WP manifesto: healthcare

• oxford mushroom

  5 Feb 06, 15:22

  I have studied the WP Manifesto and would like clarifications and a debate on it to help me decide who to vote in the coming elections. This thread is on the healthcare issue (http://www.wp.sg/party/manifesto/m2006_chp06.pdf) only, an area that I am more familar with. Perhaps others can debate other issues in the manifesto:
  
  Beliefs
  The statements are generally acceptable and indeed attractive to most people. It's the implementation that may be difficult.
  
  WP believes that it is more cost-effective to pool the risks of the population to meet healthcare needs. That is true but I would caution that with an aging population, that risk will only escalate. The government talks about delaying the inevitable with a healthy lifestyle. What the Minister of Health does not know (or prefers not to reveal) is that it may not make much difference to the healthcare costs.
  
  We will all die from some disease or other - I have never seen a death certificate that lists the cause of death as due to old age. We all die from diseases associated with old age, like heart failure, cancer etc...Healthy lifestyle or not, the time will come when we will need healthcare. In fact, as technology improves, we are dying from diseases for which treatment is increasingly expensive. My grandfather died from simple pneumonia which would have been treated with antibiotics (few hundred dollars), my grandmother died from a bleeding ulcer (surgery costs 1-2 thousand dollars) but chances are that I will die from cancer, treatment of which will costs tens to hundreds of thousands of dollars.
  
  The WP states that all should be provided with basic healthcare. But how basic is basic? When my grandfather had TB in the days before streptomycin, the only treatment is to rest the lungs by creating a pneumothorax because antibiotics were too expensive. Early breast cancer was treated by surgery and standard chemotherapy, but now there are new drugs that will improve the cure rate from 60% to 80%, at the cost of tens of thousands. Is that drug basic? HIV drugs do not cure at all but improve the length and quality of life. Is that basic?
  
  The fact is, our expectations are rising way beyond our means to pay for them. What is basic healthcare for an Ethiopian with an ischaemic foot (an amputation to treat the lack of blood supply due to disease) is not acceptable for the Singaporean who wants vascular surgery and reconstruction. Can we afford to offer all Singaporeans the WP's basic healthcare? Do we need to define it in dollars and cents?
  
  The NHS in UK offers free basic heatlhcare at delivery. HIV drugs and many expensive drugs not available to Singaporeans are provided free here. But the people are demanding more. They want newer, more effective drugs like Herceptin and Velcade for various kinds of cancer but the costs can bankrupt the entire system.
  
  The WP must be clear in their definition of basic healthcare and the costing. How much more will they expect the government to fund and where will the money come from?
  
  
• iveco

  5 Feb 06, 15:40

  It isn't fair that taxayers are charged double for healthcare in a sense that they pay taxes to the government yet have to bear the brunt of the costs when they seek medical treatment at government clinics and hospitals. The amount collected from taxes should be enough to pay for healthcare at government hospitals. The patient should not bear more than one quarter of the costs of hospitalisation.
• oxford mushroom

  5 Feb 06, 16:14

  Proposals
  Medishield and deductibles: WP wants to increase the limitation on Medishield claims per year (currently 50k) but does not specify how much. They want the government to fund most of the healthcare costs but does not specify how much more.
  
  Does the WP know how much more it will cost the government to implement its policies? Suppose the WP were to take power tomorrow, how much more will it pump into the healthcare budget and where is the money coming from?
  
  Health insurance: WP wants a comprehensive public health insurance scheme but does not specify who is going to pay for it. (I think they mean Singaporeans themselves). I have purchased fairly comprehensive health insurance policies for my parents and they cost me about 1.5k per person per year. How many Singaporeans can afford it?
  
  WP also talked about a compulsory basic hospitalisation insurance scheme but it is not clear how it sits with the comprehensive public health insurance scheme. Presumably the former is optional and paid by Singaporeans and the latter is compulsory. But why should I have both? If I have paid for a comprehensive package for myself already, why should I pay more into the basic healthcare policy?
  
