Parliament Debate on ministries' budgets: Health: FromThe Gallery

Covid-19, two ministries and their vastly differing trajectories

Different challenges for transport, healthcare, but same concerns of financial sustainability

In some ways, the impact of the Covid-19 pandemic on the transport and healthcare sectors could not be more different, in how both have been impacted and how they have had to respond.

One is facing job cuts as many planes are grounded and travel has been severely curtailed; the other is doing all it can to attract and retain talent. One has had to put major infrastructure projects on hold, while the other is going full steam ahead with plans to support Singapore's greying population, among other priorities.

Yet, in speeches made yesterday by political office-holders from both ministries, MPs would have detected a common dilemma: How does one keep the current system financially sustainable in the long term?

On the transport front, subsidies for the operation of buses and trains will have to continue, said Transport Minister Ong Ye Kung.

But will Singapore be able to keep paying for these operating costs - including manpower, electricity and maintenance - year after year?

"The bill to taxpayers cannot keep ballooning," he stressed.

"If it does, we would leave our future generations a growing financial burden."

The solutions he outlined: Cut back on bus routes which run parallel to rail lines to reduce excess capacity, make use of the changes to travel patterns brought about by the pandemic and work-from-home routines, find new ways to be cost-efficient;and raise fares "from time to time".

Should fares go up, Mr Ong added, lower-income households will get extra help.

His colleague, Health Minister Gan Kim Yong, faces a similar challenge.

Singapore's healthcare spending has spiked in recent years, due in part to its ageing population.

It is telling that whenever the issue of raising taxes to fund growing government expenditure is brought up in Parliament, Mr Gan's ministry invariably comes under the spotlight.

The minister spoke on the importance of MediShield Life, the compulsory national health insurance scheme which gives Singaporeans a basic level of protection against large hospital bills.

"But insurance has an inherent risk of over-consumption," Mr Gan said. "We are tapping on other people's money in the pool to pay for healthcare services. So, we need safeguards to encourage prudence when deciding on healthcare services."

The challenge, however, goes beyond just health insurance - which is why Mr Gan yesterday announced a significant overhaul of government subsidies at hospitals and specialist outpatient clinics.

With these changes, subsidies will be more targeted, and those who have more, will have to fork out more.

"Overall, government spending on healthcare has grown year after year and is likely to continue to increase," Mr Gan said.

"That is why we have to be prudent in how we allocate limited resources to ensure that the support we provide is more targeted to benefit those with greater needs."

Even as political office-holders spoke of the need to keep spending sustainable in their respective sectors, MPs called for more to be done in areas where gaps remain.

Delivery riders, for instance, often feel equally unwelcome on footpaths and on roads, said labour MP Yeo Wan Ling (Pasir Ris-Punggol GRC).

She cited the example of a rider who broke his wrist in an accident and was laid up for four months, and said that more can be done to protect this group.

Public education on safe and considerate use of footpaths can also be stepped up, noted MP Dennis Tan (Hougang), describing scenarios in which friction can arise between different users.

"The aunties and uncles who may get upset when people are ringing their (bicycle) bells," he said. "Keeping left or right; people walking their dogs on the PCN (park connector network) or footpaths; stopping to chat. These are very everyday moments."

On the healthcare front, Dr Tan Wu Meng (Jurong GRC) called for more formal support to help seniors navigate their many clinic appointments.

Often, their children have to take time off from work to help them out, he said. "With an ageing population (and) shrinking family sizes, this poses a challenge for many seniors in the community."

In this tale of two ministries - glass and metal contrasted with blood and bone - surprising congruences have emerged.

Mr Ong compared Singapore's transport ecosystem to the parts of an enormous body.

Its air and sea ports are like lungs, drawing in life-giving oxygen, while the many tributaries of its land transport network are like arteries and veins, he said.

Can the nation's healthcare system similarly be seen as a vast transport network, with its citizens making increasingly frequent trips down the streets and avenues that are polyclinics and hospitals?

Whatever the analogy one prefers, it is clear to see that the road ahead for both sectors is paved with never-ending needs and difficult choices.

And Singapore must chart its forward course as it always has - the best it knows how.

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A version of this article appeared in the print edition of The Straits Times on March 06, 2021, with the headline Covid-19, two ministries and their vastly differing trajectories. Subscribe