We should uphold the humble structure and noble objective of MediShield Life.

The proposed revamp of the scheme to expand some benefits is welcome news although premiums will have to rise for long-term sustainability. During this time of public consultation, the authorities should look into the following:

• Analyse the income from premiums and claims costs of MediShield Life and Integrated Shield Plans (IPs). The cost burden should not disproportionately fall on those who do not claim.

• Scrap IPs or unbundle them from MediShield Life. Policyholders who prefer treatment at Class A/B1-type wards, and at private hospitals, can purchase separate insurance from private insurers, but not as an extension of MediShield Life. This way, complications in disbursing subsidies do not arise.

• Allow MediShield Life to have basic riders to increase claim limits and coverage, but pegged at Class B2/C-type wards. Currently, riders are offered only in IPs and are pegged to Class A/B1-type wards, which is causing the higher premiums.

• Cap hospital treatment costs under MediShield Life and make hospitals responsible for cost overruns instead of making patients pay for unnecessary treatments.

• Review hospital care costs and exclude items that are irrelevant to basic service delivery. For example, does the location of a hospital, say, in Orchard Road versus in the suburbs, factor into the cost of treatment? Are the costs of underutilised, specialised equipment pooled across all treatment costs? How they determine treatment costs should be reviewed as the hospitals could have built in land costs and depreciation, and allocated these across all treatment costs.

It is inevitable that insurance premiums have to rise to keep up with rising healthcare costs. But all stakeholders have to ensure a fair and equitable way of sharing the burden instead of an across-the-board increase.

Ee Teck Siew