Thursday 27 October 2011

MPs, experts call for Medisave to cover more ailments

Some MPs, experts also urge yearly revision of usage to match rising costs
By Poon Chian Hui, The Straits Times, 27 Oct 2011

Medisave should be further liberalised so Singaporeans can draw on it more often and to cover a wider variety of ailments, said some MPs and health industry experts.

Echoing a recent call by Dr Lam Pin Min, head of the Government Parliamentary Committee (GPC) for Health, they said Medisave use should be expanded to cover more outpatient treatments such as those for chronic ailments.

The usage should be revised yearly to keep up with the rising cost of living, they added. They also urged that Medisave be allowed to cover more items that are costly, such as scans which are now allowed only for cancer patients.

At the debate on the President's Address at the opening of Parliament last week, Dr Lam, the MP for Sengkang West, had said Medisave use should be liberalised as there were many instances of genuine spending on outpatient consultations, treatments and investigations.

He suggested that government subsidies be increased for the lower- and middle-income groups as the rise in medical costs is ahead of wage increases.

Medisave was introduced by the Ministry of Health in 1984 to help Singaporeans tide over major medical events such as hospitalisation. Between 6.5 and 9 per cent of a CPF member's pay goes into his Medisave account, depending on his age.

Over the years, the scheme has been gradually expanded to cover more situations. In 2006, Medisave could be used for outpatient treatment of diabetes under a newly formed Chronic Disease Management Programme (CDMP). More ailments were added over the years and, today, those who suffer from any of a list of eight diseases can use their Medisave to pay for outpatient treatment, subject to a cap of $400 a year from next year. Besides diabetes, the CDMP covers hypertension, lipid disorders, stroke, asthma, chronic obstructive pulmonary disease, schizophrenia and major depression.

Asked to elaborate on his views, Dr Lam pointed out that the CDMP was just one area that could be reworked.

'One suggestion is to extend the CDMP to more conditions or even any medical condition,' he added, noting that the ministry could impose an annual withdrawal limit to guard against abuse or premature depletion of Medisave funds.

Associate Professor Phua Kai Hong, a health economist at the Lee Kuan Yew School of Public Policy, said the withdrawal limits could be adjusted every year by pegging them to inflation.

This would help people keep up with rising health-care costs, added Prof Phua, who has served on boards of health-care organisations here, as well as national health policy and advisory committees.

But Dr Chia Shi-Lu, an MP for Tanjong Pagar GRC who is also on the GPC for Health, cautioned against liberalising too much as it could lead to quick depletion of Medisave funds.

Still, Sembawang GRC MP Ellen Lee, who is also on the GPC, said the Government should trust most Singaporeans not to spend frivolously. She felt people should be able to withdraw higher amounts. 'With the cost of living increasing, Singaporeans could be holding back on needed treatments because they cannot draw on their Medisave to pay the full bill.'

Associate Professor Annabel Chen, who is from the School of Humanities and Social Sciences at Nanyang Technological University, suggested that reliance on Medisave could be eased by changing health habits to promote mental and physical wellness.

One example is to introduce rebate schemes that reward people who stay healthy - a method that has proven successful in the Cleveland Clinic in the United States, she said. Employees at the clinic earn rebates for good results in their annual health tests, and this has been widely cited as an exemplar of how to fight rising health-care costs in the US.


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