Healthcare in Singapore

b) How is our government responsible for healthcare in Singapore?

What is MEDISHIELD?

Medishield-> MediShield is a low cost catastrophic illness insurance scheme. Introduced in 1990, the government designed MediShield to help members meet medical expenses from major illnesses, which could not be sufficiently covered by their Medisave balance. MediShield operates on a co-payment and deductible system to avoid problems associated with first-dollar, comprehensive insurance.Premiums for MediShield can be paid by Medisave. A very large medical bill can easily wipe out your Medisave balance, as it is only a savings account. For this reason, you are advised to take up MediShield or an appropriate private Integrated Shield Plan in order to stretch your Medisave dollars. Your co-payment and deductibles can also be paid using Medisave or cash.MediShield will cover up to 80% of your large medical bill at the Class B2/C level.
For Singaporeans who plan to use Class B1 or higher ward classes, you may wish to consider purchasing Medisave-approved private Integrated Shield Plans on top of your Medishield. MediShield and other Medisave-approved private Integrated Shield Plans are designed to cater to your different insurance coverage needs. MediShield is operated by the CPF Board.

CHART


THIS A CHART WHICH SHOWS THAT SINGAPORE'S TOTAL CARE EXPENDITURE IS THE LOWEST, WHICH IS A GOOD THING. IT TELLS US THAT SINGAPORE PLANS AND DOES EVERTHING SMOOTHLY.




A PICTURE OF A HEALTH CARE CRISIS.













AN ARTICLE

Healthcare in Singapore

By Lau Ah Pek, on February 4th, 2006B

Something that knocked me off my feet recently was the government's seemingly magnanimous pledge to increase the Medisave withdrawal limit from $300 to $400. Then there was the Workers' Party Manifesto bit on health matters which I don't agree fully but there were some points worthy of proper debate. I then gathered that the sheer cheek of the $100 increase in withdrawal was astounding. Election is coming soon and here the PAP is throwing pitiful scraps at us! My fellow Singaporeans. A Medical Savings Account scheme is excellent but Medisave is still our money. Every cent of it. It is not some dollar for dollar contribution by both citizens and the government. The Medisave purse is ours. Yet what the government is telling us is that"Alright, we feel generous now and decide to let you spend $100 more of your own money." Does that sound incredulous or not?The government is correctly concerned about footing the health bills of Singaporeans. I thump on the table loudly in support of it, especially with an ageing population projection in Singapore's demographics. I too don't want my hard earned tax dollars totally spent on saving some guy who stubbornly smokes non stop, drinks too often, eats too much, does not exercise and engages in unsafe sex, sometimes all at the same time. The hedonistic bastard. I believe that tax dollars should be spent on subsidising public healthcare especially for the lower income group but individual responsibility to be healthy has a role in this grand Utopian healthcare plan. A shared responsibility in healthcare. I bought that idea the government is selling. But the government can obviously do better than offer to increase the Medisave withdrawal limit by $100 to improve the healthcare situation in Singapore.
Some basics about healthcare in Singapore. Contrary to scary urban legends that one can die in Singapore but cannot be sick, the government arguably does provide for us in the form of a medical savings account and bigger subsidies for lower class wards. This savings account, Medisave, forces us to put aside a sum. The current Medisave contribution ceiling is $32,500. The Medisave contribution rate is for those below 35 is 6% (max $270 a month), those 35-44 is 7% (max $315 a month) and above 45 is 8% (max $360 a month)

Besides saving money for an unfortunate event, when someone gets a nasty heart attack or something equally worrying and needs to be hospitalised, opt to stay in a C or B2 class ward in a restructured hospital i.e. the likes of SGH, NUH, TTSH rather than Mount E. Like my fellow Void Deck contributor had mentioned earlier, there is high government subsidy of 80% for C class wards, 65% for B2 class wards while the nice air-con with TV B1 and A class wards have 20% and 0% subsidy respectively. Be wise and don't overreach. The difference between a B2 and a B1 ward is conservatively at least $200 a day, using the example of a stay at Alexandra Hospital for dengue fever. Stay in a cheap ward and if you really want to pass your time while you are hospitalised for a few days, try to finish War and Peace in this latest attempt, or you can get a cheap portable TV for less than $100 and a portable DVD player with screen for less than $300. Do the maths and weigh the trade-offs between cost and comfort. Healthcare in Singapore is one of the best and more affordable in the world, as long as you pick your ward and hospital wisely, Medisave can take care of it.

