Tuesday, January 30, 2018

We need a simple and cost effective health care system

I wish to raise this third issue in the Budget 2018 forum being organized by Maruah.

It concerns taking care of the rising cost of health care and the aging population.

My main focus is the rising cost of health care. It hits the elderly harder, as they need more health care than younger people.

Some of the elderly cannot cope with the rising cost of living, apart from health care. This can be addressed by providing suitable jobs for them at a decent wage. I have addressed them separately.

On health care, there is already a system of subsidy in our polyclinics and private GP clinics. This helps to reduce the cost of health care to the elderly.

It can be expensive if they need hospital care. It is covered by Medishield, except for the deductible. I suggest that the deductible should be removed.

There is no need to have a deductible to discourage people from being treated in hospital. Most people go to hospital out of necessity and not of choice.

There is a perception that there a long waiting time for subsidised care in hospital. This perception result in many patients opting for private care leading to high medical charges. In many cases, there is no need to incur this higher expenses. But the patients are badly advised.

This game of pushing patients to private care also occurs in public hospitals. There is a conflict of interest within the government between taking care of the needs of the people and reducing the subsidy.

This conflict of interest should be removed.

On a broader issue, we need to find a better system than our current 3M system - medisave, medishield and medifund. It is confusing and inefficient to administer. It does not address the rising cost of health care.

We can look towards other countries for a more effective system. I suggest that we study the system in Japan.

They have an integrated single payer system. Each year, the government negotiates with all the medical providers for the fees to be charged for every medical procedure. The patient pays 30% of the cost. The remaining 70% is paid by the government or through insurance.

It is simple and cost effective. It avoids the expensive cost that patients in Singapore have to pay for private care.

We have a broken 3M system. We need to review it and find a more effective system. The system in Japan is a good model.

What are your views?

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