Public healthcare subsidies to be adjusted to benefit more lower-income patients

MOH said subsidies for drugs under the Standard Drug List will rise to a range of 50-75 per cent for Singapore citizens. PHOTO: ST FILE

SINGAPORE -From Nov 1, patients using standard drugs at acute and community hospitals will be means-tested when they apply for subsidies, in a move aimed at benefiting the lower-income group.

In a statement on Tuesday (Aug 30), the Ministry of Health (MOH) said the subsidies for drugs under the Standard Drug List at these hospitals will rise from the current 50 per cent to a range of 50 per cent to 75 per cent for Singapore citizens, when means-testing, based on per capita household income, is introduced.

Permanent residents will continue to receive a 25 per cent subsidy.

There are more than 600 drugs on the list, including some used for cancer treatment.

The change is in line with the public healthcare subsidy system changes that MOH announced in March last year, which were aimed at ensuring that people at the lowest income levels get the help they need as healthcare spending rises.

It meant that hospitals would use per capita household income instead of individual income during means-testing to determine subsidies.

Per capita household income, which is based on total gross household monthly income divided by the number of family members living in the household, reflects the number of people dependent on a patient's income.

For instance, an income-earner supporting a family of four will get more subsidies than another person earning the same amount but has only one dependent.

In its statement on Tuesday, MOH said these are significant changes that will provide more subsidies to patients who need greater support as well as encourage patients to access care in the most appropriate healthcare setting.

MOH also updated the implementation dates for the changes, which will be done in phases.

From Sept 1, the Medication Assistance Fund (MAF) drug subsidies will be extended to more Singapore residents seeking help at public healthcare institutions, when the eligible income criteria is raised.

MAF subsidises expensive drugs that have been deemed clinically necessary, such as certain cancer drugs.

From Nov 1, MOH will change the basis of means-testing in the acute inpatient setting from individual monthly income to per capita household income.

The subsidy rates for inpatient care and day surgery at acute hospitals will be also merged across B2 and C ward classes to provide those with a lower per capita household income with a higher subsidy for a B2 ward, while those with a higher income will get lower subsidies in C class.

At the same time, the subsidies in community hospitals will go up to more closely reflect the levels in acute hospitals.

From Jan 1, 2023, the subsidy structure changes for outpatient care in the specialist outpatient clinics will also mean that those who earn more will pay more.

In its statement, MOH also said it is progressively streamlining the household means-test process, by using the per capita household income that is already computed for MediShield Life premium subsidy administration.

This will eliminate the need for repeated subsidy application when care is sought in different settings, it said.

"Overall, the financing and subsidy scheme changes will help target and increase subsidies to those who need them most, while managing healthcare cost growth sustainably," said MOH.

"Patients who still face affordability concerns at public healthcare institutions may approach medical social workers for financial assistance. No one will be denied appropriate healthcare due to an inability to pay."

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