Friday 4 July 2014

Asset-rich, Cash-poor can apply for transitional subsidy for MediShield Life premium rises

MediShield support for asset-rich, cash-poor
They can get transitional subsidy for MediShield Life premium rises: Gan
By Kash Cheong, The Straits Times, 3 Jul 2014

HEALTH Minister Gan Kim Yong yesterday assured Singaporeans with annual home values above $21,000 that they will be able to apply for additional help if they struggle to cope with increased MediShield Life premiums.

About a fifth of all properties here are estimated to have annual home values (AV) - the amount an owner would get in a year if he were to let out the property - over this figure.

Mr Gan has clarified that this group will be eligible for a transitional subsidy to help them cope with the rises. This will last for four years after MediShield Life is introduced next year.

However, they will not receive a permanent subsidy.

There had been complaints that the system penalises people who are asset-rich but cash-poor, such as those who have inherited property but have little income.

Mr Gan responded by saying that MediShield Life subsidies have been means-tested according to per capita household income and a person's asset value, as this makes best use of limited resources.

For two-thirds of households - who have a monthly per capita income of $2,600 or less - the Government will provide permanent MediShield Life subsidies, means- tested according to their income.

They must stay in properties of annual values of $13,000 or less to qualify for the full subsidy. This would cover almost all in Housing Board flats, Mr Gan said.

Those with homes of annual values of $13,101 to $21,000 receive 10 percentage points less permanent subsidies than those in a similar income tier with homes of AVs of $13,000 and below.

But Mr Gan stressed that all Singapore citizens would receive transitional subsidies, to offset premium increases by 80, 60, 40 and 20 per cent respectively from 2015 to 2019.

For the asset-rich, cash-poor, "we have additional premium support that will consider their situation on a case-by-case basis," he said, and encouraged anyone needing help to write to the government.

Remisier Teo Hoon Seng, 63, who lives in a property of over $21,000, wishes the scheme was "more equitable". People who have higher-value properties but really need help have to "deal with bureaucracy" in order to get it, he said.

Mr Gan spoke about the new national medical insurance scheme at a topping-out ceremony of a patient rehabilitation facility in Simei, to open in December.

Jointly managed by Changi General Hospital and St Andrew's Community Hospital, it will have 280 beds and provide rehabilitation to patients recovering from illnesses or accidents.

MediShield Life: Those in financial difficulty ‘can apply for more subsidies’
By Laura Elizabeth Philomin, TODAY, 3 Jul 2014

The premium subsidies for MediShield Life are meant to be targeted at those most in need of help, said Health Minister Gan Kim Yong, in response to concerns over the means-testing framework for the subsidies, which some felt disadvantaged those who were cash-poor but lived in homes with high values.

Acknowledging the difficulties faced by this group, Mr Gan said they can apply for the additional premium subsidies.

“For such cases, we still have additional premium support that will consider their situation on a case-by-case basis. Therefore, I would encourage those who see difficulties to come forward and apply for this (additional premium) subsidy in time to come. If they are deserving, we will help them wherever possible,” he added.

In addition to age and income, premium subsidies for MediShield Life are tiered according to the Annual Value (AV) of residences, with a cut-off at S$13,000. Singaporeans living in residences with an AV between S$13,101 and S$21,000 will receive 10 percentage points less in subsidies, while those with AV of above S$21,000 will only receive transitional subsidies, which are given to all Singaporeans regardless of income.

While the criteria for additional premium subsidies will be kept flexible, Mr Gan stressed it will still have to be targeted at families who really face difficulties with their premiums.

For cases that have been rejected because they did not clear certain criteria or explain their situation clearly, families re-appealing will be seriously considered on a case-by-case basis, he said.

Mr Gan also clarified some confusion over MediShield Life claims for patients warded in higher-class wards and private hospitals, saying these patients in B1 or A class wards and private hospitals will be allowed to make claims.

“But of course because it’s private wards, the charges are higher, so the claims have to be adjusted, to be pro-rated. So relatively speaking, the amount that they can claim will be smaller, but they can still claim from MediShield Life,” he added.

As the population ages and healthcare consumption inevitably grows, Mr Gan said avoiding over-consumption of services is just as important as building more capacity to prevent overcrowding of hospitals.

“We will continue to work with healthcare providers, we will work with patients, family members, together with the various upcoming agencies, including our public hospitals, to ensure that we always deliver appropriate cost-effective care for our patients,” he said.

Following a Facebook chat organised by government feedback unit REACH on MediShield last night, Senior Minister of State (Health) Amy Khor said while Singaporeans generally welcomed the new scheme, they need a better understanding of how it works.

The Government will aim to raise awareness and understanding of the scheme through dialogue sessions, the grassroots and various groups, she said. About 250 comments have been received by REACH since the MediShield Life Review Committee submitted its report last Friday.

'No' to permanent subsidies for asset-rich, cash-poor

I APPRECIATE that the Government is looking into offering MediShield support for asset-rich, cash-poor Singaporeans on a case-by-case basis ("MediShield support for asset-rich, cash-poor"; Thursday), but it is important that subsidies are not made permanent.

In the short term, people with assets can still find themselves unable to make ends meet, when they encounter unexpected situations such as temporary unemployment.

It is unreasonable to expect them to sell illiquid assets quickly in these situations.

