Wednesday, 23 January 2013

New Medifund Junior scheme set up

MOH pumps additional $10 million over five years to help needy children with healthcare costs
Channel NewsAsia, 22 Jan 2013

From March, the Ministry of Health (MOH) will set aside S$8 million annually under a new Medifund Junior scheme to help needy Singaporeans defray their children's healthcare bills.

The scheme, applicable to children aged below 18, will require an additional S$10 million in Medifund assistance over 5 years, to supplement current funds. The ministry will review whether the amount is sufficient thereafter, said the MOH in a statement.

Needy families will be able to draw on Medifund Junior for help with their children's healthcare bills at public hospitals, said the ministry.

"By creating Medifund Junior, MOH can target more financial assistance for sick children from needy families. This will also help defray costs incurred by children diagnosed with congenital or neonatal conditions before 1 March 2013," said the ministry.

From March, MediShield coverage for congenital and neonatal conditions will kick in. All Singaporean newborns born on or after March 1 will be covered, without having to be assessed for pre-existing conditions, if their parents do not opt them out.

All existing policyholders will automatically receive coverage for any congenital conditions diagnosed on or after March 1, 2013. This extension will be implemented together with previous MediShield enhancements announced earlier.

To support Singaporean families pay for their child's MediShield premiums and defray other healthcare expenses, the government will set up a Medisave account and deposit a one-off Medisave grant of S$3,000 over two tranches for all newborn Singapore citizens born on or after August 26, 2012.

The KK Women's and Children's Hospital (KKH) puts up on average 400 Medifund applications a month.

95 per cent of these applications are usually successful with families getting assistance from Medifund.

However, as Medifund is targeted at lower income families, the middle income families are usually left out as they don't meet the criteria.

"Some of them, even though they are from the middle income families, some of the bills can be quite costly. So for these large bills, we are giving the hospitals more flexibility under the Medifund Junior to be able to help these middle income families," said Health Minister Gan Kim Yong.

Healthcare institutions will assess the out-of-pocket expenses by the needy families and their family resources before offering them assistance under this new fund.

Needy children diagnosed with congenital or neonatal conditions before 1 March will also be able to use the new fund to help defray costs. These include stays at the Neonatal Intensive Care Unit (NICU) at KKH.

Ms Mavis Teo, a medical social worker at KKH, said: "For example, a couple with a newborn child with congenital problems and this is a dual-income family with an average income of about S$4,000...if (the child stays) in NICU and it costs them about S$20,000 to S$30,000, we would be able to help them to cover some of the medical expenses for the NICU stay."

For those with more serious premature cases or those with neonatal or congenital conditions, hospital stay may range between one month and six months, and on the average bills can be anything from S$10,000 to S$60,000.

In extremely rare cases, babies with severe complications needing multi-stage surgeries and treatment, medical expenses may even exceed S$100,000.

The hospital's NICU, which also treats premature babies, will be expanded.

Doctors at the KKH say that its NICU is usually run at full capacity due to the rising number of admissions in the past few years.

As such, the unit will undergo renovation and see its bed capacity rise from the current 24 to 40 in the next five years, making it the largest facility in the region.

Associate Professor Samuel Rajadurai, a doctor at KKH, said the incidence of premature babies has gone up by 10 to 13.5 per cent over 20 years.

A number of factors have led to this phenomenon, including the older age of mothers and better monitoring of mothers during their pregnancies.

The hospital also plans to expand its outpatient as well as ambulatory services and increase the number of beds.

Baby ICU stretched to the limit
More babies born with problems now than before, says KKH doc
By Salma Khalik, The Straits Times, 23 Jan 2013

A RISE in the number of children born prematurely or with health problems is stretching Singapore's top neonatal intensive care unit (ICU) to the limit.

KK Women's and Children's Hospital's (KKH) 24-bed unit is running at 100 per cent to 120 per cent occupancy, said the hospital's head of neonatology.

Associate Professor Samuel Rajadurai said the proportion of children born with neonatal problems has gone up from 10 per cent 20 years ago to 13.5 per cent now.

Prof Rajadurai puts this down to many factors, such as an increase in older parents and more babies being born through assisted reproduction. These mean a higher risk of babies being born prematurely or with congenital problems.

Thanks to improved medical technology, babies who are born at 24 weeks at KKH can be saved. The normal gestation period is 38 weeks.

He said staff are having to push in more cots to cope with the high demand or transfer babies to the children's ICU if there are vacancies - although the hospital has enough portable equipment for the extra infants.

Health Minister Gan Kim Yong yesterday visited the site at KKH where an expanded neonatal ICU is being built.

This will add eight more beds by May, with space for another eight beds in five years' time.

"Today they're really stretched. Even with the lower birth rates, we're seeing many children with complex problems. We want to make sure the capacity is sufficient and we also need to plan for the future," said Mr Gan.

Prof Rajadurai said medical technology has improved which allows more premature babies to be saved. KKH is where many women in Singapore who have "high-risk pregnancies" turn to.

It is also the referral centre that other maternal hospitals turn to for their complex cases, said Prof Rajadurai.

As a result, about 3 per cent or 4 per cent of babies born at the hospital suffer from congenital anomalies like malformed heart, intestines and nervous system.

The ICU for neonates - babies up to a month old - is already the biggest and busiest in the region, he said. And it gets 5 per cent to 10 per cent more patients every year.

Last year, it treated 450 babies of whom about 200 were born weighing less than 1.5kg. Another 1,500 required special care before discharge.

Among the more common problems are general infections, jaundice, which may require blood transfusion if severe, and breathing difficulties.

The hospital operates highly sophisticated equipment, such as an extra-corporeal membrane oxygenator which will do the work of an infant's lungs and heart. The baby's blood is taken out, cleaned, given oxygen and returned to the body by the machine, which takes the stress off the child's organs and allows them to develop properly.

KKH also has a device that can do 600 breaths for the baby in a minute.

Around 93 per cent of infants who go through the neonatal ICU survive.

Most are discharged quickly, though the more serious ones may stay anything from one to six months, chalking up bills that could exceed $100,000.

Said Prof Rajadurai: "The majority of the babies, both pre-term and those with congenital malformations, do well and live normal lives."

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