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HEALTH Minister Khaw Boon Wan yesterday answered one major question over means testing at public hospitals: Will Singaporeans have to pay more?
Not the majority of those who currently opt for the heavily subsidised C- and B2-class wards, he said.
His message would likely bring cheer to Singaporeans who are worried that means testing would mean higher medical costs.
He also promised that people would still be free to choose their preferred ward class. The difference is that the rich will get a lower subsidy for that class than the poor.
Determining the level of subsidy will also be made easy, possibly even automated, if based on salaries declared in tax or Central Provident Fund returns.
The type of housing one lives in could be considered in determining subsidies for retirees, housewives, children and the unemployed. But here too, Mr Khaw has promised to be generous, with possibly all HDB residents and those living in lower-end private housing continuing to enjoy current subsidy rates.
He said a deadline had not been set for implementing means testing, but its introduction is inevitable.
It will enable the Government to provide better care for the poor in the future, without also attracting the well-off to compete for scarce resources.
'We do not begrudge lower-income patients the improvements in service which we can now better afford,' Mr Khaw said.
But he added: 'If significant improvement results in us drawing in patients who can well afford private treatment, our efforts will be nullified.'
A high-income patient occupying a C-class bed does deprive a low-income patient - who has no alternative - of using that service.
Currently, 9 per cent of C-class patients and 13 per cent of B2-class patients are from families in the top 20 per cent income bracket.
Last year, the Health Ministry spent $1.5 billion in subsidies. This amount will go up over the years, but there is a limit. Means testing is needed as a 'fair and pragmatic way to allocate limited health-care resources', Mr Khaw said.
Addressing the fears of the middle-income group that means testing would drive up costs considerably, he promised to err on the side of generosity.
At a briefing to health-care professionals at Changi General Hospital (CGH) yesterday, he said these were valid concerns that would be taken into account in the planning.
He is aware that frequent hospitalisation for the chronic sick, prolonged hospitalisation or major complications can cause 'severe financial hardship'.
Yesterday, he gave the same assurance he had given on previous occasions: 'We will be flexible in implementation so that at the margins, we will always give patients the benefit of the doubt.'
In the short term, he said, the 'majority of Singaporeans should continue to receive the same level of subsidies as they do today and will not be affected'.
Feedback over the next few months will help determine the income cut-off point and how much subsidy to give richer patients. The first public dialogue will be held on Sunday, with about 500 participants from the People's Association.
In the same way that MediShield reforms were introduced after much public discussion, Mr Khaw said he preferred to have all concerns ironed out before pressing ahead with the scheme.
Mr T.K. Udairam, head of CGH, said the plans were 'very practical'. 'From what we've seen so far, 80 to 90 per cent of patients won't have problems,' he said.
Dr Noreen Chan, head of Dover Park Hospice, said: 'I'd encourage everybody to get insurance - as young as you can afford it, and as high as you can afford it.
'Because whatever we think it's going to cost, by the time we need it, the cost would have spiralled.'
salma@sph.com.sg
TEXT OF MR KHAW'S SPEECH, REVIEW
GET SET FOR MEANS TEST, EDITORIAL
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