Means testing may kick in within the next 12 months, says Health
Minister Khaw Boon Wan.
And the first to be affected will be patients in C-class wards who
stay more than five days in hospital.
Patients in C-class wards now enjoy an 80 percent subsidy.
But the Health Ministry realised that not all patients need such a
subsidy, as there are some in the high income bracket who choose to
be hospitalised in such wards.
To ensure that there is no abuse of the system, the Health Minister
says means testing must be done on those who stay more than five
days in hospital - the average length of stay.
Means testing, which is a way to determine how much subsidy a
patient should get, is already done in nursing homes and community
hospitals.
Mr Khaw says: "We are in this business where all of us want to
constantly improve our service level. But if your prices are wrong,
if they are heavily subsidised or free or whatever, you are going
to attract more and more patients to you, including those who can
go to Gleneagles Hospital and Mount Elizabeth and so on. And we
have very good doctors, very good specialists. So we know that at
the end of the day, means testing are important.
"And until you introduce proper means testing, I'm afraid all these
problems will remain, will simmer. I'm seriously thinking about all
those who are long stay, who should now be discharged to community
hospital, we should do means testing on them. Now they are saying
that if they go to nursing homes they will be means tested but if
they remain at SGH they are not means tested, therefore it's
cheaper - then we will never solve this problem."
Mr Khaw says for those who can afford to pay more, their subsidy
may be reduced to less than 80 percent but they will not be asked
to move to a higher class ward.
However, he is not keen to extend means testing at the polyclinic
level for practical reasons.
Mr Khaw says: "It's not just looking at your personal income - we
are talking about family income here. The whole family should be
supporting the patient. So therefore I need to know how many
children you have and how much are they earning. And we cannot have
self-declaration because everybody will say they are poor, they
earn $800 when actually it may not be so. So you begin to see the
complexity of means testing.
"We know that at our polyclinics, waiting time is already very
long. If at the counter we are going to start asking all these
questions, you know, I think we cannot do business. We will end up
doing only means testing and no treatment. So it's not practical
unfortunately."
Mr Khaw was speaking at a dialogue session on on Saturday with
unionists in the healthcare sector, where he answered several
questions.
These ranged from whether the 3M framework (of Medisave, MediShield
and Medifund) will see Singaporeans through their healthcare needs
to what the government is doing to relieve the workload of
healthcare professionals.
Mr Khaw hoped Singaporeans will manage their expectations, as the
authorities continue to improve the healthcare sector.
He says: "Be prepared that if you want this higher level of care so
that you can demand this and demand that, your co-payment has to go
up, there's no other way because if you want us to continue to pump
in more resources so that instead of one doctor to three patients,
you now want one doctor to two patients or whatever, the costs just
goes up."
At the end of the seminar, Mr Khaw urged Singaporeans to remain
within the 3M framework to ensure that their healthcare needs
remain affordable throughout their lives.
He also reiterated the fact that Singaporeans should attempt to
stay healthy to minimise the chances of being hospitalised.
On Eldershield review, Mr Khaw says there will be rebates for those
who have not claimed for the past five years.
The rebates may be used to offset any increase in premiums for
those currently insured under the disability scheme, when the
scheme is revamped.
And if the premium increase is affordable, he may even allow the
payout period to extend to 7 years for the basic Eldershield
scheme.
But a lifetime coverage is unlikely.
Mr Khaw says: "We are currently talking about those who are young,
about 40 years old, we are talking about life expectancy which may
well go into 90s. So we are making a promise of 50 years, who dares
to give that kind of promise?"
The Eldershield scheme, introduced to help the elderly with
disabilities by providing a monthly payout, is being
reviewed.
The revamped scheme is expected to kick in by October this year. -
CNA/ch