Saturday, 23 March 2013

SDP: ‘Fundamental shifts’ in healthcare financing system?

23rd March 2013

Healthcare systems expert Dr Jeremy Lim recently questioned Health Minister Gan Kim Yong’s commitment to “fundamental shifts” in healthcare costs in Singapore.
During the recent Budget debate in Parliament Mr Gan said: “The review of our healthcare financing system will be extensive, and will involve fundamental shifts.”
He added that the Government will “take on a greater share of national spending, from the current one third to about 40 per cent and possibly even further”.
He added that the Government will “take on a greater share of national spending, from the current one third to 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 one important question to ask in the healthcare cost debate is whether healthcare in Singapore is affordable to the extent that it gives the people “peace of mind”.
Unfortunately, the Minister for Health continues to miss the point by simply tweaking the fundamentally flawed 3M system (Medisave, Medishield and Medifund). He announced that Medisave would henceforth be allowed to be used for health screening and certain disease treatments.
Singaporeans should remember that Medisave funds are taken from our CPF savings. Even if its usage is liberalised, users continue to expend their own retirement income leaving them with insufficient savings for the future. Medisave is also used to pay for our children’s and elderly parents’ hospital bills when they fall ill.
All this adds to the financial burden of the people while the Government cuts back its share. This is not the way forward to a sustainable system where Singaporeans’ healthcare needs are taken of at an affordable rate.
As Dr Lim correctly notes, the SDP does not advocate a system where the Government shoulders all of the cost and users pay nothing.
Our plan calls for Singaporeans to pay an average of $600 a year (taken from our CPF) into a fund called the National 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 into the 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 and cleaner than the complex current 3M system, requiring less bureaucracy and, therefore, administrative costs.
Most important, the SDP plan treats healthcare as a basic right of Singaporeans rather than a commodity to be purchased when one falls ill. Such an approach undergirds the difference between the SDP’s and PAP’s systems, the former is people-centric while the latter is profit-oriented.
The last thing that we want to worry about when we or our loved ones fall ill is whether we can afford the medical treatment.
Will we have peace of mind to fully recover and continue to lead productive and meaningful lives without financially burdened by the medical expenses? The SDP National healthcare Plan: Caring For All Singaporeans was designed specifically to answer this question.
Paul Tambyah
for the SDP Healthcare Advisory Panel

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