Wednesday, 21 August 2013

Tweaks or Tricks - PM's NDR 2013

Highlights of PM Lee's speech: Health-Care Financing


At the Institute of Technical Education College Central last night, Prime Minister Lee Hsien Loong said shifts to social policies in housing, health care and education will be needed

The Government will enhance the Community Health Assist Scheme by removing the current minimum age of 40 to include younger Singaporeans. It will also increase subsidies for lower- and middle-income patients at specialist outpatient clinics, and means-test those who seek additional subsidies.

MediShield will be revamped to become MediShield Life, in order to cover every Singaporean for life, including the elderly and those with pre-existing illnesses. It will provide Singaporeans with better protection for very large bills.

Under the Pioneer Generation Package, the Government will help those who are retired and in their late 60s or older pay for their MediShield Life premiums.

read more

ND Rally: New MediShield Life for universal coverage

The Community Health Assist Scheme (CHAS) card gives beneficiaries a subsidy of up to S$80 for visits to participating general practitioners and dental clinics.

Only Singaporeans with a per capita household monthly income of S$1,500 and below, aged 40 years and older qualify. However, this age restriction will now be removed so more young Singaporeans can benefit.

read more

Doctors, patients welcome changes to MediShield and CHAS


PM: MediShield to be revamped, premiums & Medisave rates to go up



At the National Day Rally today (18 Aug), PM Lee said that the Govt will improve healthcare financing to give all Singaporeans “more peace of mind”.

The current medical insurance scheme, MediShield, will be revamped to become MediShield Life, he said.

“The MediShield Life will not stop at 90. So don’t worry, it will cover old people. Secondly, MediShield Life will be universal. It will cover everybody, every Singaporean – old ones, young ones, those newly born.”

read more

BN Special: Letters to the Prime Minister: Healthcare

Dear Prime Minister... (Image by Ernest Goh)

As someone in my mid-20s, I am heartened to hear you promise that “every Singaporean family who is working can afford a HDB flat.”

At an age where the spectre of having to save enough for my marriage and a flat of my own looms ever larger, I feel reassured by the fact that for just $67 per month (in addition to my CPF monies), I can plausibly afford a new four-room flat in Punggol. And even if I can only afford a two-room flat at first, I am glad that grants are available for me to upgrade – to keep up with the Chans and the Tans. Coupled with measures such as a record number of new flats and higher income ceilings, things are indeed looking rosy for would-be first-time buyers such as me. Thank you, I can ‘ROM’

What’s new: Health
  • Community Health Assistance Scheme now open to younger Singaporeans
  • More financial aid for specialist outpatient care
  • MediShield now MediShield Life – universal, for life, and better coverage for larger bills; premiums to go up
  • Progressive increase of MediSave contribution rates
read more

A disillusioned Singaporean says PM Lee needs to resign: Medishield Life


YOG & Garden by the Bay were epic failures and inexcusable waste of taxpayers money, now Gardens at the Airport? They might as well transplant the iconic old Kallang Airport aka PA HQ onto Changi Airport to safe taxpayers money! Pinkie really thinks money grow on tree is it?

Universal insurance for Singaporeans is a good step in the right direction. But how much are you going to make us pay? I will reserve comments for now until I see your price list. And, if you are not going to declare the pooled Medishield fund amount to the public, how could we trust you with our money?

You could be raising premiums as and when you like it, like how you always tinker with our CPF’s Minimum Sum and Withdrawal Age without public consultation [Source]. We had enough of you telling us “you cannot opt out”. Your CPF Life Annuity was like this [Source]. Why am I not allowed the choice to opt-out when you have no accountability and transparency to show of in your system?

Compare yourself to the Australia Government [Source] who could detail how much withdrawals and deposits are made, how do you expect the average citizen to trust our money under your care? We are not naive PAP voters who take in every word you say. Before we part this topic, we have also not gone on to the worsening quality of healthcare in Singapore [Source], so could you please get your basics right first before introducing new ideas?

read more

Healthcare Financing: Tweaks or Tricks?

In his 2013 Budget announcement earlier this year, Deputy Prime Minister Tharman Shanmugaratnam said the government would look into lowering Singaporeans’ out-of-pocket health spending.

On Sunday evening, we learned more about how this may be achieved through Prime Minister Lee Hsien Loong’s 2013 National Day Rally (NDR) speech. In summary, these are the tweaks to healthcare financing Singaporeans can expect in future:
  • Medisave usage will be expanded to more medical conditions;
  • Medishield coverage, renamed Medishield Life, will extend to those above 90 and will be universal. It will be expanded to include those with pre-existing illnesses;
  • There is no opting out of Medishield Life and premiums will be higher;
  • A “Pioneer Generation Package” will be introduced to help elderly Singaporeans in their late 60s and above pay for their premiums under Medishield Life;
  • Medisave contribution rate will increase;
  • State spending on healthcare will increase;
  • The Community Health Assist Scheme will be open to younger Singaporeans below 40;
  • Means-tested subsidies will be increased for those with more serious conditions who need to visit Specialist Outpatient Clinic
Details will be finalized after a public consultation exercise (reports here and here).

read more

Why must MediShield break even?

