Tuesday, 26 March 2013

MediShield may cover big outpatient expenses

Review also considering extension of Medisave use for home hospice care
By Salma Khalik, The Straits Times, 25 Mar 2013

THE scope of both medical insurance and medical savings will likely be expanded under the current review of how health care is to be financed.

MediShield, the national medical insurance, might be expanded to cover expensive out-of-hospital treatments, revealed Health Minister Gan Kim Yong yesterday, while Medisave might cover the cost of home hospice care.

MediShield now covers only large hospital bills, as well as outpatient treatments for cancer, kidney failure and organ transplant.

Said Mr Gan: "We are seriously considering moving MediShield beyond hospitals, for example, to cover expensive outpatient treatments."

He did not specify the treatment types being looked at. But costlier outpatient treatments could be for people with chronic obstructive pulmonary disease.

Mr Gan was speaking on the sidelines of a health-care financing dialogue organised by REACH, the Government's feedback unit. It comes after last month's announcement that the Ministry of Health (MOH) is doing a thorough review of health-care financing.

About 100 people turned up at the Health Promotion Board for the dialogue, which lasted almost an hour longer than the 1 1/2 hours planned, because of the large number who wanted to be heard. Many wanted Medisave to be freed up for many different uses.

Mr Gan was receptive to a suggestion that Medisave be allowed for hospice care for patients who live at home. Mr Gan said MOH can look into this if the service is offered by an approved hospice. Up to $160 a day can now be used for inpatient hospice care.

Other Medisave uses that MOH is seriously looking into include vaccinations and health screening, he said. "We need to do what has maximum impact on health."

But he baulked at a suggestion to allow Medisave to pay for a maid caring for a patient at home.

Medisave can now be used to pay premiums of approved health insurance, hospital bills and up to $400 a year for outpatient treatment of chronic ailments.

In his opening address, Mr Gan said the Government will spend more on health care, but how the money is spent is important. He said in Parliament this month that the Government's share of health-care cost will rise from 30 per cent today, to 40 per cent.

Mr Gan emphasised it is important to keep overall costs down. "We must ensure that overall cost does not skyrocket. The money has to come from somewhere."

If it is from insurance, premiums will go up, so everyone will pay more. If from the state, the Government will have to get the money from somewhere, like higher taxes, he noted. He added: "It's important not to pass the cost to the next generation, or we'll have big problems down the line."

Some suggested that private-sector doctors be made to help care for subsidised patients. Mr Gan said MOH is exploring various public-private collaborations.

MOH is in talks with a couple of private hospitals on using their facilities to ease the public-sector load, he said. Changi General Hospital has an arrangement to use Parkway East's wards to ease bed crunch. The Community Health Assist Scheme also has general practitioners and private dentists treating subsidised patients.

Mr Gan said he is also looking at how to put the various help schemes together to make it easier for people, including their not having to be means-tested multiple times for different services.

Health-Care Financing
Review will be forward-looking

WE REFER to Professor Feng Pao-Hsii's letter ("3Ms are outdated, says professor"; last Thursday), as well as several other letters on health-care financing.

Medisave helps patients save up for their future health-care needs, while MediShield provides Singaporeans with insurance coverage for catastrophic illnesses. And Medifund offers direct financial assistance to needy patients.

The 3Ms framework, together with heavy government subsidies at public health-care institutions, has served us well so far, by keeping our overall health-care costs low while delivering good outcomes.

Nevertheless, the demographic of the population and our health-care needs will change significantly going forward.

The Ministry of Health is therefore undertaking a fundamental review now to address future challenges, particularly that of an ageing population profile.

We understand the concerns of Prof Feng, Dr Leong Choon Kit ("Prevention key to lower costs"; Monday), Mr Koh Tze Hock ("Yes, it's time to review MediShield"; last Thursday) and Ms Linda Woo ("MediShield should be more inclusive"; March 16), and thank them for their feedback.

We continue to welcome suggestions as we undertake the review to strengthen our health-care financing framework. Those who wish to share their views can do so via the Ministry of Health's Our Singapore Conversation channels (MOH_OSC2013_myviews@moh.gov.sg) or write to MOH_info@moh.gov.sg.

Bey Mui Leng (Ms)

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