  WP wants universal basic healthcare based on costs of B2 wards. Do they mean the cost to the hospital or cost to the patient? As it is, the government subsidizes a large part of the B2 charges. The actual cost of the B2 wards is much higher than what you see on the fee schedule in our public hospital. Do they know that?
  
  How basic is basic healthcare? Currently HIV drugs, expensive cancer drugs like Gleevac, Rituximab, Velcade, Herceptin, Irresa etc are not standard drugs and are not available to B2 patients unless they pay for them. WP wants HIV drugs to be included but what about the others? How much is the limit on payouts for the universal basic healthcare policy?
  
  WP wants the premium to be based on the 90th percentile of medisave contribution, but what sort of claim limit will a universal healthcare insurance policy yield? Can that amount pay for the basic healthcare package?
  
  WP also wants a cap on the maximum deductibles based on 2 years' medisave contribution on a salary of $2000 and Medifund to pay for those who cannot afford to pay. Does WP know how much will be the shortfall based on a claim limit of say, 50k a year as per current practice? How much more will the government have to fund to meet the shortfall?
  
  Medisave for treatments not classified as basic hospitalisation insurance
  WP wants to allow Medisave to be used for specialist and other treatments not considered as basic healthcare. Is this a backdoor exit in case the basic healthcare insurance policy works out to be too expensive for the government to fund? Because the WP has not defined what is basic healthcare, when push comes to shove, what if a WP government simply declares that basic healthcare means treatment not exceeding $2000 per year per patient? Everything else must come from the patient through the medisave. With hospital costs running up to tens of thousands, how far will that go?
  
  We need to know exactly what basic healthcare insurance covers.
  
  Subsidy for polyclinics and means testing
  WP wants to continue subsidy for polyclinics but wants to introduce means testing as to the quantum of subsidy. The question with means testing has been how to implement it. By income tax returns? Then all the rich tai tais who do not work but spend their time at dim sum will get subsidies. By housing types? Then the well-off single Yuppies will get subsidies whilst the struggling family in a 5-room flat who cannot sell their apartment except at a huge loss will not get healthcare subsidy.
  
  
• oxford mushroom

  5 Feb 06, 16:22

  Originally posted by iveco:

  It isn't fair that taxayers are charged double for healthcare in a sense that they pay taxes to the government yet have to bear the brunt of the costs when they seek medical treatment at government clinics and hospitals. The amount collected from taxes should be enough to pay for healthcare at government hospitals. The patient should not bear more than one quarter of the costs of hospitalisation.

  Have you worked out the sums? The amount allocated for MOH is definitely not enough if the patient were to pay less. So where do you propose the shortfall come from? Take from the Ministry of Education? or Ministry of Defence by reducing the number of overseas exercises, buy fewer weapons maybe? Or increase taxes?
  
  It is either increase taxes or re-distribute government funding. I would favour less spending for Defence, cut overseas army exercises and a smaller defence force. The current threat to our security is terrorism, and you cannot fight terrorists with F16s. Why are we spending so much to fight a future imaginary enemy whilst patients with real needs now are dying?
• ceciltan

  6 Feb 06, 00:28

  Just my 2 cents worth,
  
  Defence, Healthcare and Education are 3 areas that the govt must spend in order to secure a better and secured future for singapore. One cannot give way to the others. All 3 must be in tandem with one another.
• Atobe

  6 Feb 06, 03:53

  Is the merit of Healthcare Insurance scheme being exclusive considered by the Worker's Party only ?
  
  The report Lee Kuan Yew's "Socialism" Reconsidered' detail the following:
  
  

  : "From its inception, the PAP advocated that social security be available to 'all those who through sickness, infirmity or old age can (no) longer work'. The Party's 1955 election manifesto went further by calling for the introduction of child endowment, maternity allowances and unemployment benefits, as well as the benefits outlined in the party's original Manifesto. During the subsequent election campaign the PAP called for the abolition of the CPF."
  (Page 35 - 36)
  
  On 15 March 1962, Lee Kuan Yew had told the Legislative Assembly that the Government intended to introduce social insurance benefits:
  
  ... first, to cover unemployment and redundancy; next sickness; then old age; and finally, of course, the Central Provident Fund can be dissolved in this wider and bigger institution to ensure stability and security for the worker.....
  
