Channel NewsAsia
Updated: 12/23/2013 20:57 | By Channel NewsAsia

Review of healthcare financing system under spotlight in 2013

Review of healthcare financing system under spotlight in 2013


Review of healthcare financing system under spotlight in 2013

SINGAPORE: A review of the healthcare financing system to make healthcare more affordable for Singaporeans took centrestage this year.

In addition, discussions on MediShield Life, the revamped insurance scheme, have kicked off and its Review Committee expects to deliver its recommendations to the government within the first half of next year.

In his Committee of Supply speech, Health Minister Gan Kim Yong had said that the review of the healthcare financing system will be extensive and involve fundamental shifts, and take more than a year to complete.

A greater share of national spending from the current one-third to about 40 per cent to help reduce the impact of rising healthcare costs was just one of the major policy shifts by the government to give Singaporeans a greater peace of mind.

Also being discussed is MediShield Life - a scheme that offers all Singaporeans, even those with pre-existing conditions, universal coverage and better protection for large hospitalisation bills.

A MediShield Life Review Committee has been tasked to study the design of the new medical insurance scheme and seek feedback from Singaporeans.

But premium affordability remains a concern.

Dr Lam Pin Min, chair of the Government Parliamentary Committee for Health, said: "For MediShield insurance, there is always this component called the deductibles after which there is also another small component called the co-insurance, whereby all these deductibles as well as the co-insurance are actually paid for by the patients before insurance comes in to pay the rest of the portion.

"If we are able to cut down this component of co-insurance and deductibles, then the out-of-pocket expenditure or even Medisave deduction... can be lowered and people will feel that it is more affordable."

He added: "One of the suggestions is to even consider having a reverse structure whereby as you grow older, the amount of deductibles and co-insurance actually come down proportionately, because we know when we are young and healthy and working, we are able to afford the higher out-of-pocket expenditure.

"But when we are old and retired, when we do not have any active regular income, then coming up with the cash component to pay for the co-insurance as well as the deductibles can be a problem."

Dr Lam also suggested a Needy Family Package to help the lower-income families pay for the premiums for MediShield Life.

He said: "For the low-income family, this can be an issue and we do not want Singaporeans having their MediShield coverage lapse, and if there is such a package to help needy families, then we can ensure that MediShield Life can be sustainable and beneficial to all Singaporeans."

The expansion of Medisave to cover more medical conditions will also be studied. Medisave is a scheme that helps individuals put aside part of their income to meet their future personal or immediate family's hospitalisation, day surgery and certain outpatient expenses.

Dr Lam said: "If we are able to liberalise the use of the CPF Medisave account for certain conditions, then that would give Singaporeans a sense that healthcare can remain affordable. In addition to that, the government should also look at increasing subsidies, especially for lower-income families."

He added: "MOH (Ministry of Health) can also consider expanding its standard drug list because there are more and more new medications introduced into the healthcare sector. Many of these drugs are quite basic drugs that are required for many conditions and if you are able to include some of these drugs into the standard drug list, then the cost of purchasing these drugs can come down for Singaporeans.

"For example, in the treatment of many chronic diseases like hypertension, diabetes and hyperlipidemia, you have very basic medications that have been available for many years and these are classified under the standard drug list.

"But over time, we do realise that with the introduction of newer generation drugs, it becomes a norm for doctors to prescribe such drugs to patients as a first line for the treatment of these conditions, and if that is so, then these drugs that are commonly being prescribed as a first line should also be included in the standard drug list."

Another area of concern is the demand for eldercare services in light of Singapore's rising ageing population. While initiatives are underway to ramp up infrastructure, services and manpower, experts have said that the community has to play a more active role in caring for the needs of the elderly.

T K Udairam, Group CEO of Eastern Health Alliance, said: "We have a huge pool of untapped talent in terms of those who are retired, housewives who can come forward and provide a certain amount of hours of service. I do not think we should look to have people in the house 24 hours, seven days a week to look after the older or disabled person."

Mr Udairam added that there should be more awareness of what is available at day care centres and senior activity centres instead of just opting for nursing homes and public hospitals to care for the elderly.  - CNA/ms

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