Tan Kin Lian's Blog: Means Testing

Monday, January 14, 2008

Means Testing

Mr. Tan,

What are your views about means-testing?

REPLY

It is a lot of work, all lot of uncertainty, for quite negligble savings. The Minister for Health said that the subsidy will be reduced from 80% to 65%. The savings to the government is only 15%.

Most people who uses the C wards are likely to be the older and poorer people. Those who are affluent are most likely using the A or B wards. Those covered by employers will use the higher class wards anyway.

I hope that the Minister will drop this idea. It is not worth the trouble.

11 comments:

Anonymous said...: From the way I see it, the government is playing a good card. They want to start small so people are more receptive to the idea. Once means testing kicks in, they will gradually move the subsidy level lower and lower. What do you think, Mr Tan?

HK; January 14, 2008 11:55 PM
Anonymous said...: i think moh is just in the intro phase. the fact the means testing has been a political hot potato means moh has to tread carefully, so kbw is trying to make it seem less painful.

we had better be prepared for a lot more adjustments to less subsidy (esp for the middle income and well to do) in time to come.; January 15, 2008 10:38 AM
Anonymous said...: True.. but the focus here might be controlling the demand on subsidized wards as opposed to cost savings.

It might not sound like a problem now, but in future, we can expect:
1. The quality gap between subsidized wards and normal wards to close, especially with the building/upgrading of hospitals
2. A greying population.

These 2 factors work to increase the demand of subsidized wards. Therefore, we might need to introduce a mechanism now to pre-empt future problems of over-demand in subsidized wards - caused by people who do not need the subsidy.

I would draw a parallel between the ERP system and the means testing system. In the former, variable pricing is used to control traffic. In the latter, variable subsidy (65% currently) is used to control the demand of subsidized ward.; January 15, 2008 10:59 AM
eng60340 said...: 15% for now. baby steps. :D
but think it's the right direction though.; January 15, 2008 12:49 PM
Anonymous said...: I find that C class ward should be opened to all, regardless of class.

I earn a decent income, but when I am hospitalised, I always asked for C class - why? save money of course! tell me who don't want to save money?

Even when I am more well-off, I will still take C class ward - since access to hospital services are the same, regardless of class of wards, then it doesn't matter when I am warded. I can certainly bear with no air-con or TV. Got discount or cheap bargains, I sure grab!

Maybe for some other more affluent people they take A or B wards because they like more privacy but for me, no matter how rich I am, C-Class is the way to go. I think there is no reason for doctors to earn so much for the same operation.

Therefore, I sincerely think Minister should drop the idea too. Waste of time, effort and money. Better spend more effort to monitor the monetary injections into the foreign banks.

If anyone wants to petition for Ministar to drop the idea, please announce it, I will sign up.; January 15, 2008 9:39 PM
Anonymous said...: Many people will put their old folks in B2 or C ward, even if they are middle class.

1. Worry of long stay cost

2. Post followup subisdy

Many are not willing to pay for the higher premium of the Shield Plan for their older folks.

This result in more people using subsidised ward.

- Thomas Phua; January 15, 2008 9:56 PM
Anonymous said...: Mr. Tan,

Minister is paid to do his job. So he has to do a good job. While it is not simple enough for you to understand, it is well known that means testing will ease the burden of demand overstripping supply, that the real needy has access to the good and affordable hospital services. It is not only one-facet about saving the 15%.

Suggestion: let us all not second guess the Minister and make things too simple such that it obscures the better intentions of the Minister - means testing is for the future of healthcare, especially 20 years down the road, where people are older and relying on affordable healthcare for chronic or old age medical conditions.

Show your support for means testing, because it will affect you too.; January 15, 2008 11:19 PM
Anonymous said...: Mr.Tan,

I share similar views. The means-testing debate and policy is counter-productive.

Affordability is subjective and perceive differently from different people. An mid to high income earner may need C wards as he has higher mortgages and expenditure. Another unemployed stayng in a 3-rm HDB flat may have less expenditure or no mortgage and may even afford A or B wards.

Let Singaporeans decide the classes of ward which already have different subsidies applied.

Why means-testing? Singaporean working in Singapore are automatically a tax-resident in Singapore. Why deprive or give less subsidy when they pay more tax? Take care of them with public health care that is not bias. Isn't SG Govt concern about brain-drain?; January 16, 2008 1:26 PM
Anonymous said...: Hope you are alright, Mr. Tan. Have not seen your posting.
Best wishes to u.; January 18, 2008 10:07 AM
Anonymous said...: Means testing can be mean to those who really need if property is used as one of the criteria of means.; January 20, 2008 5:45 PM
Anonymous said...: I think Means Testing can be used as an alternative measure for future increase/inflation in health care cost. There will be a limit in which the premiums for the basic MediShield can increase, hence "Means Testing" can be another way to keep the premiums affordable.; January 20, 2009 6:07 PM