  Having sweated over this comprehensive social security scheme... we are not likely to just forget about it....
  
  Lee's reference to "having sweated over: this scheme was not just a piece of polemic. The speeches of Lee and Goh earlier in this debate reveal that Goh had laboured greatly over the drafting of an unemployment insurance scheme and had successfully negotiated an arrangement with employer groups. His negotiations with the pro-communist trade union leaders broke down only when they refused to promise industrial peace in exchange for the introduction of the scheme and when the Government insisted that employees must contribute to the scheme alongside employers and the government. Although Lee stated the Government intention to replace the CPF with a social insurance scheme, he also used this debate to indicate that the matter was not a high priority. (Page 36 - 37)

  The report further highlighted that Goh Keng Swee saw the competitive need between national development and public housing for the limited funds available.
  
  CPF was seen as the best vehicle to accumulate funds at the expense of the long term social security of Singaporeans.
  
  After FORTY YEARS of development, CPF has served its purpose of national development and housing, however, what of the social security of the Citizens ?
  
  Singaporean's social security remains uncovered with the present CPF mechanism.
  
  The high costs of medical, health, and unemployment security remain unresolved with the limited resources of each CPF Account Holder.
  
  This situation is fully known to the Singapore Government a.k.a the Ruling Political Party - which solved the inherent problem of the CPF, by requiring the Singapore Citizens to pay CASH with the limited CPF clearing a minor portion of the Medical and Health Costs.
  
  
• Atobe

  7 Feb 06, 13:21

  
  The medical and health care of Singaporeans can be better served when the resources are pooled into some insurance funds, or managed by fund managers to hedge against the continuous rising cost of future medical and health care.
  
  What is the benefit of the paltry handouts to individual Singapore CPF accounts - that amount from $400 to $1500 ?
  
  This paltry size can have no positive impact to help in the medical or health bills, or which will most likely be dissipated into useless expenses ?
  
  However, if the total sum that is annually released to Singaporean CPF accounts - from the Annual Revenue Surplus - to the sum of $1.0 BILLION a year, this will be quite an interesting and hefty size "insurance premium" for a Medical and Health Care Insurance to benefit ALL SINGAPOREANS - to those who need it the most.
  
  Place this sum in a simple Endowment Fund, and it will be grown by the Fund Managers employed by the Insurance Companies - which will benefit Singaporeans in a more comprehensive way.
  
  The only reasonable explanation for the Endowment Fund being replaced by the CPF - despite being seriously considered in the 1950s by the Ruling Political Party - were that there was insufficient capital to start the Endowment Fund - which is a fund based on a collective basis, while the CPF is more personal; and also that the CPF is non-performing account earning minimal interest on its concept of personal savings, compared to the Endowment Fund which is a growth fund managed by Fund Managers.
  
  The limitations of CPF is as clear as daylight, and if no alternative is found to replace the CPF - there will be alot more Singaporean senior citizens living out of charity and handouts over the next twenty years - as the baby boomers of the 1950s begin to grey.
  
  
• BillyBong

  7 Feb 06, 18:18

  With the CPF bubble having burst, the current viable option is for the people to invest in their own medical insurance plans to safeguard their financial future.
  
  CPF and it's special medi-accounts have limitations that the govt is only now realising and attempting to address. Evidently, this will not help the current dependent generation.
• claudetnt

  7 Feb 06, 21:11

  Most of us just cannot fathom that the govt must be responsible for basic health care.
  
  Now the definition of basic health care can be argued till the cows come home with no agreement.
  
  I think the govt in Singapore had some of the medical priorities all screwed. They built hospitals that are more like hotels. The most modern, sophisticated and expensive equipment are in use. There are more specialists than good doctors. The end results more expensive treatment even for a minor operation like cataracts and for more serious operations - heart by-pass, etc
  
  Now, its cheaper to go into a good private hospital in JB / KL / Bangkok and have the above operations done satisfactorily with 30 to 40% cheaper!
  
