Tan Kin Lian's Blog: Using subsidised wards (B2)

Monday, September 21, 2009

Using subsidised wards (B2)

There are two big advantages of using subsidised wards (B2)

a) You get a subsidy of 50% to 65% of the hospital bill
b) As the government is paying a large part of the bill, they will check that the bill is reasonable.

If the patient has to pay 100% of the bill (i.e no subsidy), there is a risk that the hospital may charge more, or give more treatment than necessary. You have to pay 100% of a larger bill.

I estimate that a bill from a private hospital could be 3 times of the subsidised bill, for the same treatment.

Some people said that the doctors treating patients in subsidised wards are under training and not experienced. I do not agree with this comment. It may be true that the doctors are under training, but they do the routine medical checks and are supervised by the experienced doctors.

When it comes to surgery or other major procedures, an experienced specialist will carry out the procedure. There is really no need for the patient to choose his own doctor.

However, if the patient is willing to pay a higher bill to be treated in a private hospitals or A class ward, and enjoy the privilege to choose their own doctor, it is all right. They can also buy insurance for the more expensive treatment, but the cost of the insurance can be three times.

Tan Kin Lian

10 comments:

Sobri said...: Mr Tan,

It is NOT true that all classes of wards get the same kind of medical treatment.

I know from experience that certain kind of surgery is limited only to Classes A and B1 ward patients. If you are in B2 or lower, you have to choose the older form of surgery, which is more painful and takes longer to recover.; September 21, 2009 9:48 AM
Anonymous said...: This article has shown that communication between patient and hospital must improve further despite hospital had played its role.

MOH may have to do a communication audit to check the problem area and improve it.

Example 1
How can elderly patient in a Q aware when a nurse-aid call his/her name?

Suggestion: give elderly a name tag.

Example 2
How do a yong doctor talk with
elderly patient who speak only dialect?
I had observed that young doctor speak dialect by a book and can NOT communicate !; September 21, 2009 10:03 AM
Anonymous said...: A major surgery can cost $30k-40k.

B2 patient may have to pay $20k from Medisave if not insured. Has elderly got $20k in Medisave?

To stretch dollars & cents, elderly better go
C class if a surgery is required. Complication (if any) during surgery will cost more money.; September 21, 2009 10:20 AM
Tan Kin Lian said...: Those who are quite well off, and can afford the higher premium can go for Private Shield and the upper classes.

For the middle and lower income groups, subsidised ward is suitable most of the time and is quite affordable. I know of many major surgeries for elderly relatives, and can be covered by Medishield.

The chance of getting a big bill in a subsidised ward that is not covered by Medishield is likely to be small. I have many elderly relatives who have since passed away. They did not have to face big bills, beyond Medishield.; September 21, 2009 10:29 AM
Anonymous said...: One year ago, I visited my father-in-law at SGH ward (C class). I was shocked with the costly bed (estd. S$3600)a C class patient has. I really appreciate it.

Later, I visited my mother-in-law at Mt E. I was disappointed with the ordinary bed (no auto mechanism) she was lying. She had knee surgery and can not walk afte surgery for few days.
The ward space is very limited.

(I am ex-Hospital worker); September 21, 2009 10:42 AM
Anonymous said...: I've just gone for a minor surgery in TTSH, C ward. I was operated by a snr consultant. I was also impressed by the post-operation care I received. The first two days after the operation, the snr consultant and his team would personally enquired about my condition and the nurses were generally attentive. In my humble opinion, it was worth every cents I paid for.; September 21, 2009 12:20 PM
Anonymous said...: The rich go to C ward the not so rich not so poor want A ward but it is the choice. More painful or less painful surgery? I haven't heard of this. This should be brought to the attention of the MOH.How can?
Insurance agents always quote the most expensive and the most rare surgery or illness to frghten people in the hope they can buy their insurance.
Imagine telling people that one in three will get cancer. In other words 2 million Singaporeans will get cancer. This is a scare tactic. Assuming it is true , don't you think people should be insured adeqautely? Instead the agents sell them wholelife which the buyer can afford only 1/3 of the coverage .The WL is too expensive instead of term. The premium of the WL can buy more than enough coverage for the buyer but commission is only 1/10 of the WL commission. You now know why agents don't sell term.
So all this talk about getting the best from higher plan is in fact the agents' idea of earning a higher commission.
Commission is the root of all evils.
MAS should know by now WHY Singaporeans are under insured.; September 21, 2009 7:24 PM
Anonymous said...: Can anybody share with me the info for the Ward? I am very confused between pte hospital, restructured and govt hospital?

The ward category got how many bed?

A1 ward = 1 bed (got A2 ward?)
B1 ward = 2 or 4?
B2 ward = 6?
C ward = 8?

Thank you in advance; September 21, 2009 8:16 PM
Vincent Sear said...: The modern C ward is not much different from the B2. The most significant difference being, the C2 ward has 6 beds and no toilet (patients to use common corridor toilet if necessary), whereas the B2 has 5 beds and a toilet.

It's nice, but I feel that it's an extravaganza that escalates medical costs beyond more and more low income earners. What's wrong with the old army barrack hall style of beddings that could serve many low income earners who fell ill or got injured?

We don't go hospitals for vacation, we go there to seek treatment. After recuperation, the patient can go to any hotel to enjoy 5-star vacation as he can afford and choose to.

Of course, there're patients who must have VIP accomodation even when ill or injured. There should be high class facilities catering to them too. But the point in discussion is, why even base bottom class C has become expensive and even luxurious? Is there a need to? I'm not saying like, treat poor patients in environments like POW camps. Just that, there no need to be so extravagant when all that's need is treatment and habitable environment.; September 21, 2009 8:16 PM
Anonymous said...: I'm no expert but can only comment from personal experiences.

There are some minor surgical procedures which a private specialist can perform in his clinic (save hospitalisation costs). But specialists in public sector have to require hospitalization due to standard operating procedure or because using older medical techniques. Sorry but have forgotten the specific surgical procedure.

Anaemia in elderly patients.
--------------------------------
I have 2 elderly relatives whose families put their faith in the public sector specialists. The standard treatment is iron tablets/capsules. This causes constipation. So in addition, prescibe a standard anti-constipation tablet. (I can't give out the brand names because of potential legal issues.) Bottom-line, this standard treatment is not very effective. A private sector specialist treats my mum's anaemia with EPO injections and an intravenous iron drip. Problem solved with no side-effects like constipation. The persistent giddiness due to anaemia also stopped.

Yes, my mum's treatment is more expensive. But think how much more it would cost me if her intestines suffer a tear due to constipation or she falls (and breaks a bone) due to giddiness. These things have happened and are not idle speculations on my part.

Heart Problems
--------------
I had a customer from Bangladesh who flies in once every year for his medical check-up by a private specialist based at a private hospital. One year, they detected a problem in the morning. The heart surgery was completed in the same day in the afternoon.

Anybody want to tell me how long you have to wait for heart surgery in public hospitals? I know of 2 cases but will not write about it here. I don't want to worry about being sued.

The debate should not be about hospital cost alone. But rather the total costs (including care-givers' time) of very good treatment versus adequate treatment.

Furthermore, some doctors are just better than others.

I once had a medical problem that 3 different specialists and 2 years could not solve. I went to a renown specialist (more expensive) who made the correct diagnosis and problem was solved in about 6 months. So which choice turned out to be cheaper in the end?; September 22, 2009 1:36 PM