In the end, when all the tears have dried and euphoria has died down, you start to get this niggling feeling that something doesn’t feel quite right. You toss and turn through Sunday night, wondering if the deal you’ve just been sold may not be such a great deal after all. Then, come Monday morning, you begin feeling a little silly to have gotten so excited in the first place. On hindsight now, after much careful thought, you put it down to that creepy smile and repeat assurance to not worry that threw you off-guard.

In the National Day Rally yesterday, PM Lee played housing agent like a seasoned salesman. Complete with a neat PowerPoint presentation and a cooperative audience in a game of Show of Hands, he demonstrated how a 3-room or 4-room HDB flat can be affordable for ordinary Singaporeans. Even more impressive was how he went on to play the insurance salesman. Indeed, if he ever becomes one, he will no doubt be sweeping all Agent of The Month accolades.

For where in the world will you ever find an insurance agent who gets cheered and praised by his customers for telling them that, in order to get higher and more comprehensive coverage on their health plans, they need to pay a higher premium? The best most agents can hope for is a polite no in place of the phone slamming. When Singtel told its customers the higher price they are now paying for the English Premier League will come with a comprehensive 80 other channels, all they got were brickbats and mio Boxes thrown at them from angry football fans.

read more

MediShield Life — Painting Roses Without Thorns

Prime Minister Lee Hsien Loong announced changes to MediShield, which will be renamed MediShield Life, at the National Day Rally:
  • Coverage will be for life, instead of up to 90 years now.
  • Coverage will be universal and will include those who have dropped out and those with pre-existing illnesses.
  • Coverage will be higher for large hospital bills.
  • Coverage will be compulsory.
All these are nice. But, as PM Lee warned, "It may cost you a bit more, but it can be done."

Isn't it rather premature to announce the proposed changes without having already looked into the most important aspect — cost?

read more

National Day Rally 2013: But How Much Will The Government Pay?

According to the Today newspaper, Medishield will be “will be “revamped” as MediShield Life, with its age ceiling of 90 years removed to provide lifelong coverage for all Singaporeans”. Also, PM Lee said that Medishield is now “universal” and that “there will be no more opting out, with everyone covered including the elderly and those with pre-existing illnesses”. Also, “MediShield Life will also give better protection for very large hospital bills, and patients will pay less out-of-pocket”. Today also reported that, “the Government will roll out a special Pioneer Generation Package, helping to foot the medical bill of older Singaporeans under the revamped national insurance scheme, MediShield Life.”

It was also announced that “the age floor in the Community Health Assist Scheme (CHAS)” will be removed, so that “children from low-income households will be eligible for subsidised outpatient medical treatments”. “Subsidies for lower- and middle-income patients will (also) be increased for visits to specialist outpatient clinics.”

PM Lee had also said that, “there have been many requests for Medisave to be used for more outpatient treatments”. He added that, “In principle this is sound … We want to move in this direction … We’ll be studying carefully how to do this.”

read more

No More Opting Out

He's kinda thick, isn't he? After one whole year of feedback through the National Conversation/Our Singapore Conversation, he still doesn't quite comprehend the complaints about affordable healthcare.

Instead of reducing medical expenses, he plans to hike the Medisave, which is basically our own hard earned money deducted to pay for ever inflating government charges. Medishield is the other horror. Most private insurance companies quote you a fixed rate for the type of policy you decide upon. And stays fixed for the duration of the contracted cover.  Medishield increases your premium without your permission. No wonder many have opted out.

Do we need Medishield Plus for cover beyond age 90? Not many of us fancy living like a zonked-out zombie like that character, who is 89, going on 90 in September. Whatever good ideas PM Lee floated for housing and education, it all went out the window when he announced: "There will be no more opting out for MediShield.”

read more

NDR 2013: A move toward universal healthcare?

This year’s National Day Rally speech was noted for steering clear of politically controversial topics such as immigration, foreign influx, overcrowding, and frequent train breakdowns, and completely ignoring criticisms made by alternative media. This was probably a calculated move to get Singaporeans to focus their attention squarely on new initiatives such as a revamped healthcare system, a revised approach to education and grades, and expanding our aerospace infrastructure.

The new healthcare system is the topic that concerns me most deeply. The key changes include the introduction of a new Medishield Life plan that will cover the person for life. The new plan will be universal, in the sense that it will include everyone without the possibility of opting out. It will also take in people with pre-existing conditions. In exchange for enhanced benefits, insurance premiums will be higher. To keep up with rising medical costs, medisave contribution rates will also be increased.

