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SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Debts!

makapaaa

Alfrescian (Inf)
Asset
[h=1]THE REALITY BEHIND THE MEDISHIELD LIFE HYPE[/h]
Post date:
1 Feb 2015 - 7:50pm








“Universal and basic coverage for all”, “reducing out-of-pocket payment”, “look at ways to help the elderly”. These are some of the buzzwords that the Government has used to sell its Medishield Life Bill. Now let's take a look at the reality.

Essentially, what Medishield Life has done is to take a portion of funds from your Medisave to pay for bills of patients who end up with catastrophic or chronic illnesses which require expensive treatments.

Many of these patients cannot afford to pay these bills and the hospitals end up having to write these debts off. In 2011, Singaporeans owed $110 million to public hospitals.

This presents the PAP with two problems: One, the Government is unable to collect the money because many of these patients genuinely cannot afford to pay the bills and, two, it makes the Government look heartless by making Singaporeans go into debt because of medical expenses.

The introduction of Medishield Life will allow the Government to take the Medisave funds from Singaporeans through Medishield Life premiums to pay for these debts. It will top up the shortfall of funds by about $800 million a year.

In principle, this is a step in the right direction. It is what the SDP proposes – everyone shares in the stake of the health of our fellow citizens by pooling the risks in a national healthcare insurance scheme.

The difference between the SDP's plan and the PAP's Medishield Life – and it's an important one – is that the PAP continues to place the burden of paying for healthcare on the people.

While the SDP proposes that Medisave be scrapped and the funds of $43,500 be returned to our CPF, the PAP insists that the Government retains this amount to pay for our healthcare expenses.
On top of this, Medisave payments are restricted, making the people pay even more from out of our pockets.

Also, the deductibles – the portion of the hospital bill that must be paid out of pocket before Medishield Life will pay the remaining expense – remains unchanged between $2,000-$3,000. Most routine hospitalisations fall into this category.

What's more, the Government claims that it subdises medical expenses. The SDP has questioned the Government's prices because subsidy of inflated prices is a gimmick (see here). By doing this, the Government not only makes the people pay more but also inflates its subsidy levels.

Such practices has allowed the PAP Government to shirk its responsibility and use public funds to do business all over the world through Temasek Holdings instead of focusing on the people's health.
healthcareexpenditure.png

The chart on the right says it all. While governments in most industrialised economies pay about 70% of the country's total healthcare expenditure, our Government pays only 30%.

Even with the added $800 million a year, its portion comes up to only 40%. The Government collects this amount in road tax alone.
Stop profiting from the people

Another point that Singaporeans must remember is that our public healthcare system is still a profit-making one. The PAP euphemistically calls this approach “cost recovery”.

This is consistent with its philosophy that nothing in Singapore is free, meaning that this Government considers itself more like a corporate entity than a steward of public interests and monies; it treats the people more like customers rather than citizens.







And because it thinks like a business, it will recoup whatever costs it lays out. This can easily be done by raising taxes or levies at some later stage.

The end result is that Singaporeans still end up paying the bulk of their healthcare expenses through their Medisave and out-of-pocket payment, leaving little in their CPF savings for retirement. This is not the right thing to do.

The SDP's National Healthcare Plan proposes that the Government increases its portion of the country's total healthcare expenditure. This can be paid for through a combination of paring down the Ministry of Defence's budget, levying a tax of luxury goods, abolishing GST for medical expenses, etc.

Only when the PAP stops trying to make money from Singaporeans in healthcare can it truly say that the Medishield Life is “universal and inclusive”. Until then, it will just be buzzwords that Singaporeans will see through.

For this reason, the SDP would have voted against the Medishield Life Bill in Parliament and tabled our alternative.
Singapore Democrats
Source: YourSDP.Org
 

mojito

Alfrescian
Loyal
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

But 70% of sinkies don't pay taxes. How will we pay our retinue of evil servants if we don't find more money?
 

osxcza

Alfrescian
Loyal
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

But 70% of sinkies don't pay taxes. How will we pay our retinue of evil servants if we don't find more money?

by bending down haha
 

Hans168

Alfrescian
Loyal
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

I agree with SDP in that this friggin govt profiteers from its own citizens - every time we turn a corner there is a tax, levy or fee etch waiting to pounce on us!
A govt which got prosperous on the bleeding of its pple!!!!!!!!!!!!!!!!!!!!!!!!!!!
 