Furthermore, not only pick the right ward according to one's means, do get hospitalisation insurance. Then there are confusing issues of riders, co-payment, deductibles etc. It is not that smooth sailing of course as many insurance companies are in the game such that it becomes almost like comparing apples and oranges between one product and another. Understand more about such hospitalisation insurance at Tan Kin Lian's blog but bear in mind that he is naturally pro-Incomeshield. The only irritating thing is that hospital insurance gets astronomically more expensive as you get older and there might even be an cut-off age.

But what can the government do about Medisave and Medishield? There are many improvements they can implement besides that Scrooge move of $100 increase in the Medisave withdrawal limit.

Firstly, the Medical Savings Account approach is laudable in bringing down the government's health expenditure. But it can be tweaked. I think the government could make hospitalisation insurance mandatory. The premium can be paid from Medisave, just like now. The problem with the current situation is that some people just don't bother about hospitalisation insurance at all even if they are not covered by their employer, and they don't know that Medisave is not an insurance policy. Furthermore, if such an insurance scheme is implemented nationwide and compulsory, Singaporeans as customers can benefit from economies of scale and even enjoy lower premiums (and whether it means lower deductibles is another controversy). Even a pathetic PAP Minister mentioned this national hospitalisation insurance before but somehow it didn't catch on. Maybe it is because it was Lim Boon Heng who said it. Who the hell listens to him right? Whatever it is, there is not enough debate in this direction.

After some money from Medisave is set aside for mandatory basic hospitalisation insurance, any extra in the Medisave can be used for outpatient treatment depending on the type of treatment and the amount per year. This is something that Medisave currently is rigid about. If the government is worried that people are going to spend away their Medisave willy nilly and deplete it prematurely, then set some sort of limit for outpatient withdrawal per year up to X amount or something. Let's face it. There is no pleasing anyone totally in any policy making but this sort of middle of the road accommodation is a commendable one. Any reasonable citizen can see that this is the first step towards balancing individual responsibility in long term healthcare and using our money in Medisave for healthcare only. Remember again, Medisave is totally our money.

So let's say if the government for whatever reason does not want to implement mandatory hospitalisation insurance (compulsory Medishield) to complement the medical savings account (Medisave). Fine, then there should be a policy to benefit those who opted to have hospitalisation insurance. Those who signed up with some Medishield plan e.g. Aviva Myshield, can be the ones who can withdraw Medisave money for more types of outpatient treatment while those who don’t choose to have any Medishield type of plan will remain status quo in terms of Medisave use rules. People are free to choose but they must realise the impact of their Medisave decisions.
I did not ask for more subsidies. I am asking for more flexibility. I worked on the premise that Medisave, an admittedly "clever" healthcare scheme that is studied by other governments, is our money and we have the right to spend it, but responsibly only on healthcare. There could be mandatory hospitalisation insurance so that in the event of any inpatient treatment, Medisave and the insurance can take care of almost every incident. If that is the case, then there is less reason to be so uptight about spending Medisave money for other healthcare needs e.g. outpatient treatment, on condition that there is still money stashed inside to settle the annual Medishield-type premiums for X number of years. The current policy is one of tight control of our own purse. There is something ethically wrong about it and it need not be this way. More flexibility in using Medisave should be accorded to people who can show that they are trying to take care of themselves.

