MOH should stop sponsoring the rich at the expense of the poor.
It is unjust for Ministry of Health (Singapore)(MOH) to be blindly subsidising medishield-life premiums REGARDLESS of whether a person has an integrated (upgraded/ enhanced) medishield-life healthcare insurance plan (+/- riders) because many integrated-life plan holders are actually/ relatively much more wealthy people who DO NOT DESERVE any medishield-life subsidies even if they satisfy the MOH sole 2 criteria towards their award: namely: low income and low annual value of residence address (the latter 2 criteria are easily faked by under-declaring one's salary scale and replacing one's residential address with a relative who stays in a cheaper/ smaller public housing unit).
In addition, it is reported that person's with medishield-life integrated plans, with or without riders submit 20-25% higher claims on a per-capita basis upon the common pool medishield-life insurance fund. (see report: 'Insurers want all patients to pay part of hospital bills' as appended below).
MOH must thus establish equitability and be prudent in its use of government funds by DISALLOWING any citizen owning ANY integrated medishield-life healthcare insurance plan from receiving ANY form of medishield-life insurance subsidy whatsoever at all, regardless of how low their income level or registered residential address (which at times may be outdated or deliberately faked (so as to obtain increased undeserved benefits other government subsidy schemes such as the annual GST credits, CHAS healthcare subsidies scheme for instance)).
In fact, those who own any form of enhancement over and above the plain vanilla basic medishield-life national healthcare insurance plan should either have their medishield-life basic claims payouts reduced by 20-25% or have their basic premiums raised by 20-25% in line with this cohort increased claims record in order not to place an excessive economic burden upon the poor who in comparison, make 20-25% REDUCED claims upon the basic medishield-life insurance fund pool as compared to the well-insured rich who leverage the generous payouts of their integrated (enhanced/ private) healthcare insurance plans to make 20-25% higher claims out of the national common pool.
A person who can afford to UPGRADE his basic compulsory medishield-life national healthcare insurance plan into an integrated (enhanced) one and even more so, add on riders to afford either 100% waiver of all medical costs or special VIP privileges cannot possibly be described as poor even if he claims to live in a small house or reports a low income. In a police state like Singapore, all insurers have to be licensed to operate in Singapore and the government knows exactly whom and how many people own integrated medishield-life healthcare insurance plans: it is thus unconscionable for the Singapore government to continue upon its immoral ways of sponsoring the rich at the expense of the poor.
I would thus like to propose that the MOH:
Firstly: suspend all medishield-life basic level subsidies to anybody owning an integrated medishield-life plan or higher,
Secondly: monitor the claims records submitted by the 6 healthcare insurance providers of the integrated medishield-life insurance plans for their claims record per-capita upon the common basic medishield-life insurance pool to see if the claims per capita remain 20-25% higher: if so, then perhaps a levy upon all private insurers (e.g. Prudential, Great Eastern, NTUC, AIA etc) equal to the increased claims history of their customers should be imposed so as not to burden the majority poor who are by compulsion, also forced to pay premiums to the common pool only to benefit the rich who leverage upon integrated/ enhanced insurance plan riders to make larger claims to the detriment of the remaining poor.
Over generous subsidies by MOH to the rich and wealthy is the main reason why Singapore's GST (/VAT) (a regressive tax) is scheduled to increase between 2021 and 2025 from 7% to 9% http://www.straitstimes.com/singapore/si...1-and-2025 MOH should stop just throwing $$$ at the problem, use medical subsidies as a vehicle for vote buying or medishield-life subsidied as a siphon of $$$ to the rich. Excessive healthcare consumption shouldn't be encouraged and instead of incentivising the purchase of healthcare insurance plans, MOH should incentivise heath and fitness attainment in society by providing subsidies based upon IPPT scores, % body fat levels, resting heart rate levels etc, all of which are parameters correlated with REDUCED healthcare costs claims. MOH should thus stop navel gazing and its wasteful, regressive, inequitable and ineffective policies involving the throwing of good money after bad.
'Insurers want all patients to pay part of hospital bills' ST pg A1, 7 March 2018.
Proof that MOH uses only the blunt and inaccurate measure of declared income for the disbursement of subsidies, these criteria can easily be satisfied by false/ under-declaration of income and residential address. The ownership of coverage enhancements such as an integrated plan and even riders should be considered a sign of wealth on par with the weightage of annual value of residence by residential address being the current approximate measure. The ownership of enhanced insurance plans is also less likely a measure subject to fake/ corrupt reporting since insurance companies are audited and also by protocol forward proportionate claims to the MOH medishield-life basic fund pool, unlike the easily achieved misrepresentation of relative's HDB address as personal residential address to corruptly receive increased government prescribed welfare credits.
Singapore MOH medishield-life 2015 age specific premium, subsidy table for various income group brackets.
Alt img source URL: https://imgur.com/QybxnEM.jpg
Same topic at another forum/ thread:
Tremere (HWZ) said:You write in to ST and MOH with your suggestion lor.
Will write to my MP first.