Hans168

Alfrescian
Loyal
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

But 70% of sinkies don't pay taxes. How will we pay our retinue of evil servants if we don't find more money?

hello how izzit possible?...........GST is oso tax!!!
 

bic_cherry

Alfrescian
Loyal
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

[h=1]THE REALITY BEHIND THE MEDISHIELD LIFE HYPE[/h]
Post date:
1 Feb 2015 - 7:50pm

“Universal and basic coverage for all”, “reducing out-of-pocket payment”, “look at ways to help the elderly”. These are some of the buzzwords that the Government has used to sell its Medishield Life Bill. Now let's take a look at the reality.

Essentially, what Medishield Life has done is to take a portion of funds from your Medisave to pay for bills of patients who end up with catastrophic or chronic illnesses which require expensive treatments.

Many of these patients cannot afford to pay these bills and the hospitals end up having to write these debts off. In 2011, Singaporeans owed $110 million to public hospitals.

This presents the PAP with two problems: One, the Government is unable to collect the money because many of these patients genuinely cannot afford to pay the bills and, two, it makes the Government look heartless by making Singaporeans go into debt because of medical expenses.

The introduction of Medishield Life will allow the Government to take the Medisave funds from Singaporeans through Medishield Life premiums to pay for these debts. It will top up the shortfall of funds by about $800 million a year.

In principle, this is a step in the right direction. It is what the SDP proposes – everyone shares in the stake of the health of our fellow citizens by pooling the risks in a national healthcare insurance scheme.

The difference between the SDP's plan and the PAP's Medishield Life – and it's an important one – is that the PAP continues to place the burden of paying for healthcare on the people.

While the SDP proposes that Medisave be scrapped and the funds of $43,500 be returned to our CPF, the PAP insists that the Government retains this amount to pay for our healthcare expenses.
On top of this, Medisave payments are restricted, making the people pay even more from out of our pockets.

Also, the deductibles – the portion of the hospital bill that must be paid out of pocket before Medishield Life will pay the remaining expense – remains unchanged between $2,000-$3,000. Most routine hospitalisations fall into this category.

What's more, the Government claims that it subdises medical expenses. The SDP has questioned the Government's prices because subsidy of inflated prices is a gimmick (see here). By doing this, the Government not only makes the people pay more but also inflates its subsidy levels.

Such practices has allowed the PAP Government to shirk its responsibility and use public funds to do business all over the world through Temasek Holdings instead of focusing on the people's health.
healthcareexpenditure.png

The chart on the right says it all. While governments in most industrialised economies pay about 70% of the country's total healthcare expenditure, our Government pays only 30%.

Even with the added $800 million a year, its portion comes up to only 40%. The Government collects this amount in road tax alone.
Stop profiting from the people

Another point that Singaporeans must remember is that our public healthcare system is still a profit-making one. The PAP euphemistically calls this approach “cost recovery”.

This is consistent with its philosophy that nothing in Singapore is free, meaning that this Government considers itself more like a corporate entity than a steward of public interests and monies; it treats the people more like customers rather than citizens.


And because it thinks like a business, it will recoup whatever costs it lays out. This can easily be done by raising taxes or levies at some later stage.

The end result is that Singaporeans still end up paying the bulk of their healthcare expenses through their Medisave and out-of-pocket payment, leaving little in their CPF savings for retirement. This is not the right thing to do.

The SDP's National Healthcare Plan proposes that the Government increases its portion of the country's total healthcare expenditure. This can be paid for through a combination of paring down the Ministry of Defence's budget, levying a tax of luxury goods, abolishing GST for medical expenses, etc.

Only when the PAP stops trying to make money from Singaporeans in healthcare can it truly say that the Medishield Life is “universal and inclusive”. Until then, it will just be buzzwords that Singaporeans will see through.

For this reason, the SDP would have voted against the Medishield Life Bill in Parliament and tabled our alternative.
Singapore Democrats
Source: YourSDP.Org
More proof that the gahmen has ignored preventive healthcare for many years till now, which is why so many Singaporeans have chronic disease and much GDP wealth goes into treatment for essentially PREVENTABLE chronic disease...

