Medisave should be used to cover more services and MediShield should pay for a larger share of treatment bills, according to the Government Parliamentary Committee (GPC) for Health.
These were among a slew of changes to health-care financing that it recommended in a report to Health Minister Gan Kim Yong yesterday. Led by GPC head Dr Lam Pin Min, the team of eight MPs gathered feedback from the public, health-care professionals and social workers.
Its suggestions include widening subsidies to cover more medicines, reviewing Medisave limits regularly, and removing age limits for health insurance and the portable primary care subsidy.
GPCs are groups of People's Action Party backbenchers who take a special interest in the workings of a ministry. They are regularly briefed by the ministry and consulted on issues of public interest. But it is unusual for them to issue a public report like this.
This committee's suggestions aim to help the many Singaporeans "worried and apprehensive about their current and future medical needs".
It said restrictions on the use of Medisave encourage unnecessary hospitalisation. Dr Lam pointed out an example to The Straits Times: Medisave pays up to $250 a day to patients in a nursing home but $450 to those in hospital. The committee wants the same limit for both.
The report added: "Social workers indicate that they see regular cases of clients who choose to voluntarily admit themselves or extend their stays in the hospitals so that they can utilise their Medisave for treatment."
It also suggested a tiered withdrawal limit, with older people allowed to take out more. Dr Chia Shi-Lu, another GPC member, said: "The current level of Medisave monies is probably a bit high and can be put to better use."
The Ministry of Health says people aged 65 to 70 have an average of $19,000 in Medisave. The GPC suggested freeing up Medi-save cash for health screening, dental procedures, physiotherapy and occupational therapy.
But it wants to cap the amount that can be used on treatment for relatives, so a person's savings are not depleted prematurely.
The GPC also highlighted failings in the national health insurance scheme. Some Singaporeans let their MediShield lapse because they can no longer afford the high premiums. Government top-ups do not help as these are often used to pay medical bills.
"Doctors shared that they would deliberately advise elderly patients to allow their MediShield coverage to lapse as the premiums were too high," said the report. The GPC added that it means their years spent paying into MediShield are wiped out.
It suggested letting people pay higher premiums when they are young to offset higher ones as they age, adding that it is best to use government top-ups only for paying premiums.
Mr Gan announced early this year that the ministry was undertaking a review of health-care financing. In his reply to the Health GPC yesterday, he said: "I agree with the key thrusts proposed by the committee. They reflect the same spirit of review that my ministry is undertaking for our health-care financing framework."
He added: "Several of our current policy reviews are aligned to your recommendations."