Enough of my lay person's ramblings on healthcare. Is mandatory health insurance the solution? Maybe. The bottom line is that the government is not doing enough in terms of Medisave flexibility in the healthcare front. There is not enough debate on the matter. Perhaps the government is saving the best for last and they will unveil the persuasive grand plan with fireworks and fanfare when the election arrives. I hope so and they better address some of the issues raised by the Health Feedback Group. Expectedly not all the proposals are feasible now but they can’t all be unworkable right? Offering views to the government is what the feedback group is for in an open and inclusive society that seeks public consultation in national policies right?


Reflections from annonymous:

1)S'poreans don't understand about healthcare or healthcare needs. We are a very hard society, as I have realise.


2)Yes it's true. We are not there yet as a society. Plus and minus, the equations just don't add up together.

























AN ARTICLE

Get Moving and Eat Right for a Healthy Lifestyle


Engaging in physical activity and eating right are key to living healthily. With more Singaporeans eating out, it is recommended that a balanced diet should be a varied diet that is low in fat and salt and rich in fruit and vegetables. Physical activity is important for maintaining good health and has been shown to reduce the risk of coronary heart disease, hypertension and diabetes.
Findings from the National Health Survey 2004 revealed that among adults aged 18 to 69, 24.9% exercised regularly, 27.0% exercised occasionally, while 48.1% did not exercise at all (physically inactive).
The physically inactive cited the following three main reasons for their status:
“No time due to work / family commitment” (47.7%),
“Too tired” (20.7%),
“Too lazy” (16.2%).
NHLC 2006 aims to encourage those with a more sedentary lifestyle to move for health. It is recommended to engage in physical activity for 30 minutes daily, five and more times a week. Involvement in physical activity need not be in the traditional forms of exercise such as gym workouts, running, jogging or other types of sports. Commonplace daily activities such as household chores, climbing the stairs, taking brisk walks, or walking to a lunch destination during the work day also translate into physical activity.
This year’s Campaign also introduces interesting activities such as in-line hockey, beach volleyball, windsurfing as novel ways of keeping physically active.



AN ARTICLE



Introduction


Singapore is 704 kilometres squared, making it one of the very few remaining city-states around the world.Since its independence in the 1950’s, Singapore has continued to increase its standard of living. Foreign investments, along with island-wide industrialization, has created a more modern economy based on their electronics and manufacturing trade. Today, Singapore is noted as the 17th richest country in the world based on GDP. In fact, Singapore has more than US$147 billion in foreign reserves.
Singaporean healthcare overviewSingapore has one of the highest medical standards across Asia. In fact, this highly-industrialized nation is Asia’s regional centre of medical excellence. The well-established healthcare system is composed of thirteen private hospitals, ten government hospitals and a number of specialist clinics, each one specialising in catering to the needs of different patients at varying costs.Patients are also free to choose their healthcare provider, both within the public and the private healthcare system. The medical facilities of Singapore are considered one of the best in the world. Medical practitioners are well-trained and qualified. Furthermore, pharmaceuticals are widely available from a number of pharmacies and outlets that include department stores, supermarkets, shopping centres, and hotels. Registered pharmacists normally work between 9am and 6pm and there are some pharmacies that open to 10pm. Also, most hotels have doctors on call 24 hours.
What is Medisave?Every working person in Singapore (Singapore Permanent Resident/ Singapore Citizen) and the self-employed are obliged by Singaporean law to make a payment to Medisave from their CPF (Central Provident Fund) account. These Medisave funds are used to pay for hospital expenses for the contributor as well as their dependents. These dependents have to be permanent residents or Singaporean citizens and can be a spouse, a child, a parent, or grandparent.
Hospitals in SingaporePrivate and public hospitals in Singapore provide services that are highly regarded by expatriates, as well as those living in neighbouring countries. Both the private and public hospitals of Singapore are equipped with state of the art medical equipment in order to maintain the highest standards of medical services. Some hospitals that are noted as benchmarks in delivering top healthcare standards are the Singapore General Hospital, the Tan Tock Seng Hospital, the National University Hospital, the Gleneagles and the Mount Elizabeth Hospital. These hospitals charge more than the government hospitals, which include the National University Hospital, Kandang Kerbau, Changi General Hospital, Singapore General Hospital, Tan Tock Seng Hospital, and the Ang Mo Kio Community Hospital.Five of these government hospitals provide services for acute cases. They also have a specialist outpatient service that has 24-hour accident and emergency services. Additionally, Singapore has six specialty institutes for dentistry, neuroscience, cardiology, oncology, dermatology and ophthalmology. Furthermore, tertiary hospitals like the National University Hospital and the Singapore General Hospital specialise in fields such as renal medicine, cardiology, neurology, haematoma, radiotherapy, oncology, reconstructive and plastic surgery, neurosurgery, paediatric surgery, transplant surgery, and cardiothoracic surgery. Additionally, five other public hospitals provide specific functions including mental healthcare, maternity, sub-acute care and infectious diseases services. There are also specialist hospitals such as the Singapore Heart Care Centre, the National Skin Care Centre and the Singapore National Eye Care Centre.
Important healthcare issues for expatriatesProspective expatriates who are talking a regular course of medication should be aware that prescriptions from your own country are not valid within Singapore. All Singaporean pharmacies require medical prescriptions from locally registered medical doctors. With this in mind, patients will have to go to a local registered medical practitioner and consult their doctors. Patients should also bring their prescriptions with them so that the local doctor can easily prescribe the necessary drugs.However, if one particular brand of drug is not offered in local pharmacies, the doctor may be able to prescribe a therapeutically equivalent drug; one that won’t compromise the treatments of the illness or the disease. Furthermore, patients can obtain new supplies of prescription drugs from the doctor himself, or obtain the prescription from the doctor and then present it to private pharmacies and have it filled.
Additional informationExpatriates who seek inpatient services in Singapore can choose the type of room they stay in. For government hospitals, they can choose between a “class A” single room, and a “class B1”, a room with two beds. Medical fees in government hospitals are lower than those of private hospitals. Non-Singaporeans will also have to pay 30% more than the fees that are charged to citizens and permanent residents.