Minister of Health Gan admits that ill-health among citizens today is a public policy planning mistake?
“If you look around, our investments in health promotion and diseases prevention, I think... it is actually significantly lower than the amount of money we spend on treating diseases,” he (Minister Gan Kim Yong) said.
: Due to a lack of "holistic approach towards health promotion, taking into account how can we empower consumers so that they make the right choice"
All this in the light of evidence that 'Healthy Lifestyle May Prevent 86% Of Heart Attacks' [Åkesson, A et al “Low-risk diet and lifestyle habits in the primary prevention of myocardial infarction in Men” J Am Coll Cardiol 2014; DOI: 10.1016/j.jacc.2014.06.1190.]

Poor Minister of Health Singapore, he is locking the stable door only after the horse has bolted...: a lack of "investments in health promotion and diseases prevention"...
s0ApnVw.jpg



The consequence of avoiding healthy lifestyle adoption/ change= 1 in 3 get diabetes, one new kidney dialysis patient every 5 hours in Singapore...
 

Confuseous

Alfrescian (Inf)
Asset
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

The PAP is like the fella who caused the accident and then offers to "help" you by repairing your car at their workshop, at their prices.
Huat ah!
 

shittypore

Alfrescian
Loyal
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

THIS IS wat LIP SERVICE is all about by Pay and Pay.
 

Papsmearer

Alfrescian (InfP) - Comp
Generous Asset
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

But 70% of sinkies don't pay taxes. How will we pay our retinue of evil servants if we don't find more money?

PAP take your CPF and pay you 2.5%. They then take the money and earn 17%, which you could have done yourself. That 14.5% difference is a tax or are you too stupid to know.
 

Papsmearer

Alfrescian (InfP) - Comp
Generous Asset
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

The main question I want to ask is why is the SDP coming out with this well thought out and researched piece instead of the opposition Workers Party? The WP is really a wayang party. This is an excerpt from the parliamentary debate. See how WP Png Heng Huat whole heartedly supports this fucked up bill:

By MP for Hougang SMC, Png Eng Huat
[Delivered in Parliament on 29 Jan 2015]

Madam, the proposed MediShield Life will address the fundamental issue of providing basic universal health insurance for all Singaporeans.


For Singaporeans with pre-existing conditions, it means a lot to be able to buy health insurance for their pre-existing conditions finally albeit at a higher premium. Medishield Life is taking a step in the right direction. I urge private insurers to ride on this and provide better coverage for those who need more benefits and to keep the additional premiums affordable since the underlying risk of covering someone with pre-existing conditions is already underwritten by Medishield Life.
 

yellowarse

Alfrescian (Inf)
Asset
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

MediShield Life – A leaky green umbrella

20 March 2015


Tan Lip Hong & Leong Yan Hoi

SDPMedishield.png


The Government has taken a step in the right direction by implementing MediShield Life, a national health insurance scheme that is both universal (covers everybody) and comprehensive (covers all illnesses). No longer will anyone be denied coverage due to old age, pre-existing illness, congenital conditions or mental illness.

Under-Insurance

However, one of the main inadequacies of MediShield Life is that it does not adequately cover large medical bills. In other words, it under-insures us, requiring us to still pay out large sums of money in the event that we fall ill, despite being insured. This is clearly evidenced by the fact that each of us is still required to maintain a huge Medisave balance for use in case of illness.

Below is a representation of the portion of a medical bill that is covered by MediShield (in green) versus the portion that is paid by patient, either out-of-pocket or via Medisave (in blue):


medishield-chart1.png


Note that of the total bill, MediShield Life only covers the green portion. The blue portion is paid out by the patient. Note also that the claim limits – for each day’s stay in hospital, for surgery, procedures, medicines and ICU stay – are based on subsidised B2 class bill sizes.

As can be seen from the above diagram, the two main factors contributing to the problem of under-insurance as regards MediShield Life are the high deductibles and low claim limits. In cases with small medical bills, the high deductible forms a relatively large portion of the final bill and poses a significant barrier to patients from low-income households, thus limiting healthcare access.

On the other hand, in cases with multiple complications, or multiple or severe illnesses, the overall bill can become very large, and the portion above the claim limit becomes very significant. In this case, the portion (in green) paid out by MediShield Life remains capped, and the portion paid by the patient (in blue) gets proportionally greater the larger the bill size. This is especially true if the person is means tested to receive less subsidy, or if the person stays in a B1 or A class ward.

