Referring to middle-income people who might have difficulty meeting their hospital bills, especially in long-drawn illnesses, he said he would rather be more generous than strict.

He is prepared to let some better-off people get the full subsidy, rather than deprive anyone in need of help with medical bills.

He said this while taking in concerns raised at two dialogues with 900 people over the first weekend since he announced his plans to introduce means testing here.

The main concerns put to Mr Khaw focused on

high-income people with many dependants to support, as well as retirees who might be asset rich but cash poor.

The minister had announced that ability to pay will be based on income for working adults, and house type for unemployed patients.

People may continue to choose any ward class they want, but with wealthier patients paying more. For C-class patients, the subsidy will range from 65 per cent to the current 80 per cent.

In answer to concerns raised yesterday, the minister promised to err on the side of generosity, with a relatively high income cut-off for full subsidy. He tossed figures like 40th or 50th percentile, and housing types up to the 80th percentile as the possible measure for full subsidy.

Surprisingly, several of the 500 community leaders at the Grassroots Club at Ang Mo Kio yesterday afternoon wanted full subsidy only for people at the bottom 20 or 30 per cent income level.

One participant even suggested giving the lowest subsidy to all, and getting those who want more to apply for it.

To this, Mr Khaw explained that he felt that was being ungenerous. He said he preferred to use the maximum subsidy as the starting point, and get the better-off to pay a little more.

At the other extreme were people like Mr Robert Chua, who felt the same level of subsidy should be given to all, since the rich pay the most taxes and should not be discriminated against.

Some at the dialogue session were worried for asset-rich but cash-poor retirees who may be living in landed property bought cheaply decades ago.

A couple of them asked the minister to allow patients who had opted for higher ward classes, to downgrade should the bill start mounting. Mr Khaw said that this was already allowed, subject to means testing.

Some, like Mr Arthur Chia, preferred the means testing to be based on per capita family income, rather than on personal income. He argued that a person with no dependants, and one who has to support several people should not be treated the same simply because both drew the same pay.

To this, the minister said he prefers a 'less correct but simple' test to a 'correct but complicated' one.

He said he would likely rely on the Central Provident Fund Board for information on income. He added that there was little he could do about the self-employed who under-declare or do not declare their income.

Mr Khaw also promised to be flexible at the point of implementation, so those who feel they need the full subsidy have recourse.

The main reason for introducing means testing, explained Mr Khaw, was to prevent abuse and help keep health-care costs to no more than 8 per cent of GDP. Today, it stands at 4 per cent.

salma@sph.com.sg