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30% jump in Class C hospital bills since 2006.
"The Ministry of Health (MOH) puts this
down to multiple factors - including a
greater number of more ill and older
patients, and patients asking for
non-subsidised drugs and implants.
" - Straits Times 8 Jan 2011.
Saturday, January 08, 2011
Is the MOH blaming the rising cost
on the old and sick? Didn't the govt
implement means testing that would
have caused the hospital bills to escalate?
Didn't the govt plan to make Singapore
a medical hub for rich foreigners causing
a strain on our resources and cost to spiral up?
In an earlier posting, I pointed out that
the Medisave Minimum Sum has been
raised at an annual rate of roughly 7%
[earlier posting here] - that translate to
a rise of about 30% for 4 years. When
I posted that, I speculated that the
increase may be linked to rising cost
of medical care in Singapore and this
is a concern because it is rising much
faster than wages. Based on the figures
released by the MOH, class C bills have
increased 30% in 4 years. If you look at
the average bill across all ward classes
and hospitals we see a jump of more than
50%. The bills at a few of the hospitals
have doubled. Look at the table below:
When you read the table you have to be
very careful not to misinterpret the data
given which is average and 95 percentile
bill figures. For those not familiar with
what goes on in a hospital they might
think that the figures still look okay
because they are under $10k for
95 percentile. A typical hospital handles
numerous small cases e.g day surgeries,
short stay for a few tests, hospitalization
for observation (chest tightness, shortness
of breath, pain etc). These small cases
overrun the statistics and the very big
bills are concentrated on a small number
of cases when a person has a serious
illness so what they should publish is
the average of the top 5% of the bills
or average of, say, the top 1% of the bills.
Showing the 95 percentile is misleading
because it misses the very big serious
cases - the type that we are afraid would
hit us once in our lifetime. Deficient as it
is, the numbers are useful in showing
that cost has escalated sharply in the
past 4 years.
Minister Khaw had this to say about the
massive increase in medical cost:
"The bottom line : We have good
high-standard public hospitals that
are affordable because of the 3Ms"
-Minister Khaw
Affordable? In the same sense as
Minister Mah when he said housing
is still affordable after prices jumped
by 60% in 2 years As for the 3Ms, it is
full of holes. Many self-employed
individuals don't have Medisave,
hundreds of thousands are not insured
[Link] and for you to get Medi-fund
you have to exhaust all your savings,
live in a home and have kw enough
income to pass the criteria for receiving
Medifund. It is more dangerous for
Minister Khaw to say that medical care
is affordable than for Minister Mah to say
that HDB flats is affordable. For HDB flats,
everyone knows the truth but for medical
care many don't know what is going on
until they get seriously ill ....then it is too
late. There many holes and gaps that
people can fall through. Take Medishield,
many people are still on Basic Medishield.
Basic Medisheld has limited payout for
hospitalization/surgery that is now
insufficient for the 'catastrophic illnesses'
it is designed for because hospitalization
cost has escalated. In 2005, Enhanced
Medishield was introduced. However,
many people developed various pre-existing
conditions or are not aware and didn't
upgrade to the new insurance. The word
"enhanced" is actually misleading because
it gives people the impression that it is
unnecessary. It is essential for you to
move to Enhanced Medishield because
Basic Medishield is inadequate and will
expose you to great financial risk. In
fact Basic Medishield no longer offered
to new Medishield applicants. Please
double check your Medishield policy to
make sure you're on Enhance Medishield.
Even Enhance Medishield has cracks you
can fall through. Under Enhance
Medishield there is co-payment amount
that you have to exceed before Enhance
Medishield will pay you. You may think
that paying a few thousand from your
pocket is okay, however, many patients,
especially those with early cancer, found
out the hard way that certain illnesses
require many short hospital stays and
you end up paying more than a few
tens of thousands. To fix this you
need to purchase a rider to cover the
co-payment amount - which is another
crack in the scheme that people are
not aware of. Newborns with congenital
illnesses are not covered [Link].
When Minister Khaw had a heart attack
and needed surgery, he paid $8. Many
poor people will pay much more than
$8 when they get hospitalized.
In our system, the richest in our society
like Minister Khaw pay less than the
poorer members because they can
afford better insurance i.e. the less
financially well-off have to shoulder
heavier burdens when they get sick.
Minister Khaw should make the
medical coverage he has universal
for all Singaporeans. We already
have the biggest income gap
among developed countries and
our healthcare system further
exacerbates the inequality
in our society.
