“Fundamental shifts” in healthcare financing system?

March 21, 2013
Singapore Democrats

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Singapore Democrats

Healthcare systems expert Dr Jeremy Limrecently questioned Health Minister Gan Kim Yong’s commitment to”fundamental shifts” in healthcare costs in Singapore.$CUT$

During the recent Budget debate inParliament Mr Gan said: “The review of our healthcare financingsystem will be extensive, and will involve fundamental shifts.”

He added that the Government will “takeon a greater share of national spending, from the current one thirdto about 40 per cent and possibly even further”.

While the SDP applauds these steps which bring Singapore closer to where we were in the 1980s, we share with Dr Lim the concern that there is a need to go beyond incremental steps to real fundamental shifts.

As Dr Lim pointed out that the oneimportant question to ask in the healthcare cost debate is whetherhealthcare in Singapore is affordable to the extent that it gives thepeople “peace of mind”.

Unfortunately, the Minister for Health continuesto miss the point by simply tweaking the fundamentally flawed 3M system(Medisave, Medishield and Medifund). Heannounced that Medisave would henceforth be allowed to be used forhealth screening and certain disease treatments.

Singaporeans should remember thatMedisave funds are taken from our CPF savings. Even if its usage isliberalised, users continue to expend their own retirement incomeleaving them with insufficient savings for the future. Medisave is also used to pay for ourchildren’s and elderly parents’ hospital bills when they fall ill.

All this adds to the financial burden of the people while theGovernment cuts back its share. This is not the way forward to asustainable system where Singaporeans’ healthcare needs are taken ofat an affordable rate.

(Read also Medisave or Medispent?)

As Dr Lim correctly notes, the SDP doesnot advocate a system where the Government shoulders all of the costand users pay nothing.

Our plan calls for Singaporeans to pay anaverage of $600 a year (taken from our CPF) into a fund called theNational Health Investment Fund (NHIF) which is a universal, national health insurance scheme based on the principle of risk pooling to ensure that all Singaporeans have peace of mind about their health.

The Government also pays intothe NHIF for those who cannot afford the payments.

There are also different copayments for outpatient treatment for acute conditions and for serious hospitalisations which are capped. Such a single-payer system is streamlined andcleaner than the complex current 3M system, requiring less bureaucracy and, therefore, administrativecosts.

Most important, the SDP plan treatshealthcare as a basic right of Singaporeans rather than a commodityto be purchased when one falls ill. Such an approach undergirds thedifference between the SDP’s and PAP’s systems, the former ispeople-centric while the latter is profit-oriented.

The last thing that we want to worryabout when we or our loved ones fall ill is whether we can afford themedical treatment.

Will we have peace of mind to fully recover andcontinue to lead productive and meaningful lives without financiallyburdened by the medical expenses? The SDP National healthcare Plan:Caring For All Singaporeans was designed specifically to answerthis question.

Paul Tambyah
for the SDP Healthcare Advisory Panel