  If you have a common cold or are injured in Malaysia or Thailand, the doctors in the govt hospitals will treat you for less than S$10.00. In Singapore, will the govt hospitals even admit foreign workers who are injured without a guarantor?
  
  In Singapore, even the polyclinics pharmacies and laboratories are now privatized which means itÂ’s more expensive than before for sure.
  
  The private practitioners are not allowed to bring their charges down below that of the polyclinics.
  
  So we are made to believe artificial indicators to measure health costs unless we check for ourselves other alternatives available in our neighboring countries.
  
  Basic health care can be affordable once again if the govt allows the doctors in the private sector to set the costs!
  
  
• oxford mushroom

  8 Feb 06, 06:06

  Originally posted by claudetnt:

  The private practitioners are not allowed to bring their charges down below that of the polyclinics.
  
  So we are made to believe artificial indicators to measure health costs unless we check for ourselves other alternatives available in our neighboring countries.
  
  Basic health care can be affordable once again if the govt allows the doctors in the private sector to set the costs!
  

  First time I hear of this despite having been a medical practitioner for almost 20 years. Where's your evidence?
• oxford mushroom

  8 Feb 06, 06:11

  However, if the total sum that is annually released to Singaporean CPF accounts - from the Annual Revenue Surplus - to the sum of $1.0 BILLION a year, this will be quite an interesting and hefty size "insurance premium" for a Medical and Health Care Insurance to benefit ALL SINGAPOREANS - to those who need it the most.
  

  Agree. That amount will be more than sufficient to pay for a comprehensive insurance policy for all Singaporeans but I think revenue surplus goes into a general pool for all sorts of other expenses. I think military expenses take up too large a piece of the pie.
• claudetnt

  8 Feb 06, 09:02

  Honestly, can you as a private practioner set your own rates which will be cheaper than those offered by the polyclinics or govt?
  
  Recently, some doctors wanted to set their rates to that lower than the polys and they were told by the medical board or council not to do so!
• sgdiehard

  8 Feb 06, 10:44

  Used to buy Arthro-flex, a supplement for osteoarthritis, here for S$60 a box of 30 sachets. Went to australia recently and bought it for A$19 per box.
  
  why is it so expensive here?????
  
  Many types of medicine are very expensive here. In Malaysia we can find cheaper medicine, even in Australia and US, I find many medicine cheaper, who in singapore are profiteering???
• Atobe

  8 Feb 06, 12:52

  Originally posted by oxford mushroom:
  Agree. That amount will be more than sufficient to pay for a comprehensive insurance policy for all Singaporeans but I think revenue surplus goes into a general pool for all sorts of other expenses. I think military expenses take up too large a piece of the pie.

  The SAF has to be kept at the edge of technological superiority in the most affordable manner, and this is kept at 5% of GDP as stated in the 2003 budget - this amount is about 28% of the government operating expenses.
  
  A PERCENTAGE surplus generated from the various revenue collection programs should have been allocated to collective programs that can benefit Singaporeans - such as the Medical Endowment Fund proposed here.
  
  It is regrettable that the surplus is tranferred from the Finance Ministry to GIC and Temasek Holdings, and through their annual expansion program of acquisition of foreign companies, the funds spent have largely benefitted in windfalls to the owners of those foreign companies.
  
  Meanwhile, Singaporeans are left to struggle on a daily basis the high costs of living, perpetual increases in fees that result in further annual operating surplus enjoyed by various Government departments and statutory entities - that result in further surplus being transferred from the Finance Ministry to GIC and Temasek Holdings.
  
  The money-spinning cycles continues at the expense of Singaporeans.
  
  
• Atobe

  8 Feb 06, 13:31

  Originally posted by sgdiehard:

  Used to buy Arthro-flex, a supplement for osteoarthritis, here for S$60 a box of 30 sachets. Went to australia recently and bought it for A$19 per box.
  
  why is it so expensive here?????
  
  Many types of medicine are very expensive here. In Malaysia we can find cheaper medicine, even in Australia and US, I find many medicine cheaper, who in singapore are profiteering???