-------------
"The Ministry of Health (MOH) puts this
down to multiple factors - including a
greater number of more ill and older
patients, and patients asking for
non-subsidised drugs and implants.
" - Straits Times 8 Jan 2011.
Saturday, January 08, 2011
Is the MOH blaming the rising cost
on the old and sick? Didn't the govt
implement means testing that would
have caused the hospital bills to escalate?
Didn't the govt plan to make Singapore
a medical hub for rich foreigners causing
a strain on our resources and cost to spiral up?
In an earlier posting, I pointed out that
the Medisave Minimum Sum has been
raised at an annual rate of roughly 7%
[earlier posting here] - that translate to
a rise of about 30% for 4 years. When
I posted that, I speculated that the
increase may be linked to rising cost
of medical care in Singapore and this
is a concern because it is rising much
faster than wages. Based on the figures
released by the MOH, class C bills have
increased 30% in 4 years. If you look at
the average bill across all ward classes
and hospitals we see a jump of more than
50%. The bills at a few of the hospitals
have doubled. Look at the table below:
When you read the table you have to be
very careful not to misinterpret the data
given which is average and 95 percentile
bill figures. For those not familiar with
what goes on in a hospital they might
think that the figures still look okay
because they are under $10k for
95 percentile. A typical hospital handles
numerous small cases e.g day surgeries,
short stay for a few tests, hospitalization
for observation (chest tightness, shortness
of breath, pain etc). These small cases
overrun the statistics and the very big
bills are concentrated on a small number
of cases when a person has a serious
illness so what they should publish is
the average of the top 5% of the bills
or average of, say, the top 1% of the bills.
Showing the 95 percentile is misleading
because it misses the very big serious
cases - the type that we are afraid would
hit us once in our lifetime. Deficient as it
is, the numbers are useful in showing
that cost has escalated sharply in the
past 4 years.
Minister Khaw had this to say about the
massive increase in medical cost:
"The bottom line : We have good
high-standard public hospitals that
are affordable because of the 3Ms"
-Minister Khaw
Affordable? In the same sense as
Minister Mah when he said housing
is still affordable after prices jumped
by 60% in 2 years As for the 3Ms, it is
full of holes. Many self-employed
individuals don't have Medisave,
hundreds of thousands are not insured
[Link] and for you to get Medi-fund
you have to exhaust all your savings,
live in a home and have kw enough
income to pass the criteria for receiving
Medifund. It is more dangerous for
Minister Khaw to say that medical care
is affordable than for Minister Mah to say
that HDB flats is affordable. For HDB flats,
everyone knows the truth but for medical
care many don't know what is going on
until they get seriously ill ....then it is too
late. There many holes and gaps that
people can fall through. Take Medishield,
many people are still on Basic Medishield.
Basic Medisheld has limited payout for
hospitalization/surgery that is now
insufficient for the 'catastrophic illnesses'
it is designed for because hospitalization
cost has escalated. In 2005, Enhanced
Medishield was introduced. However,
many people developed various pre-existing
conditions or are not aware and didn't
upgrade to the new insurance. The word
"enhanced" is actually misleading because
it gives people the impression that it is
unnecessary. It is essential for you to
move to Enhanced Medishield because
Basic Medishield is inadequate and will
expose you to great financial risk. In
fact Basic Medishield no longer offered
to new Medishield applicants. Please
double check your Medishield policy to
make sure you're on Enhance Medishield.
Even Enhance Medishield has cracks you
can fall through. Under Enhance
Medishield there is co-payment amount
that you have to exceed before Enhance
Medishield will pay you. You may think
that paying a few thousand from your
pocket is okay, however, many patients,
especially those with early cancer, found
out the hard way that certain illnesses
require many short hospital stays and
you end up paying more than a few
tens of thousands. To fix this you
need to purchase a rider to cover the
co-payment amount - which is another
crack in the scheme that people are
not aware of. Newborns with congenital
illnesses are not covered [Link].
When Minister Khaw had a heart attack
and needed surgery, he paid $8. Many
poor people will pay much more than
$8 when they get hospitalized.
In our system, the richest in our society
like Minister Khaw pay less than the
poorer members because they can
afford better insurance i.e. the less
financially well-off have to shoulder
heavier burdens when they get sick.
Minister Khaw should make the
medical coverage he has universal
for all Singaporeans. We already
have the biggest income gap
among developed countries and
our healthcare system further
exacerbates the inequality
in our society.
-------------
