Tuesday, July 22, 2014

Stingy On Health

One year ago we helped a relative with the paperwork to pay for his monthly consultation bills via Medisave. There were "packages" to choose from, which determined how much could be drawn down within one year; the bigger the sum, the higher the cash co-payment attached to each application. First frustration encountered was the administration fee - he had to pay to access his own money. Obviously enough brickbats were received to make them cancel that charge months later. Recently, the scheme has been cancelled altogether. Now it's a cash co-payment upfront if Medisave is to be used for payment at each visit. No cash, no medical attention, even if money is sitting pretty at the Medisave account.

World Bank President Jim-Yong Kim would be less effusive in singing the praises of the Singapore’s healthcare system if he had a better grasp of the chicanery in the system that makes sure Singaporeans pay for their own bills. There's nothing to be proud about when he crowed, “I don’t think there’s a single system in the world that spends as little as Singapore does in terms of percentage of GDP (in healthcare) and gets the outcomes that it gets." Especially when the outcome is that an elderly woman would rather take her own life rather than burden her family with huge medical bills.

According to World Health Organisation statistics, the total health expenditure (the sum of public and private health expenditure) for Singapore as a percentage of Gross domestic product (GDP) is only 4.7 percent, compared to Australia's 9.1. Singapore's GDP (nominal) per capita is US$78,744 (2013), Australia's is US$43,550. Either Singaporeans are super healthy, or the Singapore government is super stingy.

18 comments:

  1. Instead of looking at just government spending vs outcome, shouldn't one compare overall national spending (ie both government plus patient plus charities like St Luke's, Chung Hua Free Clinic, Kwong Wai Shiu etc) as a percentage of GDP to compare cost effectiveness and efficiency of a healthcare system? Jim Young Kim is speaking like a govt-appointed bureaucrat - as long as government pays little, its considered efficiency. No wonder the admin service folks keep going to harvard to be brainwashed by academics like JYK (where he taught before obummer preferred him over Jeff Sachs as president of the yankee organ called "world" bank..

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  2. Super stingy?.. cannot be right, we did convert a SIA plane into flying hospital for 1 singaporean

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    1. But there was only because the almighty's consort could not wait for her turn and wanted to jump queue in the NHS putting the PM in a fluster to have to explain to the public that no special treatment was accorded to the very important visitor.

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    2. u must mean the late "empress dowager" right? "consort" can suka suka be sacked by the emperorif her night duty was not carried out well leh! On the other hand, an empress dowager can sack his son the emperor. Empress Dowager Wu sacked 2 of his sons, and slaughtered half the lee (Tang emperors' surname hor, don't play play) clan and made herself Emperor (not empresss hor!). We need an empress dowager Wu leh!

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    3. Err! Dowager insinuate a dead husband ! But can also mean just an elderly woman of stately dignity ! Both descriptions to me does not fit the you-know-who !

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  3. The Singapore Government is not stingy when it comes to paying themselves silly with million-dollar stipends.

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  4. Its an unstated fact many myanmar VVIPs incl drug lords and generals (maybe there isn't difference between the 2) use our public hospitals to treat their relatives, now how much of that 4.7% goes to upkeep of VVIP suites is very hard to say. And what about the FTs working here with no PR - the public hospitals may turn away singaporeans with no cah, but if you have cash to pay downpayment, no FTs would be turned away. They may not get a "subsidy", but they nonetheless burden the public healthcare system - forcing the government to spend more to build more hospitals and add bed spaces - all of which are paid with taxpayers' money. Just last week we visited a nephew serving his NS, sent to hospital for dengue. He lied in the corridor for 2 days due to lack of beds space while the wards were filled with voices in dialects from shanghai, people from myanmar, vietnam, and quite a few ang mohs (they didn;t seem to mind the stench of the locals, or maybe there were too few locals in public hospitals nowadays??) from I don't know where because they weren't speaking in english. NS for locals - yes, but when it comes to sharing the govt healthcare expenses, they are extremely generous with the foreigners.

