The Straits Times says

Ensuring access to public healthcare

An ageing population and people seeking medical help more readily because of new government subsidies are major reasons for hospitals and clinics reporting big increases in attendance. This is only natural as the reach of the healthcare system widens to match demographic change. Indeed, it would have been worrying had the elderly sick not sought medical help because of the absence of subventions. While fiscal conservatism is a solid principle of governance, healthcare is an equally indispensable aspect of national life. In this context, subsidies for Singaporeans, including those in the pioneer generation, for drugs and consultations provided at polyclinics and specialist outpatient clinics have fuelled the jump in demand at these public facilities.

Benefiting from official largesse are the elderly in particular, who are likely to have more frequent acute health events in addition to coping with long-term chronic conditions. In keeping with the Health Ministry's philosophy of providing affordable and quality basic medical services, seniors and others need to have financial access to such healthcare.

Playing a critical role in the equation is MediShield Life, the national scheme which ensures that everyone has insurance to meet big hospital bills when they receive subsidised treatment in public hospitals. Universal coverage - extended to all, irrespective of age or health condition - would naturally contribute to a higher consumption of medical services. Therefore, supply must keep pace with demand. Future demographic attrition might affect the latter, as apparent now where education is concerned, but the aim must be to ensure no generation suffers because of a failure to achieve supply-demand equilibrium. Another change MediShield Life has wrought is the fall in Medifund aid, the safety net for the poor. With MediShield Life taking care of a greater portion of medical bills, there was less need to draw the remainder from Medifund. Such recasting of the healthcare landscape has to be tracked closely as Singapore ages demographically and matures economically.

However sound the health system, some gaps are to be expected. The case of the Gleneagles Hospital security guard who collapsed while on duty is instructive. He faced a large bill as he could not be transferred to a cheaper public hospital (because of the absence of an intensive care unit bed) and could not be moved later (when a bed became available) because he was critically ill. Gleneagles graciously agreed to waive the bill, but others caught between subsidised care and the need for emergency treatment in a private hospital might not be so lucky. The guard's predicament ought to be studied by the authorities to produce clearer procedures on how MediShield Life can be used to ease patients' financial burden in such cases.

A version of this article appeared in the print edition of The Straits Times on October 24, 2017, with the headline 'Ensuring access to public healthcare'. Print Edition | Subscribe