Saturday 31 August 2013

More families to get health subsidies

Lower cash outlay for outpatient treatment and big hospital bills
By Salma Khalik, The Straits Times, 30 Aug 2013

FROM today, more people will get to enjoy subsidies at private clinics under the Community Health Assist Scheme (CHAS), after the qualifying household income was raised by 20 per cent.

The monthly income cap for each family member is now $1,800 instead of the previous $1,500. But this is just the start.

About half of all Singaporeans will qualify for the scheme, which is currently for those aged 40 and above, when the age floor is done away with in January.

From next year, all CHAS cardholders will also get a 100 per cent subsidy when they go for health screenings to check for any of six conditions, including diabetes and cervical cancer.

They will also receive subsidies for five more chronic conditions, including Parkinson's disease and chronic kidney illness.

In addition, Medisave will be allowed to cover outpatient treatments for these five conditions from January.

Health Minister Gan Kim Yong announced all this yesterday, when he fleshed out the changes first announced by Prime Minister Lee Hsien Loong in his National Day Rally speech.

These changes, Mr Gan said, reflect a significant shift in the Government's approach to national health-care financing as it responds to Singaporeans' "strong desire for greater peace of mind" over medical bills.

While personal responsibility remains a core principle, the Government will now take on a larger share of the cost, he explained.

"The Government will do more," he promised, "to give Singaporeans peace of mind, greater assurance that they would not have to face this health-care risk on their own."

The changes will take over a year to roll out, and some of them will depend on public feedback to be gathered in dialogues set to start some time in the last quarter of this year.

But essentially, it will mean a lower cash outlay for lower- and middle-income families when it comes to outpatient treatment and big hospital bills, he said.

Under the new national health insurance plan, MediShield Life, which he hopes to implement by 2015, Singaporeans can expect a bigger part of their hospital bills to be taken care of, said Mr Gan.

At yesterday's press conference, he gave details on the changes to be implemented first - aimed at lowering out-of- pocket expense for outpatient treatment.

With immediate effect, those aged 40 and above, from households earning $1,800 or less monthly for each family member, will be eligible for the CHAS card, which lets patients get subsidised treatment at more than 800 private medical and dental clinics. The card comes in two colours - blue and orange.

A third of households will qualify for the blue card, which provides for higher subsidies, after its income cap was increased to $1,100 from $900. Those who qualify but currently hold the orange card will need to re-apply.

From next year, even wealthier households will get help to pay for chronic treatments, with Medisave covering five more chronic conditions, bringing the total to 16.

Minister of State Amy Khor said this will cover 90 per cent of chronic ailments seen by general practitioners. She added that Medisave use may be expanded further as part of an ongoing review.

But she sounded a note of caution, saying that people must retain enough in their Medisave to pay for health insurance and medical expenses after they retire.

When queried, Mr Gan admitted that Medisave contributions will have to go up to take into account its wider use. The increase, however, will not be immediate, but will take place when the economy is better.


Community Health Assist Scheme
- Income criteria raised to $1,800 per capita household income, up from $1,500

FROM JAN 1, 2014

1. Community Health Assist Scheme
- Minimum age limit of 40 removed; all ages qualify
- Subsidies extended to five more chronic conditions: osteoarthritis, prostate gland enlargement, anxiety disorders, Parkinson's disease and chronic kidney diseases.
- Subsidies for chronic conditions can go up to $480 a year
- Free health screening for Singaporeans aged 40 and above for tests recommended by Health Promotion Board
- Subsidies for doctor consultations that accompany the screening tests, up to two visits a year
2. Medisave
- Can be used for the five new chronic conditions listed earlier, up to the current withdrawal limit of $400 every year for each Medisave account
- High-risk groups, such as the elderly and very young, can use Medisave to get jabs against two diseases, pneumococcal infections and influenza

MediShield Life will pay more of hospital bill
Claim limits also likely to be higher but premiums will go up: Minister
By Poon Chian Hui, The Straits Times, 30 Aug 2013

SINGAPOREANS can expect a higher proportion of their hospital bills to be paid by the revamped MediShield health insurance scheme.

Also, they can probably claim a bigger amount from the scheme, which Health Minister Gan Kim Yong hopes to roll out by 2015.

But one thing will remain unchanged: People still have to shell out a certain sum first, called the deductible, before the insurer picks up the remainder of the hospital bill.

Mr Gan painted these broad strokes yesterday when he sketched the direction of the new MediShield Life scheme, which will provide health insurance for all Singaporeans regardless of age, health and income.

But premiums will have to go up to pay for the changes, he said. Currently, people pay between $50 and $1,190 in premiums a year, depending on their age group.

The MediShield changes, prompted by people's growing concern about rising health costs, are aimed at giving Singaporeans greater peace of mind and fewer worries when faced with large medical bills.

But in extending such support, there is a need to strike a balance between enhanced benefits and the premium rates, said Mr Gan.

"One particularly important aspect is to encourage Singaporeans to take personal responsibility for their own health," he added, so that the country's health- care costs can be kept as low as possible.

The revamping of MediShield, which provides cover for more than 92 per cent of Singaporeans currently, was announced by Prime Minister Lee Hsien Loong at the National Day Rally on Aug 18.

In the current system, policyholders in Class B2 and C wards pay a deductible of up to $2,000. Of the remaining amount, they will pay 10 to 20 per cent which is referred to as co-insurance.

In MediShield Life, this co-insurance amount is set to go below 10 per cent for very large hospital bills, which are typically those that exceed $5,000.

Higher claim limits are also on the cards as the purpose of MediShield Life is to pay for a bigger chunk of large bills. In the existing MediShield, there is a lifetime limit of $300,000.

The details of the new scheme will be fleshed out after a public consultation, to be held in the last quarter of this year.

It will gather feedback through dialogues, focus groups, webchats and online polls.

Official figures show that only a small proportion of hospitalised patients in subsidised wards chalk up a huge bill.

Of the 10 per cent hospitalised every year, fewer than 3 per cent of subsidised patients have bills of $10,000 or more.

One such case was Mr Yee Kwek Chin, 49, who racked up a $32,000 bill in April, after a blood vessel burst in his head.

He stayed in a Class B2 ward for two weeks, and after the subsidy, his bill was $11,000.

MediShield paid about $4,000 of the amount, with the rest coming from his Medisave.

Mr Yee, who is jobless, feels a 10 to 20 per cent rise in premium levels would be "reasonable". "We pay more, we get more. Also, the money can help other Singaporeans. There is no point in being too calculating," said the father of two whose annual premium is about $220.


One particularly important aspect is to encourage Singaporeans to take personal responsibility for their own health.

- Health Minister Gan Kim Yong

VoicesTODAY asks: A fairer healthcare system? What does It mean for Singaporeans? - 29 Aug 2013


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