Saturday, 24 December 2016

Investing in the ‘little things’ for the benefit of Singaporeans

By Sheila Pakir, Published TODAY, 21 Dec 2016

We were at a jewellery store picking out a Mother’s Day present, and my sister had just told the shopkeeper that I worked at the Pioneer Generation Office (PGO).

“Our Government is so terrible to the elderly, you know,” the shopkeeper exclaimed.

“I must tell you what happened to my husband. All his life he was paying for this ElderShield, then he turns 65 and they send him a letter saying no more coverage.

“How can they do that, right? His whole life, paying and paying, and he never even claimed once.”

This sounded odd. I knew that ElderShield was a Government disability insurance scheme, and it did not make sense for coverage to cease just as a person entered a more disability-prone age bracket. I quietly made a quick Google search on my phone as the shopkeeper continued talking. I glanced through the first result and found a moment to interject.

“I just went to the MOH website … Are you sure the letter said they were ending coverage?” I asked.

She nodded emphatically. “I saw it myself,” she said. I replied: “It’s just that it says here that at age 65, you stop paying premiums … But then your coverage continues for life.”

Her eyebrows shot up. “What?”

“Yes,” I continued, “See, it says so here. Don’t worry. It looks like your husband is covered. They just front-loaded the premiums so he only pays while he’s working, not when he’s retired.” By the end of the visit, we had bought a pair of earrings and the shopkeeper could not wait to get home to tell her husband the good news about his insurance.

To me, the next big thing for Singapore might, paradoxically, be a shift in focus from big things to little things. We do big things well: In policy alone, recent years have seen the rollout of many exciting national-level schemes. Where we now need to spend more energy on are the myriad little things that can make or break these plans.

One key little thing is to ensure that citizens understand the big moves, and know how to access the benefits they offer.

This is less simple than it sounds and was my team’s primary conundrum during my 18-month posting to the PGO. Created in 2014, the PGO’s mandate is to customise policy communications for seniors and then train volunteers nationwide to visit elderly families in their homes, tailoring policy explanations to each family’s situation.

Although the PGO was created to help the elderly understand policies better, it quickly became clear that their younger family members needed to be engaged too — indeed, they were frequently the most frustrated and disillusioned with the system, often because they were unaware of, or misunderstood policies.

Being able to read letters, buy newspapers and conduct Google searches did not necessarily translate to being better informed or better assured.

One difficulty with communications work is measuring its efficacy. Phone surveys? Online polls? Clipboard-wielders stationed in underpasses to gather feedback?

A multiple-choice questionnaire can tell you something about awareness but it is seldom able to capture the root of how misconceptions occur. Nor can it help to right them.

Having a conversation with the family, however, can — and this is what PGO’s volunteer ambassadors were tasked to do, every day.

We found that, quite often, policy misunderstandings were intertwined with cynicism — even lack of trust — about the Government and its intentions.

Our ambassadors would excitedly tell a pioneer citizen about his annual Medisave top-ups and show him how this would help to offset his MediShield Life premiums, only for him to reply: “Zheng hu (the Government) give me money, zheng hu take it back.”

In one heartbreaking case, ambassadors told a wheelchair-bound senior about the Disability Assistance Scheme, which would give him $100 every month.

They filled in his application form, made an appointment with a doctor for him, and left him a postage-paid envelope to submit the form in.

Six months later, they visited him again, only to find that he had not submitted his form.

Why? Because his friends had told him there was no way that the Government would “give out money for free”. That piece of misplaced coffee-shop chatter cost the senior $600 in cash benefits.

How, then, to combat such cynicism? Communication between the Government and its constituents simply needs to become more human.

Where there are human reasons behind a decision, sometimes, it is better to just tell it like it is.

When the Pioneer Generation Package (PGP) first started, it subsidised clinic consultations but not yet medication; the medication subsidy would kick in only six months later. We saw an understandable wave of anger from the first Pioneers we visited, many of whom had delayed buying medication until the PGP came into force, only to find that they still paid full price for their year’s supply.

We scrambled for an explanation, believing that the truth — that the list of subsidised medication was simply not ready in time — would not be acceptable to the public. In the end, however, our volunteers proved us wrong.

“Uncle,” they advised, “I tell you honestly, the ministry needed more time to settle the list of medications. Another six months.

“But do you know, hundreds of Pioneers pass away every month. If we had not started the rest of the PGP first, so many Pioneers would never have been able to use any of their benefits. So, better that what is ready first, goes first, right?” And the anger dissipated.

Resource limitations mean that we will not be able to explain every policy to every constituent in the highly personalised manner that PGO’s ambassadors do for our seniors today.

But perhaps we can scale what makes — in my opinion — the ambassadors so effective at quelling unhappiness and righting misunderstandings: Their humanity. It is easy for a citizen to rail angrily against a faceless bureaucracy, the very image of which invites suspicion.

You might believe an explanation coming only from someone like you, who seems to care about your situation and who has no reason to benefit at your expense. To me, this means we need to better resource frontline operations, whether by investing in staff training or sending more of our best people to the ground.

If we can get to the point where every Government representative with whom a citizen interacts is forward-leaning, genuinely interested in their concerns and sufficiently knowledgeable about available avenues of help, trust will flow back into the Government-citizen relationship.

To help such efforts scale, technology can be used, but not just to funnel queries to automated phone lines and self-help FAQ sections on websites, which are helpful for some but frustrating for others.

Human-to-human interactions give the best communications payoff, but are costly investments: Data analytics can help to at least ensure that these investments are efficient.

For instance, at the PGO, the simple act of matching volunteers to households based on language, age and gender profiles significantly increases the likelihood of a successful engagement. To do this all in a slowing economy, where Government spending needs to be increasingly prudent, will not be easy.

But dollars-and-cents analyses leave out hidden, intangible costs, such as losses in social capital and goodwill. Which is why, to me, the seemingly small act of simply having more people talk to fellow citizens about policies and benefits available to them, could end up being a rather big thing indeed.

Sheila has been a civil servant with the Singapore Government since 2010, after a short stint in the private sector. She has experience in the Prime Minister’s Office, Ministry of Home Affairs, and most recently, the Pioneer Generation Office. The views expressed in this article are the writer’s own. This piece first appeared in The Birthday Book 2016, a book of essays by 51 different authors on Singapore’s Next Big Thing.

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