Co-payment merely one tool to sustainable healthcare

It is clear from recent reports that medical charges have been increasing at such a rate that the current level of premiums for Integrated Shield Plans (IPs) and IP riders will become unsustainable.

IPs supplement MediShield Life by offering policyholders higher coverage for stays in class B1 wards and above in public and private hospitals.

IP riders cover policyholders from the first dollar and patients do not have any out-of-pocket expenses in hospital bills.

Co-payment has been an integral feature of Singapore's healthcare schemes, including MediShield Life and IP plans. To manage rising IP premiums arising from healthcare costs, the Health Insurance Task Force (HITF) recommended co-insurance and deductibles so that patients engage medical services with due consideration to the cost of the service and recognise they have a stake in the decisions made. The issuance of co-payment requirements is one way to encourage individuals to play an active role in managing their medical care costs and look for better value, especially when they are acutely aware of the charges incurred.

The goal of sustainable healthcare cannot be met with just one initiative. The HITF has also made other recommendations such as the need for medical fee guidelines to address the issue of information asymmetry by giving stakeholders access to information on appropriate charges.

Consumer education is an important area as it empowers individuals by helping them make better-informed choices. All these measures taken into consideration will help individuals in their decision to change behaviour.

When IP riders were available, they were very attractive options because they provided good value for when the patient needed medical treatment. We do not think patients wilfully abuse medical services for monetary gain, and examples of irresponsible use are most likely in the minority and should not distract us from adopting new measures to improve our healthcare.

The Singapore Medical Association advocates for patients by ensuring insurance premiums remain affordable. Now that co-payment requirements have been introduced, we hope insurers will be able to better control costs and consequently translate these to lower premiums for patients.

SMA, a member of the HITF, supports its recommendations.

Wong Tien Hua (Dr)


Singapore Medical Association

A version of this article appeared in the print edition of The Straits Times on March 14, 2018, with the headline 'Co-payment merely one tool to sustainable healthcare'. Subscribe