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January 14, 2008 Monday
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Jan 14, 2008
Debate on means testing should go beyond cost
MOST of the arguments concerning means testing have dwelt on cost issues. While not unimportant, perhaps the debate should catalyse a broader rethink on how we conceive the health-care system.

Firstly, to all the bargain hunters out there: there is no free lunch. If people regularly expect to pay less for a medical consult than a hairdo, we have a serious reality distortion field in place.

Secondly, health is good to have, but it is not a right. And when it falters, it often takes more than grandma's advice to put things right.

The sooner people, led by unrealistic expectations, stop playing a game of emotional blackmail with the Government, the more likely we will have a sustainable health- care system that can scale what it delivers to reflect advances in delivery methodology and our ability to pay.

Maintaining a consistent level of quality right through the care chain is vital, but it costs. If you do not know what this means, have an accident in any nearby country and see if out of 100 times, you end up as well as you would if it had occurred in Singapore.

Thirdly, more Singaporeans have to think about allocating some of their assets to health insurance, meaning, in addition to money, time and mindset.

It is a fallacy to equate wealth with health, though the converse is probably true. Insurance is also about doing what one can to reduce the risk of illness.

If someone invests foolishly and incurs loss, we accept it as a personal problem. If someone gets sick because he did not bother to maintain a healthy lifestyle, the prevailing populist view is that it is still the Government's responsibility to bail him out. Does this make sense?

Fourthly, for all its supposed warts, the health-care system is as compassionate and as caring for the poor as they come. It really is not a trivial thing to say because it is not so in much of the world.

Many people worry that they will be left out, but in reality, how many hard-luck cases are turned down? Delays, nuisances and irritations there will always be, but what counts is the final outcome.

Means testing is long overdue and will benefit the populace in the long run. The timing is right and in time to come, people will look back and say, although seemingly tough, it was a measure that allowed public health to scale upwards along a new architecture that befits Singapore's ascendancy into the league of First World nations.

Michael Chee Wei Liang


Means testing is long overdue and will benefit the populace in the long run. The timing is right and in time to come, people will look back and say, although seemingly tough, it was a measure that allowed public health to scale upwards along a new architecture that befits Singapore's ascendancy into the league of First World nations.

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