The proposed review of MediShield Life and expected rise in premiums seem incongruent with the scheme's very healthy 44 per cent claims-to-collections ratio (MediShield Life review: More to be done on cost control; Oct 1).

The current claims/premiums ratio (or medical loss ratio) at 44 per cent is mainly due to over-provision for contingent costs and unpaid reserves. When the ratio climbs up to 96 per cent, then it is necessary to raise premiums. Not now.

If the source of these expenses cannot be effectively curbed with robust measures, future rises in premiums will never be able to satisfy the spiralling nature of opaque medical pricing.

Also, the value and utility of MediShield Life are not negated even if the scheme becomes unable to cover its costs as a result of expanded coverage.

The primary objective of a national health insurance scheme is to uphold citizens' fundamental right to access reasonably high-quality and comprehensive healthcare, while protecting against egregious financial burdens from medical bills.

MediShield Life running at a slight loss to the government purse would arguably be far less of a failure than MediShield Life providing insufficient support.

In seeking to balance the proverbial budget, we must take care not to turn MediShield Life into an inter-generational liability, one that compels children to continue paying premiums for their parents deep into retirement. Ideally, premiums could be waived after the policyholder turns 70.

Insurance premiums need not be a lifelong burden to achieve a national healthcare system worthy of our caring and inclusive society.

Paul Chan Poh Hoi