  Profiteering in the most subtle manner - and reaping as much as possible while the sun is still shining.
  
  With a closed and captive market that is largely ensured by the Singapore Government at every opportunity to a population of Singaporeans needing medicine, 'brain-washed' to depend on the 'high quality' of health care in Singapore and to suspect the quality in neighboring countries.
  
  
• oxford mushroom

  8 Feb 06, 16:20

  Originally posted by sgdiehard:

  Used to buy Arthro-flex, a supplement for osteoarthritis, here for S$60 a box of 30 sachets. Went to australia recently and bought it for A$19 per box.
  
  why is it so expensive here?????
  
  Many types of medicine are very expensive here. In Malaysia we can find cheaper medicine, even in Australia and US, I find many medicine cheaper, who in singapore are profiteering???

  The prices of drugs are fixed by the pharmaceutical companies and they vary in different markets. I understand that the pricing of these drugs are related in part to the cost of local licensing and marketing (HSA charges a fee to test imported drugs to ensure that they are safe). Drugs manufactured in Australia may be cheaper than imported drugs.
  
  Medical practitioners do have some latitude with regard to fee setting. The incident about MOH's objection to extremely low fees referred to earlier was an isolated incident. In any case, most doctors agree that the fees set in that case were far too low to be viable and there is a suspicion that it might degenerate into a MC selling scam.
  
  Any doctor who has practised as a GP or a polyclinical doctor know of a sizeable proportion of our patients who come just for the MC. I know of people who throw away their medication when they leave the clinic. One can cater to this sector of the market by charging say, $10 per consultation, dispense a small packet of Panadol and an MC, which costs little to print. Keep the consultation time to less than 5 minutes and you can still earn. Another trick for those with contracts with companies that pay per consultation is to give half the medication required, tell the patient to return if he is not better in 3 days and then give the other half of the medication at the second visit which will be charged as a new consultation.
  
  If you pay peanuts, you get monkeys. There is always a price to everything. You may pay a much higher price for very low consultation fees.
  
• oxford mushroom

  8 Feb 06, 16:24

  Originally posted by Atobe:

  It is regrettable that the surplus is tranferred from the Finance Ministry to GIC and Temasek Holdings, and through their annual expansion program of acquisition of foreign companies, the funds spent have largely benefitted in windfalls to the owners of those foreign companies.

  I agree with the above but as there is a lack of transparency in the financial dealings of these companies, we do not know the full picture nor the quantum involved. Certainly it makes sense to re-invest a part of our revenue surplus whilst some of it should be used to support welfare programmes. The devil is in the figures. How much of our revenue surplus is transferred, for example?
  
  
• claudetnt

  8 Feb 06, 17:22

  It easy to dismiss the “cases” mentioned as “isolated incident” and move on to speculate and suspect the “reasons”! The bottom line is that the govt and the medical board do interfere with the pricing structure in Singapore, which you earlier claimed never happened in your 20 years of practice!
  
  I strongly suggest to our readers to “shop around” for your selves some expensive medications in Malaysia, Thailand, Australia and UK. The same applies to operations. The revelations will surely surprise many as to how our “subsidized” rates are cheaper in those countries.
  
  Many of us have been "conned" and unless we do the comparisons for selves we will never know!
  
  
• oxford mushroom

  9 Feb 06, 00:54

  Originally posted by claudetnt:

  It easy to dismiss the “cases” mentioned as “isolated incident” and move on to speculate and suspect the “reasons”! The bottom line is that the govt and the medical board do interfere with the pricing structure in Singapore, which you earlier claimed never happened in your 20 years of practice!
  
  I strongly suggest to our readers to “shop around” for your selves some expensive medications in Malaysia, Thailand, Australia and UK. The same applies to operations. The revelations will surely surprise many as to how our “subsidized” rates are cheaper in those countries.
  
  Many of us have been "conned" and unless we do the comparisons for selves we will never know!

  No, it has never happened to me. The incident you spoke about was more complex than a matter of pricing. There was also the issue of whether the clinic contravened the prohibition against advertisements.
  