In the MOH’s own example of a fully subsidised low-income patient admitted to a B2 class ward for a heart attack the total bill after government subsidy comes to $8,100. Of this, MediShield Life pays $5,645, and the patient has to pay $2,455, which is 30% of total bill size! This is a very large proportion and amount for a nationally insured, low-income person to pay.

The unsubsidised (B1 or A class) bill would come to at least $18000. Of this, MediShield Life pays a maximum of $$5,645 (31%), and patient pays at least $12,355 (69%).

And for bill sizes in excess of $50,000 – $100,000, the out-of-pocket payment will wipe out all savings in one’s Medisave account, and that would still be insufficient.

It can be seen that MediShield Life is not structured to insure patients against large medical bills. What then is its purpose?

Large Sums Remain in Medisave Accounts

Due to the severe inadequacies of MediShield Life, each of us remains poorly insured against large medical bills.

This is the reason that we are all compelled to continue to keep large amounts of money in our Medisave accounts. The Minimum Sum for each citizen was $43,500. This has been increased to $49,500, and re-named the Basic Healthcare Sum. This is a huge sum for the majority of Singaporeans, and yet it remains barely sufficient to cover the co-payment of large medical bills even with the implementation of MediShield Life.

The government has also been touting MediShield Life premiums as being ‘affordable’, with annual premiums of around $400 for middle income working adults, and about $1,000 for the elderly. However, this ‘affordability’ is meaningless when the majority of citizens are severely under-insured against large bills by MediShield Life, and all working adults have to continue paying large amounts of money, equivalent to 7 – 9.5% of one’s monthly wages (at least $260 per month or $3,120 per year for a median income earner of $3,700), into one’s Medisave account.

In total, there is $71 billion (as at 2014) sitting in members’ Medisave accounts, largely sitting idle. And the total Medisave balance has been steadily rising over the last 5 years (see chart below).

medishield-chart2.png


Instead of locking up our monthly Medisave contributions in individual accounts, the money should be pooled together towards a proper National Health Insurance scheme that adequately covers all medical bills, with affordable co-payment.

Over-charging for coverage – huge profits made by CPF Board

In any health insurance scheme, there are methods to prevent the health insurer from over-charging the insured for health insurance. In America, under ObamaCare, private profit-making health insurance companies are restricted in the amount of profit they can make out of health insurance schemes. This calculation is based on the total money paid out for claims versus total premiums collected in a year. The ratio above is known as the Medical Loss Ratio (MLR).

ObamaCare mandates by law that the total pay-out for claims has to be at least 80% of the total premiums collected:


Total Claims paid out
––––––––––––––––––––– > 80%
Total Premiums collected


This ensures that not too much premium is collected so that the insurance companies do not make too much profit (in this case a maximum gross profit of 20% before expenses).

The table below shows the MLR and ‘profit’ that MediShield has made over the past few years:

medishield-chart3.png



It can be seen that MediShield has only paid out an average of 64% of the total premiums it has collected yearly in the years 2008 to 2013, the rest (36%) being profit before expenses. In this way, the CPF Board has managed to accumulate huge (untouchable) reserves from our MediShield premiums.

In 2013, the percentage of claims paid out reached an astonishing low of only 43%. This means that less than half of the premiums collected was paid out in claims! When this issue was brought up in parliament, the government, instead of acknowledging this over-charging of premiums by MediShield, justified this over-collection by citing a different ratio: Incurred Loss Ratio, used by profit-making entities.

Until this government commits to putting in place measures like the capping the MLR to ensure that we do not overpay for MediShield Life, there remains no assurance that huge profits will not continue to be made in the name of national health insurance in Singapore.

Structure and Transparency

MediShield Life continues to be structured as a profit-making scheme with loading and risk stratification to reduce risk to the insurer (CPF Board). Pay-outs are capped at the expense of the insured, and profits by the insurer are not controlled. Additional complicated ‘premium subsidy’ schemes make the entire enterprise less transparent.

