A shield for one and all

The report of the MediShield Life Review Committee, which announces the schedule of premiums to go with the higher benefits available under the national health insurance scheme, comes on the back of widespread public anticipation. It is natural that Singaporeans will examine both benefits and premiums to see how they fare individually. The Government has weighed in with hefty subsidies - $4 billion over the next five years. Subsidies, whether permanent or transitional, are intended to keep premiums affordable for a scheme that will provide better protection and coverage for all.

Even as they digest the ambitious scheme's details, citizens need to focus on the scheme's national purpose. MediShield Life is a part of the social compact among citizens, and between them and the State, that all must bear in mind. Comparable in social importance to the Housing Board and Central Provident Fund schemes, its intention is to draw all into the social safety net by pooling risks, apportioning costs equitably and distributing benefits in a sustainable way.

This is not only humane but is also necessary to preserve the fabric of Singapore society so that the needy, particularly if they are old and sick, do not find themselves in the position of second-class citizens when it comes to health care. Those who are obliged to pay a little more by way of premiums, so that those in need can pay a little less, should see the scheme in this generous light. The peace of mind that MediShield Life should bring to all is a contribution to, and reflection of, Singapore's character as a nation. The market simply produces or withholds benefits without reference to personal need or social cohesion. A country that aspires to be inclusive has to do more.

The critical need for an extended social contract in today's Singapore makes it necessary for all to contribute to the success of the scheme. For example, to offer adequate benefits, those who are able must bear some of the costs of extending coverage to those at the bottom. And for the distribution of benefits to work, all its beneficiaries and service providers must focus on what is essential and not get carried away by "buffet consumption" impulses. Given advances in medical technology, which come at a price, over-consumption will lengthen waiting times and lead to higher premiums.

Universal health coverage, if it is to last, should go hand in hand with universal responsibilities. There's the personal responsibility to protect one's health by making good choices. There's the family responsibility to plan for health screenings to avoid incurring large hospital bills later. And there's the collective responsibility to promote health finance literacy among all.