PM Lee said that because the benefits and coverage are better, MediShield Life premiums will be higher because the scheme “has to break even”. We need to question why the scheme “has to break even”. Why can’t the government fund the scheme partially from our yearly budget surpluses?

read more

Health care – Please don’t help us

It has never failed. When the Govt said it is going to help you, be frighten, be very frighten. The Govt is going to help the people with a life time health care scheme. That is the good news. The bad news, you are going to pay for it dearly. It cannot be for free right? And there is no escape this time. It is going to be compulsory! Imagine the frustration over the years when Medishield cannot be made compulsory? Now with this ‘the Govt will help you Medishield Life’ it is now compulsory. And the premiums to pay for health care for life, I can’t imagine how much it is going to cost.

The minister has said that it will be ‘affordable’, another very frightening word. We all know what affordable means to the average Sinkies and what affordable means to the rich and powerful. And the assurance that those who cannot afford to pay will be subsidized is not too much of an assurance either. How poor would one has to be before one is qualified for subsidies?

What are the statistics for Singaporeans to live to 70, 80, 90 and above 100? What kind of sicknesses were they hit and how big were the bills? At the moment the number for the oldies seeking major ops or expensive ageing related sicknesses could be relatively low. Many would rather die than to live on and on like the undead or vampires

read more

Lee Hsiao Loong's mad plan to medisuck your funds dry



Lee Hsien Loong. With a firm hand, he forces everyone, insurable or uninsurable and below 90 or above 90, to be on a new compulsory medisave scheme, which will be called the Medishield Life. Whether it would benefit everyone is yet to be seen. What we can be sure is that the insurance companies will be very happy to have unsolicited customers being forced to pay them premiums. No marketing costs to have this avalanche of new clients!

On the surface, the latest Medisave plan suggested at the NDP 2013 Rally sounds good. But in reality, it is a well designed con job. While PM Lee may not be very familiar with the details how insurance companies calculate their costs, surely he would have had advisors telling him what to do. Surely these advisors would have known the very unfavourable terms that would be thrusted upon those with pre-existing conditions, as well as unto the general public.

Are these advisors sleeping on the job? Or are they complicit with the big insurance companies, as with many agencies of the govt, in trying to bleed as much money from you, so there would be enough money to fund their fat salaries?

read more

Die Happy, Die Pretty, Die Desperately Clinging to Life

Intensive care unit monitor

Like our former PM, these doctors choose not to prolong their lives (suffering) under those dire circumstances. But does everyone have a choice? Given our revered former PM’s philosophy towards life and death and his own personal choice for when to stop treatment, the implications Singapore’s latest healthcare reforms announced during National Day Rally 2013 may sound a bit puzzling.

MediShield coverage will no longer stop at 90 and will be expanded to include even those with pre-existing illnesses. In addition to the increased coverage, benefits will be increased so patients will pay less out-of-pocket. However, there will be no choice to opt-out under the scheme to be named MediShield Life and premiums will be higher. Medisave contributions will also need to go up to cover better outpatient care.

The cynics in social media call this increased taxation through Medisave. I can’t agree fully with that. For taxes, you just pay and it’s gone. A Medisave contribution will still be there, albeit untouchable until you can find some excuse to unlock it. You are only allowed access to this savings account (probably the largest savings account that some of us may have) when you or a family member suffers from chronic illness or require surgery.

read more

NDR 2013: A move toward universal healthcare?

This year’s National Day Rally speech was noted for steering clear of politically controversial topics such as immigration, foreign influx, overcrowding, and frequent train breakdowns, and completely ignoring criticisms made by alternative media. This was probably a calculated move to get Singaporeans to focus their attention squarely on new initiatives such as a revamped healthcare system, a revised approach to education and grades, and expanding our aerospace infrastructure.

The new healthcare system is the topic that concerns me most deeply. The key changes include the introduction of a new Medishield Life plan that will cover the person for life. The new plan will be universal, in the sense that it will include everyone without the possibility of opting out. It will also take in people with pre-existing conditions. In exchange for enhanced benefits, insurance premiums will be higher. To keep up with rising medical costs, medisave contribution rates will also be increased.

PM Lee said that because the benefits and coverage are better, MediShield Life premiums will be higher because the scheme “has to break even”. We need to question why the scheme “has to break even”. Why can’t the government fund the scheme partially from our yearly budget surpluses?

read more

Healthcare safety net — improvements long overdue

pic_201308_43

In his 2013 National Day Rally speech, Singapore’s equivalent of a State of the Union address, Prime Minister Lee Hsien Loong devoted considerable attention to our healthcare safety net and the gaps that need mending.

Whilst he sketched out the general direction for how we should proceed, nowhere were there any details. Particularly absent was how much the changes would cost and how the extra costs would be paid for. Perhaps he was leaving it for a public debate — he did say, “we are going to do a public consultation, seek views before we decide on the details of the scheme and it will take a year” – which isn’t a bad thing at all. However, it is quickly apparent that a good part of the cost will be borne, not by general taxation, but from individual (albeit forced) savings.

The second broad impression I got from his speech was that although the general ideas are to be welcomed, the problems they are meant to address are so obvious and long-standing, one can’t help but ask: What took you so long?

read more

related:
Hospitals Facing Severe Bed Crunch
Tweaks in Our SG Healthcare
Tweaks or Tricks - PM's NDR 2013
Health Cost