However, if these situations persist for longer, then it is a case of bad financial management.

If a person finds himself in a long-term low-income situation while holding on to assets, then the solution is to sell these assets, which he is unable to upkeep anyway.

While it is endearing to hear of people with little income trying to hold on to their inherited property, the correct thing for them to do is to sell the property so as to make ends meet, instead of looking to the Government for help.

Other taxpayers should not be funding the sentimentality of people in long-term asset-rich, cash-poor situations.

Calvin Cheng Ern Lee
ST Forum, 5 Jul 2014

Amy Khor answers MediShield Life queries in webchat
By Joanna Seow, The Straits Times, 3 Jul 2014

WHY incomes above $2,600 are considered high and don't qualify for MediShield Life subsidies, and whether people would be paying twice for health insurance when the Government's lifelong health insurance kicks in - if they already have additional insurance - were hot topics during a webchat with Dr Amy Khor last night.

Around 90 people quizzed Dr Khor, chairman of the Government feedback unit REACH and Senior Minister of State for Health and Manpower, during a 90-minute chat on the REACH Facebook page.

Responding to questions on why incomes above the $2,600 ceiling for premium subsidies are classified as high income, Dr Khor said that the amount is for each person in the household. So for a four- member household, the total income would be $10,400. Using this yardstick, two-thirds of the population will receive the subsidies.

"We used per capita household income to take into account households with more members who would need more help," she said.

Another concern raised was about "double paying" if the person already has private health insurance.

Participant Wong Boon Hong brought up the issue of those who already had complete coverage - such as 100 per cent of hospitalisation costs covered through riders and add-ons - and asked if they should cancel these riders where the person pays more to get added coverage.

A Ministry of Health representative explained that riders are usually on top of Integrated Shield Plans, which already include MediShield today - which will automatically become MediShield Life next year.

Speaking to the media before the session, Dr Khor said REACH had received about 250 comments on its MediShield Life microsite, Facebook page and via e-mail after the MediShield Life Review Committee's report was released on June 27.

A common misperception was that MediShield Life coverage was only for those who used the cheaper Class B2 and C wards. Dr Khor pointed out that MediShield Life covers all Singaporeans regardless of the class of ward they choose.

"MediShield Life coverage is pegged to expenses in subsidised B2 and C class wards, so if they were to opt to go to a higher ward class or to private hospitals, they can still claim the same benefits from MediShield Life," she said, but added that they would have to top up more.

The Government will spend $4 billion over the next five years on subsidies for MediShield Life, which kicks in at the end of next year. Benefits of the new scheme include raising daily and annual caps and removing the lifetime claims limit.

Some who took part in the Facebook chat also said the fact that the scheme covered them for life and included those with pre-existing medical conditions, gave them peace of mind. REACH will compile commonly asked questions from the chat on

Integrated healthcare facility to open in December
Outpatient clinics to start operations first; inpatient wards to open progressively
By Laura Elizabeth Philomin, TODAY, 3 Jul 2014

A new 280-bed facility that connects Changi General Hospital (CGH) and St Andrew’s Community Hospital (SACH) will start receiving patients this December, the two hospitals announced at a topping-out ceremony yesterday.

A major development in healthcare services in the eastern region of Singapore, the Integrated Building will start operating its outpatient clinics for rehabilitation medicine, neurology, geriatric medicine and psychology medicine at the end of this year. Inpatient wards will then be progressively opened, with CGH operating 180 acute beds in six wards and SACH operating 96 community hospital beds in three wards.

The facility, details of which was first announced in 2012, introduces a new model of care, combining acute care with rehabilitation, to optimise patients’ recovery from injury, illness and surgery and more effectively prepare them for the transition back to their own homes.

This new model, said CGH CEO Lee Chien Earn, will help keep patients, especially elderly patients, active to speed up their recovery by providing a seamless environment for rehabilitation and acute care at the same time.

“It’s sometimes not surprising why patients will find difficulty when they want to transit back to their own homes, because what they’re used to in the hospital is not available at home. So what we’re trying to do is help them to regain their independence as much as possible,” he added.

A mock three-room flat to mimic the home environment, dining rooms for patients to have meals with their loved ones and a therapy garden to help patients overcome daily obstacles such as slopes and steps are some of the key facilities that will be available.

The facility is also specially designed for staff from both hospitals to be familiar with the layout and equipment. Beds are also convertible from acute to rehabilitation beds, depending on the needs of the patients. Both hospitals will also be coordinating their internal processes to ensure that patients have continuity of care.

“We’re trying to work out a pathway to enable our patients to flow smoothly and ensure that what has been done is not unnecessarily duplicated and what needs to be done is not forgotten,” said Dr Lee.

In acknowledgment of the vital role caregivers play in the recovery process, CGH started its first special training workshop yesterday for doctors, nurses and all frontline staff to better engage and support caregivers.

Speaking at the end of the ceremony, Minister for Health Gan Kim Yong said: “I hope this collaboration will continue to grow as part of the Eastern Health Alliance cluster, so that we’ll be able to provide service to meet the needs of residents, especially in the eastern region of Singapore.”

When asked if a similar concept would be adopted elsewhere in Singapore, Mr Gan said the six healthcare clusters here are configured differently based on specific patient demographics, so new models of care will have to be experimented with before applicable or successful models will be adopted in the other clusters.


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