  Before your readers take your advice and start purchasing medications in other nations, it is important to warn them that should they suffer ill effects from these medications they will have no legal redress. One reason why drugs are so expensive is because pharmaceutical companies can be sued if the medication fails quality assurance...heard of the 'Slim 10 'case? If you buy medication overseas on your own and suffer harm as a result, the Singapore authorities may not be able to help you.
  
  
• oxford mushroom

  9 Feb 06, 01:40

  WP manifesto- Healthcare: Containing healthcare costs
  On this issue WP advocates the setting up of a National Basic Health Care Council to decide on the question I have raised, as to what should be included in the basic hospitalisation insurance scheme. That is not very helpful since voters have no idea if what the WP is advocating is something better or worse than what is currently covered by the Medishield schemes. Deciding what should be included is much easier if we know how much money a WP government will pump into healthcare. If I know your budget, I can tell you what the menu will be.
  
  WP wants to study how advancement in medical technology can reduce rather than increase healthcare costs. As a doctor involved in medical research, I am not hopeful that advances in technology will reduce healthcare costs. Pharmaceutical companies are not charities. They fund research so that they can sell newer drugs that will increase their profits. A*STAR is pushing biomedical research so that Singapore can earn more money from advances in medical technology, not reduce spending. In recent years Singapore has earned quite a bit from the growth of the pharmaceutical sector. The people who have paid for our increased earnings have obviously spent more in healthcare. Advances in medicine have served to improve the length and quality of life, but at a cost. Far from reducing healthcare costs, embracing the latest that medical research has to offer will tend to increase healthcare costs. There are exceptions, but they are few.
  
  I think we can better reduce healthcare costs by administrative measures. There should be greater cooperation between the two healthcare clusters to share equipment and expertise, garner the advantage of their combined purchasing power to seek the best deal from pharmaceutical companies rather than functioning as separate entities.
  
  The WP suggests the use of IT to reduce administrative and manpower costs. That has happened already under the current government. Medical records are now electronic and made more easily accessible to doctors all over the island. This has increased efficiency but I am not sure if it has reduced administrative and manpower costs significantly. It is true that we will fewer clerks to retrieve case notes if they are all available electronically but I don't think that will make a dent in manpower costs compared to the capital and running costs of the IT systems.
  
  The WP has advocated outsourcing of health care delivery to reduce costs. Cleaning and non-core functions of the hospitals are already outsourced to a large extent. Instead of 50-year old amahs, we now have 19 year old Bangladeshi health attendants who can work harder and carry heavier loads. What about the retrenched amahs though? The Minister of Health is also looking into outsourcing some XR reporting to Bangalore and will probably happen.
  
  What other areas will the WP outsource next? Singaporean surgeons are among the most expensive in the world....can we outsource operations to Malaysia? Allow Medisave deductions for patients who have their surgery done in Malaysia or Thailand, as long as they are cheaper than those in Singapore? (However, patients will have to go to the Malaysian or Thai courts for redress if anything goes wrong). It would also be cheaper to locate our labs in JB to take advantage of the cheaper rental and infrastructural costs. It will not increase the turnaround time that much since reports can be accessed electronically over the internet.
  
  The last WP proposal under this section is already a MOH policy: to make public the costing of medical treatment by all hospitals. I might add another: would the government make public the salaries of hospital doctors? Those of us in the profession are already aware of it. Surgeons and eye surgeons in particular are the highest paid although there is no lack of doctors wanting to train in these disciplines. With annual pay exceeding 1 million a year for many top surgeons, who would want to be a psychiatrist, geriatrician, radiologist or pathologist? Should we go towards a system like the NHS in UK, where all specialists in public service are paid a similar amount, with higher pay for seniority and performance? The system in Singapore fails to ensure talented doctors go into all fields of medicine.
  
  
• claudetnt

  9 Feb 06, 10:46

  “---more complex than a matter of pricing. There was also the issue of whether the clinic contravened the prohibition against advertisements---”
  
  Please do not confuse the issue. The medical board stepped in due to pricing, nothing else! If the clinic had breached any laws then they should be brought before the court, why was this not done?
  
