A consumer asked if it was possible for a person above the means test level to be treated in subsidised wards B2 and C) in public hospitals. He was under the impression that this was not allowed.
I checked the Internet and found this document. Patients at higher income can be treated in subsidised wards, but they enjoy a lower level of subsidy. There was so much publicity about means testing that gave the wrong impression to many people, including me. The final decision was not well publicised - so many people still had the wrong impression.
I spoke to a senior doctor in a public hospital. He was also not aware about how means testing had been implemented. He thought that it was still under consideration. When I told him about the actual situation, his reply was "because I was not pesonally involved in this matter, I am not aware about its actual implementation".
I lamented. Why do we have practices that are so complicated that even those who are supposed to be implementing these decisions are confused? Can we simplify matters for the citizens?
Tan Kin Lian
As usual again here. To confused and hoping that you just pay more and get less subsides. Same as all other avenues or help announce for the low paid, poor and uninformed citizens. Complexity is a very useful tool depending on which side you stand.
ReplyDeleteI suppose even the govt and hospitals don't like to publicise this means testing, such that even almost 21 months in operation, the doctors and higher-level medical professionals are not aware.
ReplyDeleteThe lower-level staff such as the front-desk staff at restructured hospitals are more or less aware, although many still had to refer to laminated checklists from their files to explain. I am guessing that formal training was only mandatory for the lower level hospital staff. Doctors and higher-level staff were probably optional for them.
Btw, in private hospitals, a large part of the bill is due to the surgeon's fees or the specialist's fees. If you know them personally, you can negotiate the payment, and the discount can be substantial. E.g. $50K bill for 5 days stay in Mt. Elizabeth for removal of benign growth, reduced to $25K as experienced by my relatives who are doctors themselves.
Hi Mr Tan
ReplyDeleteif we are previously admitted to restructured hospital private class (A / B1), treated & discharged well.
And subsequently, we got other medical condition and need to be hospitalized, are we allowed to choose subsidized class? do we need to go through some sort of financial assessment / means testing to allow us to choose subsidized ward class?
btw, if we are referred by family GP to see specialist, default will be private class...unless referred by polyclinic doctors or A&E....default will be subsidized class..
thanks!
BTW, Mr.Tan, is it true that if a patient is referred to by private outpatient clinic no subsidised ward is possible? This is what I understand. So to be able to go to subsidised ward, it has to be refer to by Govt structured hosipital or polyclinics. Could you advise on this?
ReplyDeleteHere is my reply to the few questions that have been raised about being entitled to be treated in subsidized wards.
ReplyDeleteI am also quite confused about the practice of rejecting patients who asked to be treated in subsidised wards - i.e. the unwritten rules. I think that it is bad for these unwritten rules to be applied, as it is confusing to the public.
I hope that citizens will ask for these rules to be put in writing, so that it can be scrutinised. Do not allow the unwritten rules to be applied that deny your access to subsidised wards.
When a private GP refers you for followup at a hospital (irrespective whether restructured or private), that GP is actually referring you to a specialist that the GP knows.
ReplyDeleteSuch an arrangement in restructured hospital is considered as a private arrangement and thus non-subsidised i.e. A-Class pricing. You get to select your specialist (actually your GP does it) and appointments are made ASAP.
If you do not want to pay A-Class pricing in restructured hospitals, you should ask your GP to write a generic referral letter explaining your condition and diagnosis. Bring it to a polyclinic for followup --- if necessary the polyclinic doctor will refer you to the hospital, and you can then ask for whatever class ward. Note that specialist appointment may take some time depending on your actual condition.
If your condition is serious and life-threatening, you should grab the GP letter and head straight for the A&E dept in the hospital. When they ward you, request for the ward that you want (or get your family to do the admissions procedures).
For those who have stayed previously in A-Class or B1-Class, and subsequently need to be warded in hospital again, you can ask for lower class ward. This will be treated as a separate casefile for you.
ReplyDeleteThose followup checkups and specialist appointments will follow whatever ward class that you stay in hospital. These are all treated as part of the same casefile.
Do note that as B2 or C class patients, you cannot select any particular specialist, and you may be seen by various different doctors along the way. Rejecting your assigned doctors will also be "practically" impossible, unless you can show that the doctor will have adverse effect on your healing process. But so far, those friends and relatives who went thru subsidised treatment found it acceptable.
If you are hospitalised under subsidised ward (Class B2 or C), you will be treated as subsidised patient whould you need follow up medical appointment after discharge.
ReplyDeleteIf you are warded in Class A or B1, you will be considered as un-subsidise patient even if you return for subsequent medical appointments. Please take note.
If your case is not serious, its ok to wait for specilist to see you may be in few months time in c class. If serios, better go A class and receive treatment as the wait may kill you.
ReplyDeleteactually the govt has started to mess with the system wrongly.
ReplyDeleteThey should follow a system where the young will pay more and the old will pay much lesser like the cost price.
And they should allow people to use up to 50% of the medisave in private hospital.
Mr Tan,
ReplyDeleteI am afraid no matter how you design a means tested system, it is going to be complex.
In particular, if you have a means tested system that is predicated on the mindset of eliminating "abuse", you are going to find a system that will emphasize what is disallowed rather than what is allowed. Or worst still have a system where there are lots of hidden exclusions -- i.e. medical insurance!