MOH must STOP SUBSIDISING unmeritorious needs so as to keep GST (regressive tax) low.
In fact, Heng Swee Keat has said that even with 2% increase in GST, the 2% increase is projected to be INSUFFICIENT for healthcare needs...
Thus there is an urgent need to trim fat from the system, people who leverage upon medishield-life integrated plans (enhanced versions sold by private insurers linked and in addition to basic medishield-life plans) should be considered well to do people and given ZERO medishield-life basic subsidies.
In any case, they all leverage upon their private 'integrated' plans and riders as well to rob the system of 20-25% higher claims 'Insurers want all patients to pay part of hospital bills' ST pg A1, 7 March 2018., thus subsidising who can afford an enhanced basic medishield-life insurance plan ('integrated plan') should immediately be BANNED from receiving any basic level premium subsidies and should their higher claims pan out, then they should also be charged a 20-25% surcharge on the medishield life basic portion of their integrated healthcare insurance plan.
Sim Tian said: Not true..medical bills can bankrupt anyone rich or not depending on the condition and length.
Just because medical bills can bankrupt anybody doesn't mean that gahmen should subsidise healthcare insurance for the rich, especially those who merely game the system and PRETEND to be poor but are actually very rich based upon their purchase of expensive healthcare insurance riders and enhanced healthcare insurance plans... once again, pls don't misuse future claims of high healthcare costs as a weapon to rob the poor in Singapore by increasing GST just to pay for the rich to use expensive private hospital VIP suites when they are ill.
Since gahmen has already mentioned that class C (lowest class) medical treatments are as good a standard as A1 (highest) class (see link/ pict below) treatment minus bells and whistles like air-con, private TV, telephone and single toilets, anyone demanding extra luxuries should be expected to pay MORE especially for healthcare insurance premiums.
The only REAL INSURANCE (defence) against astronomical healthcare costs is firstly to keep healthy and fit by regular medical check ups and % body fat analysis since the occurence of diabetes and subsequent sequelae such as cancers, strokes and heart disease are closely related to the chronic (silent) suffering from hypertension, Diabetes, high cholesterol, smoking etc, all essentially related to the lack of exercise (pls see http://sgtalk.org/mybb/Thread-MECHANISM-...g-activity for the mechanism by which regular areobic exercise prevents diabetes, cancers and heart disease).
Only persons with proven congenital genetic diseases should be exempted from paying hospital bills to the extent that their conditions are solely related to their congenital conditions and not due to failure to exercise or maintain a healthy lifestyle.
It is better for an irresponsible individual to become bankrupt from high healthcare costs to control/ reverse (rarely) the damage done from years of neglect of personal health than for THE WHOLE COUNTRY GO BANKRUPT paying for an individual case of personal irresponsibility and indescreation in overpriced and outlandish private hospital settings and all citizens fall into depression.
Except to be adopted by populist and corrupt politicians out to win by hook or by crook/ buy votes, your suggestion is rather myopic and remains detrimental in the long run to the entire nation.
Medishield-life turns out to be a scam that robs poor people in Singapore?
Sadly, I read in the papers that the rich who can afford the highest level medical insurance plans are probably the biggest/ worst exploiters of the compulsory national healthcare insurance scheme in Singapore. As it is reported in 'New riders for IP plans will include co-pay feature' [ST, 08 March 2018]: "People with full riders have bills that are 60 per cent higher than those without riders." http://www.straitstimes.com/singapore/he...ay-feature
As I understand, the 60% difference refers to the difference between already rich people: i.e. the rich (own just medishield-life integrated plans) vs the ultra rich (own insurance riders in ADDITION to the integrated plans). As compared to the poor (only have compulsory basic 'medishield-life'), the difference cannot be more stark since as the example highlighted by Mr Gilbert Goh (appended below or at https://www.facebook.com/goh.gilbert/pos...nref=story ) some poor Singaporeans skip medical treatments due to inability to afford transportation costs. Having more comfortable care at government and private hospitals may also mean that richer patients live longer and thus stand to benefit from the concept of 'pre-funding' since poor people finding it hard to physically transport themselves to medical care locations implicitly benefit less from the compulsory national healthcare insurance scheme since they will die earlier for reasons of transport costs difficulties and other obvious benefits ONLY available to private integrated medishield-life insurance coverage such as pre/post hospitalization care, cancer immunotherapy, prosthesis benefits, ability to port care benefits to other parts of the world (evacuation costs, overseas treatments) etc. 'Role of pre-funding' https://www.moh.gov.sg/content/moh_web/h...ding-.html
I thus will not be surprised that based upon the concept of 'pre-funding', the shortened life expectancy of poor people, the ability of the rich to afford higher quality/ comfort care / greater options, medishield-life has inadvertently (?or by design?) become a means by which the poor are now implicitly if not explicitly funding the healthcare/ treatment costs for rich people.
