From one- and two-room rental flats to three-, four- and five-room owner flats.

Yes, for flats bought directly from the HDB, subject to an income ceiling. Buyers of smaller flats get proportionally bigger subsidies as these flats are meant for lower-income buyers.

How does it affect you? Who will be affected by means testing at hospitals? Patients who choose to stay in Class C and B2 wards in public hospitals will have to go through means testing. ... more CLASS C WARDS GETTING BETTER In the past, the differences between the private and subsidised wards were stark. Class C wards could have as many as 40 beds each. But the gap is closing. Class C wards now have about 10 beds each. In the new Khoo Teck Puat Hospital, they will have their own in-ward toilets instead of having to share such facilities... RELATED LINKS  The ABC of ward charges

To qualify for a subsidised flat, applicants cannot earn more than $3,000 a month for a three-room flat, or $8,000 for a five-room flat.

Yes, most people consider the system fair. This is clear, going by the complaints aired when owners of three-room flats are seen driving Mercedes-Benzes. To their minds, someone who can afford a high-end car should not be depriving a poorer person of a subsidised flat. They are somehow 'getting around the system'.

How MOH does it

THE Health Ministry takes a different approach to giving subsidies.

From Class A to B1, B2 and C. While all patients get good clinical care, wards differ in amenities, access and comfort.

Class C wards have more beds and no air-conditioning. The patients there are treated by doctors on rotation and queue longer to consult specialists.

Class A ward patients have privacy and greater comfort, a choice of doctors and shorter waiting time for consultations.

Yes, up to 80 per cent for Class C wards. Patients can choose any class of ward, irrespective of how well-off they are.

Yes, the system has its merits. Patients have freedom of choice and peace of mind, knowing they can opt for health care they can afford, even for prolonged and expensive hospitalisation.

Those in the middle-income group worry that major complications would wipe out their finances, a concern which is valid and of which the ministry is well aware.

It's not sustainable

TWO questions must be raised about MOH's approach.

Last year, the Government gave out more than $1.5 billion in health-care subsidies. While this sum can be increased, it cannot be unlimited.

A high-income patient occupying a Class C or B2 bed deprives a low-income patient of that place. While the former can afford an alternative, the latter cannot.

In the past, the differences between the private and subsidised wards were stark. Class C wards could have as many as 40 beds each.

But the gap is closing. Class C wards now have about 10 beds each. In the new Khoo Teck Puat Hospital, they will have their own in-ward toilets instead of having to share such facilities with other wards.

Subsidised wards will approach the standards of private wards and yet cost much less. Patients who can afford B1 may then opt for B2 and C instead, which reduces the number of beds available for lower-income patients.

This has happened with polyclinics, which have improved so much that they are better than many neighbourhood general practitioners (GPs). Patients who used to go to GPs to avoid the queues at the polyclinics are now turning to polyclinics for better care for much lower fees.

The result: Overcrowding again at the polyclinics.

A different way

ECONOMISTS have two ways of dealing with demand that exceeds supply.

They either raise the price till demand drops to meet supply, or let the queues for subsidised services sort it out. Those who can afford private treatment and do not want to wait will drop out of the queue.

There is a third way:

Firstly, it is clear that all emergency cases should be attended to, regardless of the patient's ability to pay. It is also clear that frills like cosmetic surgery should not be subsidised.

In between is a range of treatments which can be tailored to different needs and abilities to pay. As living standards improve, new and better treatments can be extended to subsidised patients. But these must not unwittingly draw those who can pay but are attracted to the lower fees.

A fair and practical way to share limited resources is to get higher-income patients to co-pay more for the same treatment than lower-income patients. This means that if they opt for subsidised treatment, they will get less subsidy than someone who earns less.

While the principle is sound, implementation is challenging. The aim is to find a fair way of sharing resources which does not impose a burden on patients.