Monday 26 August 2013

Pay higher premium when you're young?

Five days ahead of the National Day Rally, the Government Parliamentary Committee (GPC) for Health released its report on making health care more affordable. And at the Rally, Prime Minister Lee Hsien Loong went on to announce what he termed a "big shift" in health-care financing. GPC chairman Lam Pin Min talks to Goh Chin Lian over supper about the hot topic of how to pay for that health-care largesse - front-loading, anyone? - as well as his work as MP for Sengkang West and his family life.
The Straits Times, 24 Aug 2013

People have commented on the timing of your GPC report.

We did not want to clash with the release of the OSC (Our Singapore Conversation) report, which was going to receive major publicity.

After it was released, we realised there was a window period till the Rally. I reckoned that was the ideal time to submit our report to the Health Ministry.

How convinced are you that it's a big shift, as the PM said, for health care?

It is a fundamental philosophical shift in health-care financing by the Government.

The current philosophy is that of pragmatism, eclecticism and personal responsibility. The fundamental shift entails the Government taking on a bigger role in providing that social safety net and extending a helping hand to Singaporeans for their health-care needs.

Is this shift enough to put to rest the sentiment that Singaporeans can afford to die but not to fall ill in this society?

This is always work in progress. The Government needs to carefully titrate the policy tweaks to meet the health-care needs of Singaporeans and to ensure that our health-care financing policies remain relevant.

However, we should not go down the slippery slope of excessive and extravagant spending so much so that it becomes financially unsustainable in the long run.

There's going to be public consultation for MediShield Life. What are the challenges?

One is that of the affordability of the premium. How much increase is fair and manageable for the majority of Singaporeans?

Second, how much coverage is necessary and sufficient? You can strengthen MediShield to cover very expensive bills, but that will result in significantly higher premiums. If the increase is too excessive, low-income and elderly Singaporeans will definitely find it difficult to manage.

One way is to seriously consider Dr Amy Khor's (Minister of State for Health and Manpower) proposal to front-load the premium.

However, we need to explain to Singaporeans the concept and rationale of front-loading. Younger working Singaporeans can pay higher premiums so that when they grow old and are retired, the premium quantum can be lowered to a more manageable level. It's like front-loading for your own policy in the future.
At the end of the day, insurance is about risk-pooling. Everybody pays into a big pool and you subsidise one another.

About 8 per cent of Singaporeans aren't covered by MediShield due to pre-existing illnesses or other reasons. MediShield Life will include them, many of whom are in the higher-risk group.

I hope the Government will step in to assist, so that the premium will remain manageable for this group. This leads us to the Pioneer Generation Package which PM announced. I'm looking forward to the details.

How will you sell the higher premiums to young people?

When Dr Khor suggested front-loading, she did receive positive feedback from the public, in particular, younger Singaporeans.

But how representative is this group? How confident are you that the Government can persuade them?

I don't think I want to jump to this conclusion prematurely. We should await the ministry's consultation process to gather more suggestions and feedback on the acceptability and feasibility of this proposal.

Risk-pooling and front-loading work only if MediShield Life has enough young and healthy people. With an ageing society and declining fertility, fewer young people will support a fast-growing number of elderly. Will premiums have to go up by a lot later? Will the scheme be sustainable?

I see front-loading as a way of funding one's health-care needs for the future. By paying higher premiums when we are young, it allows the premium to be lowered when we reach retirement age.

The challenge lies in the current pioneer generation, whose Medisave savings may be inadequate to pay for their current MediShield premium. The Pioneer Generation Package comes in handy.

A general election is due in two to three years. How will it affect the timing and quantum of the premium increase?

I feel that the introduction of MediShield Life is a positive step in the right direction. It offers universal coverage and better peace of mind for all Singaporeans.

However, I do understand the concerns of Singaporeans and I believe the Government will do its best to address these.

How are you working on the ground as an MP, seven years on?

Sengkang West is a challenging constituency because of its young demographics. It's rapidly growing. When I started in 2006, there were 11,000 to 12,000 dwelling units. Come 2015 or 2016, they will more than double to over 27,000. With the growing number of new BTO (Build-To-Order) flats, we expect many more young families.

One challenge is childcare facilities. In some childcare centres, the waiting list can be 100 to 150.

Over the past two years, we've converted five void decks to childcare centres. The situation will improve next year when new BTOs - where the HDB has pre-identified some void decks for childcare facilities - will be ready.

You put your family's photo on your Facebook page even though most politicians would have wanted their privacy. Why?

I want to let my Facebook friends know that I'm just like any other Singaporean man with a family, with children. We've worries like most other Singaporean families, such as our children's education and well-being.

Your daughter is taking the PSLE this year. How is it for you?

Fortunately, my elder daughter is quite disciplined. She does most of the revision on her own. We just need to make ourselves available in case she needs any help.

When PM announced the revamp of the PSLE T-score (to a wider band of grades), I was secretly hoping that it would be implemented this year. We're grading a child according to such a fine demarcation. The T-score increases stress both for the child and the parents.

Do you often have supper?

Oh yes. I go for supper with my wife when our kids are asleep. We usually go for bak chor mee at Rail Mall or the nearby coffee shop for zi char.

What's for supper

Old Town White Coffee
- 9 Yuk Tong Avenue in Bukit Timah
- Kaya and Butter Toast (single): $1.20
- Peanut and Butter Toast (single): $1.20
- Organic Wheat Grass Honey Juice: $4.50
- Gula Melaka Cendol Soya Freezy: $5.50
- Total (including GST): $14.60


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