SINGAPORE: The Government on Friday (June 27) accepted all of the MediShield Life Review Committee's recommendations, and will provide almost S$4 billion in subsidies and financial support over the next five years.
The insurance scheme will be implemented at the end of 2015, with more details on the implementation of the scheme will come at a later date. The committee's report will be tabled as a White Paper for debate in Parliament in July, the Ministry of Health (MOH) said in a press statement on Friday.
"The Government agrees with the committee's approach in calibrating a careful balance between providing more benefits and keeping premiums affordable, while ensuring the system is sustainable over the long term.
"MediShield Life will provide better protection, for all and for life. With better benefits, premiums will need to increase, but will be able to be fully paid for by Medisave," added the ministry, which said it would ensure that Medisave Withdrawal Limits will be able to cover all premiums.
A 1-percentage-point increase in Employer's Medisave contribution from 2015 will cover the increase in premiums for most households, it said.
One of the key tenets of the insurance scheme is to help cover those with pre-existing conditions, with the Government bearing the bulk of the cost - three-quarters of the bill, to the tune of about S$850 million over five years, said the MOH.
A further S$430 million a year will go to subsidies for the Pioneer Generation, lower-to-middle-class Singaporeans, and the needy who need Additional Premium Support on a case-by-case basis.
"No needy Singaporean will lose MediShield Life coverage due to financial need," the ministry said in its statement.
Those in the Pioneer Generation will receive subsidies of between 40 and 60 per cent of their premiums, as well as annual Medisave top-ups of about S$800 which can be used to pay for the premiums, the MOH said, noting that all Pioneers will pay less for MediShield Life premiums than they do today. Those aged 80 and above in 2014 will have premiums fully covered."
It is great that this 'I can die but I cannot fall ill if I have no medical insurance cover' fear is addressed by this MedishieldLife program. The FACT that it will TAKE a LOT of money to subsidise SOME of the population means SOME of THESE people REALLY have issue with paying for the insurance premium. So, will the subsidies be there for THEM if they are NOT QUALIFIED for the Pioneer Generation Package (PGP)?
Lessons for me are:
1. if you cannot afford it AFTER the subsidies period ended, you MUST find ways and means to SEEK individual assistance from the government to buy the MediShieldLife insurance as the premium paid will definitely be LESS than the one big major illness that lands you in hospital for an short 2-week period not the mention anything longer than that! So, if you have to beg, borrow and steal to pay for the premium, do it!;
2. that raise the question of 'for SOME people, they REALLY cannot afford to pay the premium after the subsidies end'. So, is there a need to look at HOW the whole system is operating in terms of premium income vs. premium collected in the first 3 years of existence. Since it is a government initiative and it is really a NON-PROFIT venture to pool and share risks, the scheme need to profit neutral. Of course, there is the possibility of the scheme running a huge deficit too. As for those private insurance companies riding on the MediShieldLife plan, it is out to them to tailor their plan BUT should NEVER be allowed to take advantage of MediShieldLife to let the government takes all the risks and they the benefits.
Hopefully there is a mechanism and competent people to monitor this;
3. there is STILL a fundamental issue of: can medi-care cost ONLY be on an ascending trend as most officials and people in authorities seem to suggest or believe? Much like the ex-PTC Chairman who had this mind-set that if you want a better and high quality of public transportation services, you must be prepared to pay more?
I have written on many occasions that in SOME industries, very high tech ones and very high capital investment, like semiconductors and consumer electronics CONSTANTLY face the challenge of 'dropping selling prices after each NEW and BETTER generation of products are introduced'.
So, we need to work on the 'cost of health care' AFTER the MedishieldLife is fully functional to ENSURE no super profit in this sector (much like the property developers who seem to think that they should be making super profit as an entitlement or the properties speculators who FLIPPED properties and make ten/hundred or even million of profit in the GOOD DAYS!!).
In term of fixed compensation, something may be out-of-syn if the Top 10% Earners make up MORE than last 30% of the people in the pyramid by more than 10x in terms i.e. last 30% of the people make S$2000/mth and the max the top 10% should make is S$20k/mth .
The cost of state-of-the-art treatment and medical equipment, this has to be specially funded as it is NOT for the benefits of the ORDINARY patients.
Cost of medication, South Africa government managed to get still-in-patent AIDS drug manufacturers to LOWER the prices to generic drug level.
Measurement of restructured public hospital performance and allocation of fund, NOT profit oriented. Not making money from selling medication/prescription.
Cost of infrastructure of medical facilities like hospital, do we need 5-star hotel lobby and toilet? The ever present maintenance cost of those facilities, etc must be looked into as well.
Cost of healthcare personnel, especially the front line staffs like nurses, it will go up become tapering and find a 'reasonable and commensurate' level to attract more locals to this vocation.
So, a LOT MORE work after the government COMMITTED to so much subsidies over 5-year. What happen AFTER that must be something that is TRULY SUSTAINABLE.
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