Sorry No Enough....

[Ramseth]

Err .. better not. I think last thing we want is a situation where our public hospital has to decide between

1) Saving a rich foreigner who stays in A class
2) Saving a poor Singaporean staying in subsidised C class.

In emergency life-or-death cases, I can vouch for that with personal experience. I was stretchered immediately to a B1 ward with vacancy when all classes below were full, bypassing the normal 2 to 4 hours queue for non-life threatening cases. I was given immediate blood transfusion and other necessary resucitation treatments until my life was out of danger. Subsequently, during further treatment and observation period, I was transferred to a C ward until recovered well enough to be discharged. I was billed at C rates for the whole stay.

 

[aurvandil]

In emergency life-or-death cases, I can vouch for that with personal experience. I was stretchered immediately to a B1 ward with vacancy when all classes below were full, bypassing the normal 2 to 4 hours queue for non-life threatening cases. I was given immediate blood transfusion and other necessary resucitation treatments until my life was out of danger. Subsequently, during further treatment and observation period, I was transferred to a C ward until recovered well enough to be discharged. I was billed at C rates for the whole stay.

To clarify, I am not saying that the hospitals are denying treatment to patients in need. Resources are currently already stretched. Let's not put ourselves into those kind of morally difficult situations.

 

[IR123]

To clarify, I am not saying that the hospitals are denying treatment to patients in need. Resources are currently already stretched. Let's not put ourselves into those kind of morally difficult situations.

A&E situations are different from scheduled hospital admissions.

As a medical specialty, emergency medicine requires a different set of diagnostic techniques and hence for some hospitals, they even have their own specialised wards. The standards are different. The focus is on saving lives. The availability of medisave and medishield reduces the level of defaults which prevent the type of situations faced by hospitals in other countries. (That is the good part of the PAP-led-Government)

To use the policies of this class of medicine and substitute for the policies of the other classes may lead to erroneous conclusions.

 

[Ramseth]

A&E situations are different from scheduled hospital admissions.

Within A&E there's still the difference of immediate life threatening (instant admission) or non-immediate life threatening (2 to 4 hours wait is common). For scheduled admission, 1 or 2 months wait is common.

How do they manage instant admission, one may wonder. I understand that hospitals always reserve empty beds and standby doctors for such cases around the clock. But of course, there may be unexpected disasters to overwhelm the standby reservation, e.g. Spyros tanker explosion, Hotel New World collapse etc.

 

[IR123]

Within A&E there's still the difference of immediate life threatening (instant admission) or non-immediate life threatening (2 to 4 hours wait is common). For scheduled admission, 1 or 2 months wait is common.

True, but often those are due to abuses of the system. In Singapore's context, also to get to see specialists earlier compared to polyclinic's referrals. The wait is not neccessarily 1 to 2 months. You may even get to see the specialist the next working day.

 

[aurvandil]

A&E situations are different from scheduled hospital admissions.

As a medical specialty, emergency medicine requires a different set of diagnostic techniques and hence for some hospitals, they even have their own specialised wards. The standards are different. The focus is on saving lives. The availability of medisave and medishield reduces the level of defaults which prevent the type of situations faced by hospitals in other countries. (That is the good part of the PAP-led-Government)

To use the policies of this class of medicine and substitute for the policies of the other classes may lead to erroneous conclusions.

I understand the issue of A&E situations and how it is not the best example to use. Let me give you another scenario which better illustrates the moral issues.

Patient A and Patient B post have a serious medical condition. It is not immidiately life threatening. However it is serious and will lead to death. There is a old conventional treatment which is only about 20% effective. There is a newer more effective treatment which has a 50% success rate. The cost of administering the new treatment is much higher than the old treatment. Also due to resource constraints, not all patients can be given the new treatment.

Patient A is a rich foreigner staying in Class A.
Patient B is a poor Singaporean staying in Class C.

The hospital decides the treatment.

Who will get the older treatment with lower chance of success and who will get the newer threatment with higher chance of success?

 

[Ramseth]

True, but often those are due to abuses of the system. In Singapore's context, also to get to see specialists earlier compared to polyclinic's referrals. The wait is not neccessarily 1 to 2 months. You may even get to see the specialist the next working day.

One of the abuses is Medisave. Many patients exaggerate their conditions and insist on warding when ongoing outpatient treatments and should be sufficient. Not that they're malingering pretending to be sick. They're really sick but not that serious. Though being warded is a very boring thing, it's seen to be a quicker way to cure whatever sickness once and for all rather than dragging out ongoing outpatient treatments. Before Medisave, cost of warding was a deterrent against over-eagerness to get warded when one falls sick. After Medisave however, warding doesn't require cash payment, where outpatient requires cash.

 

[Goh Meng Seng]

As an economist yourself, you should see that it makes business sense. Locals are entitled to subsidies. Encourage them to go abroad. Foreigners pay in full. Encourage them to come here.

I am an economist but also a socialist politician. I believe that if a government cannot even take care of its citizens well, then it should not think of taking care of others.

Goh Meng Seng

 

[Ramseth]

I am an economist but also a socialist politician. I believe that if a government cannot even take care of its citizens well, then it should not think of taking care of others.

This government apparently believes that in order to take care of citizens, must make more money from citizens, e.g. increase GST to help the poor.