SINGAPORE - The MediShield Life Scheme Bill tabled in Parliament on Monday gives wide-ranging powers to the administrator to access people's income and health status without explicit consent from them.
Those who object to having such information accessed have the choice of opting out.
However, those who do so will not be eligible for income-related subsidies for their premiums, nor can they be automatically given a clean bill of health.
The Bill also gives the national insurance administrator the same powers as that of the Inland Revenue Authority of Singapore to recover unpaid premiums, such as through employers or banks.
Such powers are needed because defaults on premiums by people who can afford to pay them will mean a heavier load on other policy holders. Full premiums are payable even by Singaporeans and permanent residents living overseas for long periods.
MediShield Life, which will replace the current MediShield when it starts at the end of this year, will cover everyone regardless of whether they are healthy or sick, for their entire life.
Coverage will be higher with lower co-payments and no lifetime claim caps but premiums will be higher than the current scheme.
Massive government aid, to the tune of $4 billion over five years, will make it highly affordable, the Government has assured. This includes the transitional subsidies which will be given to everyone, rich or poor, for the first four years.
On top of that, two in three people will also get 15-50 per cent permanent subsidies on their premiums. The need to access incomes is to make it easy to identify people who qualify and the amount of subsidy they are entitled to.
Additional help will be given to those who still can't afford the premiums.
For the majority, the higher premiums will be entirely covered by Medisave, with the extra 1 per cent in Medisave contribution from employers that takes effect this month.
People who are currently not covered by MediShield and have pre-existing illness will need to pay 30 per cent additional premiums per year for 10 years, after which they revert to paying the normal premiums for their age band.
To simplify the procedure of identifying people with existing serious illnesses, such as cancer or heart disease, the administrator will have access to hospital data on all Singaporeans and permanent residents.
The Bill also sets out the various penalties for defaulting on payments, providing false information, or wrongfully disclosing information obtained under the authority of the MediShield Life Scheme. Those who default on payments will have to pay penalties of up to 17 per cent of outstanding premiums and interest on late premiums.
A defaulter who tries to leave the country without paying or providing security, as well as officials who wrongfully disclose information, can be fined $5,000, jailed for up to a year or both.
The penalty for obstructing investigation into offences under the Bill is heavier with a maximum of $20,000 fine and a year's jail.
The Bill also provides for a MediShield Life Council which can review the policy and parameters and recommend changes to the Health Minister to ensure that it continues to provide effective protection to citizens.
The Council, which will likely comprise experts from people, private and public sectors, also has overview of the administration of the scheme.
Dr Chia Shi Lu, head of the Government Parliamentary Committee for Health, said he supports the implied consent to verify personal details, as there is provision to refuse access.
He said: "There has been quite a lot of feedback from Singaporeans, and particularly from the elderly, who are unhappy with government agencies repeatedly requesting personal and financial information from them in order to qualify for any number of government schemes."
He and his parliamentary colleagues have often been asked why government agencies do not share information - as will now be done with MediShield Life.