http://singaporemind.blogspot.com/2009/06/how-healthcare-costs-creep-up.html
Free markets are great when everyone has perfect information. When access to information is very difficult/ expensive (what do most of us know about cancer?), free markets are not optimal and open up thoes without information to exploitation by thoes with.
Exactly...when I saw the movie "Sicko" I had a feeling that our health ministry is moving towards the US model...try to push the cost to insurer & patients...government just sit back and tighten the policy to ease itself off the system...
First is limit Medishield coverage and then push it to private insurers...end result is less cost to government but higher premium for patients with slightly better coverage..
Second, mean testing is introduce so that 'correct' resource is channel to 'correct' group of ppl..
I see it as a way to control the amount of subsidies the government is giving..they can anytime change the income grouping and more will get lesser subsides..
Third, only subside selective medicine, some life saving medicines ae not subsides (eg, cancer drugs)
Furthermore, if hospitals decide to charge $5K for whatever service you receive, who can justify the $5K is a 'correct' amount...Yes, you can say :" Oh we a XX% cheaper than private, therefore, it's subside...but the fact the actual cost might be only $2K not the $5K being charged...
So, who's the policeman??
WL said...
Lucky
You made valid and sensible points and would request you to submit these to the MOH for their response. Write a letter and post this on your blog. Thanks.
30/6/09 10:32
WL,
I like many Singaporeans write to the MOH giving regular feedback. I think my letters just end up in a big database with the other few thousands of letters.
The PAP thinks it knows best what to do...when they do it, you are expected to take it that it is the best for you.
30/6/09 10:45
Just imagine if you are intelligent enough to become a doctor, would you leave somebody who is sick and cannot pay the bills to die? But then again, there are so many people who are sick and cannot pay the bills, you, alone, can only do so much and as time passes, you become numb and accept things as it is? Or fellow doctors will tell you not to pretend to be noble and that actually you study to be doctor is to become well-to-do in this society?
What this government thinks, well, you have to pay enough for people to become doctors, if not there will be monkeys......
In economics, we learnt that some things are public goods which cannot be justified in terms of monetary sense. Guess Singapore has lost its soul on these.....
Why do you want to be doctor? Why do you want to serve the country? Is it really about $$$? Ricardo Semler once said that when one accumulates a certain amount wealth, that additional amount meant little any more.....Life is more than just $$$. Granted the renumeration must be there to attract people, but how much is enough or how much is fair?
I just wish all these people taking millions from the people and hiding behind their so called "ideology" of not giving out welfare will contract some illness which cannot be treated with all their money. I wish their family members realise and suffer for their actions. I wish they understand what is the meaning of suffering the emotional pain the poor, jobless, underpaid and old people are going through. Please god, don't let these hypocrates get away.
It is frustating that the Government refuse to listen to sensible suggestions. Worse they do not bother to explain why the suggestions are not applicable.
The current model for health care will result in profits for the health care providers, and for the insurance companies. I am not an expert in this matter, but looking at the high costs of health care and the increasing increase in putting more savings in medisave is worrying. Sometime is wrong somewhere. And unless a careful relook is undertaken, the situation will only worsen with an aging population.
Here in Australia where I have been for the last 1.5 years, it is a public-private healthcare system. 1.% of your pay goes towards paying for the public healthcare system called Medicare. It covers all public hospital treatments, and provides a fixed schedule fee that it will reimburse GPs and specialists for treatments and consultations. If the doctors want to bill beyond the schedule fee, then the patient will pick up the difference. That way you can shop around and if you can't or do not want to wait in the public system, you have the option of paying the difference and go to a different doctor.
To ease the public healthcare system, there is a disincentive in place to encourage private health insurance. If your income (or family income) is above a threshold and you do not have private insurance, you need to pay an additional 1% of your pay towards Medicare. Also, for each year above 30 that you are out of private health insurance coverage, you pay an additional loading over and above the normal premium for the next 10 years, before the premium goes back to normal. The government also provides a 30% rebate on private health insurance premium as an incentive.
You always have the option to pay a bit extra when you can afford, as private insurance will pay for private hospital treatments instead of having to wait in the public system. If you lose your job, you can go back to the public system. There is also a family Medicare safety net that is income dependent. If your out-of-pocket cost for the year exceeds that threshold, Medicate will pick up all the balance. That way nobody goes bankrupt because of medical bills.
The public-private system works to keep public healthcare spending manageable, yet provide universal coverage for those who cannot afford. The schedule fee also automatically weeds out doctors who charge a fortune since the reimbursement is capped, and the consumer can choose if they want to still select that doctor and pay the difference. Even private health insurance has a universal premium regardless of age or medical history, only difference is 1 year of waiting time for pre-existing conditions, quite unlike Singapore where pre-existing conditions are not covered.
Since my vote never resulted in any difference, I elected to vote with my feet. I am more than glad to dump the Singapore passport when I qualify for Australian citizenship by the end of the year. For those who are able, think about your options. The more you wait and tarry, the lesser your options will be.
30/6/09 19:39
anon 7:39,
The Singapore system leaves many people uninsured and exposed to the risk of high medical costs. When medical debts are incurred they are handled by debt collectors hired by the hospital.
The lack of universal coverage, the escalating costs together with means testing exposes Singaporeans to financial risk when they get sick.
When the Taiwanese developed their system they looked at those around the adopted the best features.
The Singapore system is pretty much the product of PAP ideology. The belief that people will take better care of their health if made to pay for their illness. They believe that if affordable care is always accessible, it will be badly abused. Hence the long waiting time for specialist as subsidized patient. The $75 upfront charges at the A&E which deter poorer sick people from seeking emergency treatment. All that combined with the PAP's unquenchable thirst to seek profits in health care as a medical hub works against the interests of ordinary Singaporeans.
30/6/09 20:03
Actually the policy makers, i.e. PAP ministars and MPs, wouldn't care about the reality of healthcare costs for a typical Singaporean. They are covered by pension and free A1 class healthcare for superscalar civil servants and their family.
Just look at LKY. Who paid for the exclusive treatments for his wife? Is such treatment available to your typical Singaporean? Would the typical Singaporean have "priority" wait-times like his wife? Or is our real wait-times more like NHS which LKY mocked, and circumvented by jetting Mrs Lee back to Singapore in a converted SIA jet?
Add to that, heard that whenever LKY is hospitalised, he demands that the air-con is maintained at 23 degC at ALL TIMES (imagine the extra manpower to ensure that), all the local daily newspapers in English, Chinese, and Malay (when typical private patients get only 1 copy of a newspaper), his entourage of body guards also get special treatment (free food etc). In addition, only senior staff are allowed to enter the room to serve him, even for low-level tasks (imagine the wasted manpower and associated costs). With this extra special treatment, FOC to policy-makers like him, is it any wonder that the elite is disconnected from the reality of a typical Singaporean's life?
It is not just limited to LKY, self-declared founder of modern Singapore. Ask SHT, who foots the bill for his hospitalisation and skin grafts?
Taxpayers are made to pay for the free medical care for the policy makers and their families, while the rest have to cover one's own ass when it comes to medical bills. The only other people who get free medical care are those under the pre-independence British civil servant contract, but they are often limited to poor class treatment, i.e. C or B2.
1/7/09 22:27
Its ME said...
enjoy blogging here with you too.it's sickcare versus healthcare here.
24/1/11 03:27
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