  ”---should they suffer ill effects from these medications they will have no legal redress. One reason why drugs are so expensive is because pharmaceutical companies can be sued if the medication fails quality assurance...heard of the 'Slim 10 'case? ---“
  
  Good advise! But how many Singaporeans are suing the pharmaceutical companies? The slim 10 case is an exception. Now, trying suing the European and American based pharmaceutical companies instead one of Chinese origin. Some of us who are less fortunate had experienced adverse effects from taking prescribed medications from both the government and private specialist in Singapore at sometime or another in our lives and do you think these specialist doctors had recommended that we sue the pharmaceutical companies? Of course, there are many reasons why the prescription may work for some and not for others but that is a separate debate. Even in the USA big pharmaceutical companies have professors / Universities / doctors in various hospitals and even in the regulatory agencies in their “pockets” to cover up such “cases” that had happened many times.
  
  let us be frank we, individuals, cannot WIN doing battle with the pharmaceutical companies even if we are right not even if the good doctors are on our sides.
• Libertarian

  9 Feb 06, 21:05

  The WP states that all should be provided with basic healthcare

  This statment sure sounds socialistic to me. In my opnion, universal healthcare is a bad idea. Because of a simple reason, it forces me to pay for others through increased taxes.
• Calvin86

  9 Feb 06, 23:37

  Originally posted by Libertarian:

  This statment sure sounds socialistic to me. In my opnion, universal healthcare is a bad idea. Because of a simple reason, it forces me to pay for others through increased taxes.

  Maybe we should remove school subsidy so that taxes are lower?
  
  Should we only donate money only after we build a personal Ten- Year Reserve?
  
  Singapore needs to be a more humane place. Yes we are good with money - So is Scourge the miser.
  
  We can roll out billions for Upgrading, we can demolish buildings that are still fairly new to build new infrastrature. Why cant we use some of it to help the poor in Singapore? Will we die not having lifts on every floor?
  
  
• ndmmxiaomayi

  10 Feb 06, 11:05

  Originally posted by Calvin86:

  Maybe we should remove school subsidy so that taxes are lower?
  
  Should we only donate money only after we build a personal Ten- Year Reserve?
  
  Singapore needs to be a more humane place. Yes we are good with money - So is Scourge the miser.
  
  We can roll out billions for Upgrading, we can demolish buildings that are still fairly new to build new infrastrature. Why cant we use some of it to help the poor in Singapore? Will we die not having lifts on every floor?
  
  

  Already said that education, health and defence is Singapore's main concerns. We have no resources but humans only. Removing school subsidy means a lot of students won't get a chance to study or get a minimum education. This is a knowledge-based economy, and having minimum education means we can't work. While experience counts, but knowledge counts too.
  
  Considering that Singapore's population is aging, I find that having lifts on every floor is not wasting of money. Unless, you want to build HDB flats that are meant for elderly only and another set of HDB flats for the young only. That would save us a lot of money in the long run. By having lifts on certain floors (flats for the young), we improve their health. And this reduces the need to always build new flats and demolish old flats.
• Calvin86

  10 Feb 06, 12:21

  Originally posted by ndmmxiaomayi:

  Already said that education, health and defence is Singapore's main concerns. We have no resources but humans only. Removing school subsidy means a lot of students won't get a chance to study or get a minimum education. This is a knowledge-based economy, and having minimum education means we can't work. While experience counts, but knowledge counts too. .

  There are many countries still striving without subsidies like US still striving
  
  

  
  Considering that Singapore's population is aging, I find that having lifts on every floor is not wasting of money. Unless, you want to build HDB flats that are meant for elderly only and another set of HDB flats for the young only. That would save us a lot of money in the long run. By having lifts on certain floors (flats for the young), we improve their health. And this reduces the need to always build new flats and demolish old flats.

  If you build lifts on every floor, Singaporeans would not even exercise that 2-3 storeys. An easier and cheaper solution would be allocating families with elderly parents staying together units at the lift level. Dont you think there are more innovative ideas to save money?
  
  Dont you think there is even an ounce of pork-barrel politics in the massive uupgrading?