Means Tested: Step-Down Care for Elderly (MOH Website)


Introduction


Many patients who are well enough to be discharged from hospitals would usually like to return to the comfort of their own homes. However, because of their medical conditions, some may be unable to do so. Hence, they may require further care and treatment at centres that provide step-down care. Step-down care refer to selected services such as:
>Community Hospitals
>Nursing Homes
>Hospices
>Day Rehabilitation Centres


Home care services such as home nursing and home medical This article from geraldtan.com Government Subsidy The Singapore Government recognizes that these step-down care services can be expensive because patients are admitted for long periods of time. As such, the government provides financial assistance in the form of subsidies to the elderly. To ensure that the subsidy goes to those who need it, an income assessment framework, called the "Means Test" was introduced in year 2000. Subsidies are available only to elderly who:
Are Singapore citizens or Permanent Residents
Meet the admission criteria of the step-down care services required
Are admitted to Government funded institutions and services The subsidy will go directly to the service providers who will use it to offset the bill for the step-down care fees and charges. Means Test"Means Test" is a method to calculate the subsidies that an elderly will get if he/she needs step-down care services. It takes into consideration:
gross income of the patient, his/her spouse and the immediate family members
number of family members and
ownership of major assets such as private property Amount of Subsidy There are currently three levels of subsidy - 75%, 50% or 25%. For example, if the total income is $800 per month and there are 4 family members, then the per capita income works out to $200. The elderly will qualify for 75% subsidy. This means that the Government will pay 75% of the fees and charges incurred for step-down care while the elderly and his/her family will pay the remaining 25%

Level Of Subsidy

Rate of Subsidy Per Capita Income


$0 to $300 75%

$301 to $700 50%

$701 to $1000 25%

More than $1000 0%

(MOH WebsiteAs of Dec 2006)










SOURCE BASED QUESTION:

WHAT CAN WE INFER FROM THE PICTURE BESIDE ABOUT SINGAPORE'S SUBSIDY COST?

ANS: GIVEN IN THE ABOVE ARTICLE.

posted by social studies project @ 11:48 PM 1 Comments