My suggestion to this obviously obtuse, inhumane, unjust and untenable system of exploiting the poor is to stop any one subscribing to any integrated shield plan or worse still, insurance plan riders (conferring further medical fees waivers) from receiving any subsidies usually accruable to the basic medishield-life portion of the insurance plan. To provide subsidies to anyone who can afford to subscribe to integrated shield plans is a travesty of justice akin to funding private taxi fares (which is an obvious luxury as compared to public transport (bus/ MTR fares)), to fund people subscribing to any integrated medishield-life plan with an additional rider would be like providing subsidies for people who want to own their own automobiles (just because they under declare their income tax or report a small dwelling place as their residential address): an obvious squander of government funds and worse: complicity in the robbery/ exploitation of the poor since as earlier described, any person who gets a deliberate/ unfair 60% (upwards) upperhand in the nett 'access' to common pool medishield-life funds obtained under the communist/ socialist concept of compulsory 'pre-funding' reveals the gross injustice implicit in the design of medishield-life that blindly subsidises holders of private healthcare insurance plans; which obviously will erode national cohesion and trust in government in the long run.
Instead of disbursing medishield-life subsidies liberally (indiscriminately) like one distracts children with cheap candies, a more targeted carrot-stick based upon health consciousness can keep overall cohort medicals claims costs low: e.g. maintaining a low % body fat (below 15% for males and below 25% for females), performing well in fitness tests (modeled after universally used military fitness test like IPPT, with swimming/ cycling alternatives), non-smoking status are all very good (anti-diabetes) options to consider for substantive 'earned' waivers from the costs of premiums for compulsory medishield-life which can be implemented on a national level, as well as the total banning of the use of riders, would make the basic medishield-life scheme a more trusted medical insurance scheme whereby the concept of healthcare insurance returns to the original philosophy of insuring calamities which are unpreventable by doing everything within control to avoid the avoidable (e.g. type 2 diabetes due to sedentary lifestyle, high% body fat causing diabetes etc). Rather than a sneaky way for the rich to siphon $$$ from the poor to fund their own irresponsible and lavish lifestyles in the ultimate tragedy of the commons and let Singapore go bankrupt due to the lawless, free for all, self-serving buffet syndrom mentality, the result of an extremely poorly planned and executed national healthcare insurance policy.
Visited a 50-year-old man who skips his medical appointment twice because he could not gather enough transport money to visit the doctor. He is suspected to have initial stage of cancer of the pancreas and liver. He lost about 30 kg from his previous weight and looks jaundiced.
He also owes a few months of utilities, rental and town council charges but feels most worried about the rental debts as HDB has dropped by already to check on him. He is afraid of losing the home though I assured him that so far HDB has not go hard on rental defaultors unlike purchased flat owners.
Surprisingly, SSO has rejected his welfare application citing that he still has a son who is now working as an intern earning $1200/month. His Malaysian wife is currently back in Malaysia undergoing dialysis for her diabetic condition. Of course, the SSO wants him to get back to work but his ill health and frail body are not helping him much.
He is currently awaiting approval from Comcare side after visiting his MP.
I left Jefri after leaving him with a small amount of cash for his meals and assured him that we will assist in one way or another.
A regular donor has pledged $500 to offset the $600-over rental default and someone has already paid $100 into the SP bill. At least he will have a roof over his head as he nurses his health slowly back to normal.
Apologise that the video is abit soft and last five minutes.
Poor People's Campaign: a ground-up community initiative to improve the living condition of the poor among us.
Everyone must compulsorily conform to the concept of 'pre-funding', however, ultimately, it is the poor who paradoxically subsidise the rich since the rich (leveraging upon insurance 'riders') get to claim 60% more (even after proration is considered):
Reply from MOH
27 Nov 2013, Straits Times
Role of pre-funding
WE THANK Mr David Boey ("Problems with pre-funding"; Nov 19), Ms Maria Loh Mun Foong ("Merits of pre-funding"; last Thursday) and Mr Tan Kin Lian ("Pre-funding not feasible for MediShield Life"; Forum Online, Monday) for sharing their views on the concept of pre-funding for MediShield.
The letters from Mr Boey and Ms Loh may have created the wrong impression that the proposed pre-funding concept will require the younger generation to cross-subsidise the current elderly.
For MediShield, the pre-funded amount contributed by each cohort is set aside for the future use of their own respective cohorts, and not used to cross-subsidise the current elderly.
To address concerns over affordability of premiums among the current cohort of elderly Singaporeans, the Government has indicated its plans to provide help for the older generation of Singaporeans.
As noted by Mr Tan, health-care costs tend to be higher for the elderly. This, plus the effects of medical advancements and changing expectations, will put further upward pressure on future premiums as we age.
For this reason, it will be even more important to set aside some premiums in advance, or pre-funding, to address concerns of premium affordability during old age.
With pre-funding, members pay higher premiums during their working ages and, in return, can receive rebates to offset their own future premiums when they grow old.
With the ongoing review and enhancement of MediShield to MediShield Life, one of the key issues the MediShield Life Review Committee hopes to engage the public on is increasing the role of pre-funding. The committee welcomes all Singaporeans to provide their feedback or sign up for upcoming discussion sessions through http://www.medishieldlife.sg
Ministry of Health