24yrs MOH Mistake to allow Public Healthcare Insurance to Fund Private Hospitalization costs.

[bic_cherry]

24yrs MOH Mistake to use Public Insurance System to fund Private Hospitalization costs.

And the expansion of medishield into medishield-life (2015) just magnified and aggravated these mistakes...

Isn't medishield-life like a form of National Service / income tax, with fixed parameters (e.g. 2yrs duration)/ universally applied income tax scale designed to be fair and equitable to all citizens?

source : https://www.moh.gov.sg/content/moh_...medishield-life/medishield-life-benefits.html

Medishield-life by definition and reason for conception, is as an insurance against extremes of PUBLIC hospitalization costs and intrinsic to its design is the need to pay deductible and co-insurance (3-10%) as a deterrent against people living unhealthy lifestyles and thus requiring AVOIDABLE hospitalization for AVOIDABLE lifestyle diseases.

This deterrence effect against unhealthy lifestyles should apply across the board and like NS, cannot be shortened/ waived with the payment of a bribe/fee.

Whether officer or private rank in NS, all NSF serve the same 2yrs. NS also applies to all Singapore citizens even if they reside/study abroad/ plan to migrate in future.

Ditto income tax for all income earned in the world (except for the case where Singapore has mutual agreements with foreign governments to tax based on earned income location).

In the case of BOTH medishield-life AND NS, non-compliance will result in a jail term as well as compensation payment to the government in lieu of default.

As such, Medishield-life ought operate upon the same universal principles as NS, which means all integrated medishield-life plans should adhere to the same deductible and co-insurance requirements as basic medishield-life, meaning that anyone who wants to enjoy the blank cheque/buffet style benefits of 100% cover (free from deductible /co-insurance)/ private hospitalization cover should buy their own separate private hospitalization policy but first pay medishield-life basic premiums.

Integrated medishield-life plans should only be used to cover A and B1 ('private') wards in PUBLIC hospitals (deductible and co-insurance rates unchanged across all medishield-life based plans) and should NOT apply to private hospital use.

Just as all national taxes are pooled to support public transport, police/ fire service, people have the option of using private car transport/ attend private schools /home school/ private security at their own personal costs but that doesn't discount their national duty to pay personal income tax etc to fund these public goods.

Likewise, those who want private hospital (or 100% as charged public hospital A/B1 ward) cover should buy their own private health insurance at own costs and medishield-life should be treated like a form of income tax/national service which they have to contribute to (even if medishield-life only covered PUBLIC healthcare costs) because it is classified as a public insurance / necessity /public good. Claims from private insurers or medishield-life should be mutually exclusive: i.e. a bill can be claimed vz either process but not both (just like home schooling/ pte transport use doesn't afford one discounts from NS/ income tax payment).

The consequence of MOH policy mistake is seen today in the fact that rich people with riders are exploiting the poor by making double (approx 2.04 times* or even more ) as much as is claimed by the average medishield-life policy holder: akin to broad daylight robbery of poor Singaporeans.

Riders providing a blank cheque/ promoting buffet syndrome amongst private sector doctors and patients respectively only causes more public sector doctors to abandon public hospital patients for the lucrative private sector because the MOH (PAP gahmen) is complicit in robbing the poor to make private sector doctors rich by allowing rich people (exploiting the rider and ABSENCE of public healthcare limitation loophole), to evade fundamental location, co-insurance and deductible rules which are a main pillar in the design of medishield originally and its subsequent expansion into compulsory medishield-life- i.e. to misuse/ exploit a highly structured and focused national PUBLIC hospitalization insurance program into one that offers blank cheques and buffet style PRIVATE healthcare consumption for the privileged few who exploit glaring loopholes of a public hospitalization insurance plan for their limitless private hospitalization buffet syndrome demands.

PAP thus needs to admit its 24yrs old MISTAKE of allowing an essentially public hospitalization cover to be misused/ misdirected for private hospitalization use in order to make medishield-life sustainable and affordable for the common man on the street.
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References:
Medishield was started in 1990 and integrated plans with riders allowed in 1994 https://www.todayonline.com/singapo...l-new-integrated-shield-plans-full-riders-moh

"rich people with riders are exploiting the poor by making double (approx 2.04 times* or even more ) as much as is claimed by the average medishield-life policy holder" see article 'PAP gahmen is SQUANDERING tax payers $$$ and IRRESPONSIBLE with Medishield-life funds.'

 

[bic_cherry]

I thought Medishield.life only cover public hospital. Then those who want private pay hthe additional premium from insurance companies that offer this.

The reason is that it makes no sense to buy 2 separate insurance one for public.the other for private if one intends to be covered for private only bease oNE of them wIil be wasted...hence they "integrate" the plans so that it is one policy. whatever extra incurred for private hospital is in extra they need to pay in premium it is not build into the basic Medishield.life . Medishield.life in itself has no subsidy, subsidy is for the poor who cannit aford premiums. ..only class B2 and C hospitalization has subsidy. So nowhere is tax $ used to subsidize private hospital stay.

Problem now is one can pay premium to circumvent copayment and deductibles intended to address the buffet effect. So once everything is covered by insurance they go for treatment often...so now they are looking at this.

claiming more and more often for treatment often is a result of behavior. ..driven by flaws in the scheme that need not be addressed by separating the integrated plans. If one is required to buy 2 insurance and but use only one is even more problematic..

one way is to compute the high frequency of use of insurance riders into the rider cost itself to account for the buffet behavior of those with riders. The rider costs will go up and be discouraged. It makes no sense for the rest of the people to be penalized by behavior of those who bought riders.

Whilst it is true that riders for integrated plans covering private hospital treatments seems the problem, that is only the tip of the iceberg.

Medishield-life should be treated like NS, poll tax, income tax, GST or even COE etc and its outcome a public good like fire/police department/ public transport/public libraries which are funded from general taxes collected.

Integrated plans should only be used to cover for higher class (A and B1) wards in public hospitals and those intending to receive private hospital care should pay their own costs/ separate insurance just like they do for private car transport, private school attendance, private security service etc.

Every insurance has some limits or the holder might one day find the premiums too high and stop subscribing, thus everyone must contribute to medishield-life just incase they encounter a very high bill @public hospital (high bills @ private hospital shouldn't be Singapore gahmen problem/ immediate concern).

Likewise, almost every private car needs to pay for COE (except for vintage cars which have separate heritage rules). Owners who drive under ERP gantry, park at private/public parking, drive into Malaysia just have to pay whatever extra based on their choice of 'private' services used and even owners who don't drive the car at all (just for show off) have to pay COE regardless, likewise medishield-life which should be strictly limited (even for integrated plans) to use only at public hospitals.

Duplication?: in some ways yes, but its just like the police force, fire department and public libraries, I have never come across a rich person with private security, fire proof home/ private library access who refused to pay income tax, GST etc just because he claims little need for these 'duplicate' public and private goods since mishaps do happen: e.g. private hospital bill exceeds private insurance cover necessitating downgrade to public hospital or eventual ill affordability of private hospital insurance coverage.

Also public funds shouldn't be funding blank cheques towards private hospital treatments which attract public doctors towards private hospital practice, which is an especially wicked/ nefarious situation when the source of funds is robbed from poor people, whose funds are now ironically being siphoned off by rich people (who overall claim > double) to hijack /bribe away the public sector doctors originally treating them (the poor @public hospitals) by flushing the private hospital system with blank cheques robbed from the poor.