Parl Committee on health vs PM's “acts of faith”
Quick Summary
Whatthe GPC said
CHAS
- CommunityHealth Assist Scheme (CHAS)and the ChronicDisease Management Programme (CDMP)should be extended such that it covers all Singaporeans of all agesand all chronic diseases respectively.
- Optimiseutilisation of private resources and see CHAS GPs as part of thepublic healthcare node. More GPs should be encouraged to sign up forthe scheme. Referrals from GPs (even for non- CHAS patients) can beconsidered for subsidised care as long as patient requests and iswilling to be under the subsidy scheme.
Affordability
- Fixedrates for consultation and treatment for low-income Singaporeans atprimary healthcare institutions, like polyclinics and CHASGPs.
- Expandthe standard drug list by including more essential drugs used in thetreatment of common conditions as this will minimise theout-of-pocket costs.
- Tosurvey and make public information on professional and medical feesacross the healthcare industry. This would serve as a check andbalance on medical costs, and allow the public to make betterinformed choices. While hospitals in Singapore publish their fees,GPs and private practitioners are not required to do so.
- Asthe current Eldershieldpayout, meant for severely disabled elderly Singaporeans, isinsufficient to even cover nursing home fees, its coverage should bestrengthened to make it more relevant.
- Ministryshould rationalise thecurrent schemes in the healthcare system today, ranging fromsocial-related schemes to medical-related schemes, and collapsethese into one unified funding assistance scheme, possibly called“Medifund – Universal”.
Medisave
- AllowMedisave use in health screening, essential dental procedures,physiotherapy and occupational therapy up to a certain cap toprevent excessive utilisation.
- Thecap on Medisave limits should be increased for the CDMP and taggedto an inflation index.
- Medisavelimits should be raised, be tiered according to different age groupsand subsequently pegged to medical inflation rates to be in linewith the higher medical costs.
- Preventpremature depletion of Medisave through inter-generational use byimposing some form of limitations on the quantum used, after whichgovernment support will kick in.
- Medisave curbs across the continuum of care that over encourages the use ofthe acute health care system should be reduced and minimised. Thiscould be done by levelling restrictions evenly across the board. Asof now, the restrictions on the use of Medisave in the areas ofcommunity and social healthcare leads to cases where patientsvoluntarily choose to admit themselves or extend their stays in thehospitals, so that they could utilize their Medisave for treatment.
MediShield
- Asa general principle, the government step in to guarantee thecontinuity of MediShield coverage for those Singaporeans who cannotafford to pay. This is especially when high premiums or low Medisavebalances makes it unaffordable or unsustainable for Singaporeans tocontinue their MediShield coverage even after years of payment.Another possibility would be to use Medifund to pay for MediShield coverage of needy Singaporeans.
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Areversed premium structure, where one pays more during one’syounger years and less during one’s old age, was amendable to theyoung and could reduce the burden on maintaining MediShield coveragefor the future elderly.
MediShieldcoverage should also be enhanced and extended to cover social andcommunity care costs. The co-payments and deductibles for basicplans, though essential, should be lowered to make it moreaffordable for Singaporeans.
MediShieldage limit should be removed. Older Singaporeans have maintainedtheir Medishield coverage despite the hefty premiums in their olderage and deserve to have the insurance cover when they need it most.
Whatthe PM did
CHAS
- Extensionof the CommunityHealth Assist Scheme (CHAS) to younger low-income Singaporeans by removing the minimum age limitof 40 years so that they enjoy subsidised rates at private GPs anddental clinics.
Affordability
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Thecurrent 50 percent subsidies to be enhanced for lower- andmiddle-income patients at Special Outpatient Clinics.
Medisave
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Medisave– the national medical savings scheme will cover more outpatienttreatments in future as contributions go up.
MediShield
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RelaunchingMediShield as MediShield Life to cover all Singaporeans regardlessof pre-existing illnesses for life; No opting out will be allowed;Premiums will go up but subsidises will be given to those who cannotafford.
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Aspecial Pioneer Generation Package for the elderly to pay theirMediShield Life premiums.
AsSingapore ages, healthcare would be the most important concern forSingaporeans in the next decade. TheGPC, which comprised of eight MPs led by Dr Lam Pin Min, submittedit's report to theMinistryof Health (MOH),acknowledged this. It further added “the old adage 'it is better todie than to fall sick' resonates with many Singaporeans, especiallythose from the lower and middle income families. This leaves manySingaporeans worried and apprehensive about their current and futuremedical needs”.
Thusunder the mandate of improving healthcare affordability forSingaporeans, the GPC took a “person-centric perspective” andconcluded that “the government needs to constant review thehealthcare financing framework to ensure healthcare remainsaffordable and also to provide a peace of mind to Singaporeans,especially those from the low and middle families”.