Other Major issues in Healthcare Financing not addressed

The government has also not addressed the other major healthcare issues we face in Singapore:

1. Underinvestment by the government in healthcare in

(a). Infrastructure and manpower – long queues, over-crowded hospitals operating at over-capacity, long waiting times

(b). Running cost – thus requiring citizens to have to pay out huge lump-sum payments

2. Inequity of provision of service – A class patients get immediate attention while B or C class patients have to wait months

3. Ballooning healthcare costs

There has been a huge ballooning of healthcare cost in Singapore over the last few years. The table below shows available figures released by the government for healthcare cost and spending from 2011 – 2015:

medishield-chart4.png


The government has said that it will spend about 40% of THE. This makes the THE for 2014 about $17.75 billion, and that for 2015 in excess of $20 billion.

This is a frightening increase in numbers. Part of it is due to the catching-up as a consequence of under-investment in the past by the government, and part of it is due to the sudden increase in population. A significant portion is due to the aging population.

However, a large part of it is due to the increase in the cost of healthcare itself.

In this situation, it is irresponsible of the government to only talk about limiting Government healthcare spending, and not deal with the elephant in the room – the extraordinary increase in the total cost of healthcare in Singapore, and to continue to encourage and lead the way in making huge profits from the provision of healthcare.

What is needed is a thorough review of ways to contain the cost of healthcare.

If this is not done, then we are leading ourselves into a perfect storm of spiralling healthcare cost and unaffordable healthcare, where the leaky green umbrella of MediShield Life will be of no help to anyone at all.


Dr Tan Lip Hong & Dr Leong Yan Hoi are members of the SDP Healthcare Advisory Panel.

* * *

The SDP Healthcare Advisory Panel presented the SDP National Healthcare Plan in 2012. The report is divided into 2 equal parts, dealing with: (a). A detailed plan of how we can set up a truly universal, comprehensive, equitable and affordable National Health Insurance Scheme that provides adequate coverage for all. (b). The measures we can and should take to contain the ballooning cost of healthcare in Singapore.
 

mojito

Alfrescian
Loyal
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

The reason why Medishield payouts is only 64% of total premiums collected while ObamaCare mandates a payout of at least 80% is simple. US healthcare is expensive while Sg healthcare is cheap. For that, you have to thank the PAP.
 

yellowarse

Alfrescian (Inf)
Asset
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

The reason why Medishield payouts is only 64% of total premiums collected while ObamaCare mandates a payout of at least 80% is simple. US healthcare is expensive while Sg healthcare is cheap. For that, you have to thank the PAP.

If SG healthcare is cheap, then why collect so much premiums? Excess premiums in compulsory policies are a form of taxation. Duh ...
 

mojito

Alfrescian
Loyal
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

If SG healthcare is cheap, then why collect so much premiums? Excess premiums in compulsory policies are a form of taxation. Duh ...

Do u look for toilet paper only when you go to the jamban? Of course you must keep a little extra for a rainy day.
 

eatshitndie

Alfrescian (Inf)
Asset
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

Do u look for toilet paper only when you go to the jamban? Of course you must keep a little extra for a rainy day.

me stash 4 extra rolls in my jamban counters as insurance policy just in case 1 roll cannot handle the shit.
 

winnipegjets

Alfrescian (Inf)
Asset
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

But 70% of sinkies don't pay taxes. How will we pay our retinue of evil servants if we don't find more money?

Government already makes loads of money ...HDB flats and COE. It has more than enough money.

And it makes from your CPF too. It earns 7 percent return but pays you 2.5 percent, that's 4.5 percent of $300 billion going to the government which should have been in your CPF account!
 

winnipegjets

Alfrescian (Inf)
Asset
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

Do u look for toilet paper only when you go to the jamban? Of course you must keep a little extra for a rainy day.

There are more than enough toilet paper if the government doesn't hoard it and raise the price of it.
 

winnipegjets

Alfrescian (Inf)
Asset
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

The reason why Medishield payouts is only 64% of total premiums collected while ObamaCare mandates a payout of at least 80% is simple. US healthcare is expensive while Sg healthcare is cheap. For that, you have to thank the PAP.

That's baloney. Healthcare in sinkapore is NOT cheap by regional standard. If you want to compare sinkapore with US, why don't you compare the cost of living, housing etc. You can't pick and choose to justify your bs.
 

JohnTan

Alfrescian (InfP)
Generous Asset
Re: SDP: Real Purpose of Medishield Life is To Take SGs' Medisave to Pay Hospital Deb

SDP is full of shit. We have medishield life to take care of sinkies' hospital bills. Didn't your local grassroots leaders explain it clearly enough to you?
 
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