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Thursday, January 10, 2008

Majority of S'poreans won't have to pay more with means testing

Jan 7, 2008
Majority of S'poreans won't have to pay more with means testing
By Salma Khalik, Health Correspondent
HEALTH Minister Khaw Boon Wan on Monday answered one major question over means testing at public hospitals: Will Singaporeans have to pay more?

Not the majority of those who currently opt for the heavily subsidised C and B2 class wards, he said.

His message would likely bring cheer to Singaporeans worried that means testing would mean higher medical costs for them.

He also promised that people would still be free to choose their preferred ward class. The difference is that the rich will get a lower subsidy for that class than the poor.

Determining the level of subsidy will also be made easy, possibly even automated, if based on salaries declared in tax or CPF returns.

The type of housing one lives in could be considered in determining subsidies for retirees, housewives, children and the unemployed.

But here too, Mr Khaw has promised to be generous, with possibly all HDB residents and those living in lower-end private housing continuing to enjoy current subsidy rates.

Mr Khaw said a deadline had not been set for implementing means testing but its introduction is inevitable.

It will enable the government to provide better care for the poor in future, without also attracting the well-off to compete for scarce resources.

'We do not begrudge lower-income patients the improvements in service which we can now better afford,' the minister said.

But, he added: 'If significant improvement results in us drawing in patients who can well afford private treatment, our efforts will be nullified.'

A high-income patient occupying a Class C bed does deprive a low-income patient - who has no alternative - of using that service.

Currently, 9 per cent of C class patients and 13 per cent of B2 patients are from families who are in the income bracket of the top 20 per cent.

Last year, the ministry spent $1.5 billion in health subsidies. This amount will go up over the years, but there is a limit. Means testing is needed as a 'a fair and pragmatic way to allocate limited healthcare resources,' he explained.

Addressing the fears of the middle-income group that means testing would drive up costs considerably, Mr Khaw promised to err on the side of generosity.

At a briefing of health-care professionals at Changi General Hospital on Monday, he said these were valid concerns which would be taken into account in the planning.

He is aware that frequent hospitalisation for the chronic sick, prolonged hospitalisation or major complications can cause 'severe financial hardship'.

On Monday, he gave the same assurance he has given on previous occasions: 'We will be flexible in implementation so that at the margins, we will always give patients the benefit of the doubt.'

In the short term, he said, the 'majority of Singaporeans should continue to receive the same level of subsidies as they do today and will not be affected.'

Feedback over the next few months will help determine the income cut-off point, and how much subsidy to give richer patients. The first public dialogue will be held on Sunday with about 500 participants from the People's Association.

In the same way that MediShield reforms were introduced after much public discussion, Mr Khaw said he preferred to have all concerns ironed out before pressing ahead with the scheme.

Read the full report in Tuesday's edition of The Straits Times.

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