It is not right to assume that the more expensive the patient's home is, the more he should pay. One's dwelling is determined by many factors, including previous earning capacity, and does not necessarily reflect one's current income.

Let's take an example. An applicant bought a five-room flat from the HDB 30 years ago for $35,000. Now, in 2008, husband and wife are either retired or semi-retired with a small income to sustain them. If they sell the flat, the realisable value is about $400,000 (but only if they sell it). If not, all it proves is that they could pay $35,000 for their home. Their ability to pay is still limited to their current income.

Even ownership of landed property does not mean the applicant can afford to pay more. A good example is people who bought a terrace house in Serangoon Gardens in the 1960s. I believe it cost only about $20,000 then. Now, in 2008, the main breadwinner has long retired and is living on a small pension and some savings. They have not sold their home because it represents all their memories.

A combination of current income plus the previous year's taxable income should be used as the base for means testing at public hospitals.

Kenneth Mak Keng Kok