and psychiatric support.With the advances in anti-psychotic medications from the 1990s onwards, newer medications with less side effects have allowed people with mental illness to function better in the community and contribute to the economy.However, not many can afford the high cost of these new-generation medications, which are more expensive than the older-generation ones. Should the MediShield scheme cover mental illness, it would ease the financial burden of people with the illness and their family members.In the long run, it would be more cost-effective as benefits can be reaped from more effective treatment, thereby reducing the need for intensive care and increasing the chances of successful community integration.We suggest a scheme to cover both hospitalisation and follow-up treatment, given the chronicity of psychiatric illnesses like schizophrenia.In addition, we suggest that the standard drug list used for the treatment of severe mental illness be reviewed to include the new-generation drugs. As Mr Fernando aptly put it, give the mentally ill track shoes so that they, too, could join in the race and not be left behind.

Reply

Reply from MOH 

MediShield: Balance needed between low premiums and comprehensive coverage 

Mr Raymond Anthony Fernando, Ms Jane Koh and Ms Rajeswari K have suggested that MediShield should cover mental illness. This is a fair suggestion. 

When working out the MediShield reform, we have tried to keep premium increases to about $10 per month. This has inevitably limited the scope of increased MediShield coverage and as it turns out, MediShield remains unable to cover mental illness. 

Instead, public hospitals will continue to heavily subsidise the mentally ill. Patients who are unable to afford, despite the subsidy, will be assisted via Medifund. Last year, for example, the Institute of Mental Health rendered Medifund assistance of nearly $9 million to their needy patients. 

Meanwhile, some private medical insurers have expanded their coverage to mental illness. Singaporeans who want added protection could use their Medisave to buy such enhancement riders. 

We would like to emphasize that the medical care for mentally ill patients would not be compromised by their ability to pay, and that every effort will be made to help these patients recover and integrate into the community.