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Insurance wish list: Keep it real

Published on Apr 24, 2014 6:13 AM
Patients waiting outside the consultation rooms at the Accident & Emergency (A&E) Department at Changi General Hospital (CGH). -- FILE PHOTO: BH

In keeping with its mandate to protect the interests of workers, the National Trades Union Congress (NTUC) has weighed in on the new compulsory MediShield Life insurance scheme, whose details are being worked out. The scope of the national scheme, which will cover everyone for life and is expected to start by the end of next year, naturally has raised public expectations.

In its recommendations to the scheme's review committee, the NTUC has focused, among other issues, on removing the higher deductibles which people over the age of 80 pay now, so that they will be on a par with everyone else. What motivated this suggestion was the sense of being discriminated against, felt by older people, because they already are paying the highest amount in premiums. NTUC members also want MediShield Life's coverage of chronic ailments to be expanded from cancer, kidney failure and organ transplant, to asthma and diabetes.

The desire to lower the scheme's cost is understandable, as is the call to expand its coverage. However, premiums lie at the financial heart of any health insurance scheme, whether individual or national. In the latter case, the key question is who should help carry the burden of higher premiums in order to support greater relief for older people and the expanded scope of the scheme. Younger workers might baulk at the prospect of carrying a disproportionate load for others' sake. By default, attention would turn to the state, but that would be just another way of passing the cost around because higher expenditure would have to be financed from taxes.

Universal coverage is a social imperative. The Government is right in treating access to health care as a moral and a social good, thus placing it more firmly outside the realm of market forces and personal ability to pay than used to be the case.

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