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    1. I agree with you. When I went to collect my medical report, I notice that majority who go there are foreign workers filing claims for their injuries. Why is our public healthcare system burdened by foreigners? Ditto housing, transport, etc. In fact they burden us by taking away jobs that normal Singaporeans can do. Nowadays coffeeshops are littered with PRCs, restaurants served by Pinoys, IT engineers from India. Are they really talent? Or because they are cheap? The PAP government must be voted out to save Singaporean jobs.

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    2. Why not set up separate clinics for the foreign workers and FTs? Most of the foreign workers have work-related injuries so sending them to hospitals is just clogging the system even more. They need to build new hospitals 'intelligently' (sorry, there is more "compromise" amongst the elites in garmen than there is logic) - many of the overload in TTSH or SGH NUH comes from foreigners whose healthcare needs should be taken care of thru funding by their employers who benefit from savings when they replace the locals. Why make the locals whose jobs have been taken by FTs pay more GST, more ERPs more COEs just to fund the building of more hospitals when the users and beneficiaries are the towkays now driving 6 and 7-series BMW instead of their toyotas of 10 years ago (when they were employing locals)? Again, a very sneaky way for the elites to rob from the poor to feed the rich. Did you say the cabinet is left of centre" kish my dog? Of course a dog cannot speak, cannot be it who said that la!

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  5. I don't need anymore proof that PAP is not a pro Singaporean government.

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  6. From CPF site: "Saving for future medical expenses is important, as the need for medical care and hospitalisation increases significantly as one grows older. It is important too that you spend your Medisave savings wisely - so that you can make your savings last you a lifetime!"

    Gahmen so caring, they want our medisave to last us a lifetime, and probably beyond! Right, saving for future medical expenses is important, so Gahmen no need to spend on you. Every year medisave minimum sum keep on going up. When you die also pay GST. KNN.

    Public healthcare expenditure as percentage of total healthcare bill only accounts for 36%. The remainder comes from our out of pocket (excluding from medisave) and private spending.

    http://singaporearmchaircritic.wordpress.com/2014/02/23/healthcare-funding-in-budget-2014-government-spending-vs-private-spending/

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  7. Foreigners, however ignorant, who praise us get all their views published in the MSM. Those critical of us get banned from coming into the country or are lambasted. Is this the country we want?

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  8. Every year they keep surpluses. On top of that they made everyone pay for healthcare costs through health insurance for Life & robbing from those with short expiry dates to pay the retirement benefits for those with long expiry dates.

    That is how they save both on public healthcare costs & public spending for the aged. Then they spend lavishly on themselves through obscene salaries. Is it any wonder why they need to bankrupt or literally kill their careers of those critical of them ?

    Aren't they both cunning & cruel to come up with such schemes ?

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  9. Aliens pay when getting treated.

    SINKIES PAY BEFORE THEY FALL SICK.

    IN THE CASE OF MEDISHIELD LIFE, PAYMENT STARTS AT BIRTH.

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    1. Your last point is enlightening - this will never be published in state propaganda papers, but it is still worth repeating those asleep and think its a good scheme. Today at birth your parent start paying, no choice. Today it may be "affordable" like HDB flats 30 years ago, but 30 years later, paying the Medishield Life premium might mean pawning away another few years of your liberty at birth, like NS for boys. This creeping encroachment tactic of the MIW elitesmust be stopped.

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  10. Medishield Life is reported as compulsory on all Singaporeans. Or can it be said any breathing Singaporean.
    All payments made to Medishield Life are non refundable. If unused will be used to subsidize others. Does this not mean contributions start from birth, that is: anyone born breathing as Singaporean?

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  11. OECD finds that the major developed economies have experienced lower and lower rise in healthcare costs, at around 1% increase a year per-capita since 2011 and still falling. YET the bureaucrats at the CPF insist that the Medisave minimum sum must rise at annual rate of 9% or so. So Jim Kim is talking rubbish, and worse, someone at the MoH/PMO are not telling the truth. Please all, read this NYT article, better still read the whole OECD paper. The only way to beat them is by facts, Roy, Tattler and other bolggers have done their part to open our eyes, will the sheeple please do their own self-education? If not, its always a worked-up bunch with little basic knowledge versus a wall of mis-information and spin from the bureaucrats.

    http://www.nytimes.com/2014/07/17/upshot/the-global-slowdown-in-medical-costs.html?_r=0

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