THE Government's big shift to strengthen social support means individuals have to play their part in keeping new policies, like the introduction of MediShield Life, sustainable, said Prime Minister Lee Hsien Loong in a television forum on Tuesday.
In his first comments on the policy changes he announced in last month's National Day Rally, Mr Lee said that with the move to universal health insurance, those who default on their premiums increase the burden on the rest.
There must be strong social pressure against such free-riding, he added.
The national health insurance scheme MediShield will be extended to cover everyone, including those with pre-existing illnesses.
The current age limit of 90 will also be scrapped and the scheme renamed MediShield Life.
Before the switch to universal coverage, those who did not pay their MediShield premiums lost their benefits and were no longer covered.
"But now, we're making MediShield Life universal," Mr Lee said on the Channel NewsAsia forum. "Everybody is covered. You cannot drop out. So if you don't pay, then your benefits will effectively have to be funded by all the rest of us who have not defaulted.
"I don't think that is fair. So not paying becomes a serious matter and then we will have to find ways to encourage people very hard to pay their premiums."
He cited three ways: social pressure, rules as well as schemes to make it convenient for people to pay and meet their obligations.
He said the community should make clear what it considered to be acceptable behaviour: "Whether they think he didn't pay, that's fine, or whether if you don't pay, there is a certain amount of social disapproval...
"You're not carrying your burden, you're really free-riding. That is a very important attitude which we must develop as a community."
Mr Lee acknowledged that with the state and society stepping in to provide more social support for individuals, there was a risk that people could become increasingly reliant on government intervention.
Some countries in Europe have gone overboard in providing welfare and gone bankrupt as a result, he noted.
These very generous schemes also sapped the will of the people, with even those who were working depending on government welfare to make ends meet.
But Mr Lee made it clear he and his government would work hard to avoid repeating such mistakes. "My government is going to try very hard, not just making the right policies, but persuading people what is needed and where we should pause and think carefully and not rush forward headlong," he said.
Singaporeans will also have to play their part, he said.
"It's really also... the attitudes each population takes towards personal responsibilities, family responsibilities, what the community will do and the sense that I want to look after myself, I don't want to be just reliant on handouts from somebody else because I have pride.
"I think the older generation was very much like that and we hope the young generation will be, too."