Healthier SG participants can get $20 in vouchers, opt for enhanced chronic drug subsidy tier

Those with high chronic medication needs and bills who enrol with a GP clinic can opt for a new Healthier SG chronic tier. PHOTO: ST FILE

SINGAPORE – With hospitals and clinics well-placed to treat those who are very sick, the nation’s healthcare priorities are now focused on helping people stay healthy, and keeping seniors out of hospitals and nursing homes.

When Singapore’s major preventive care strategy known as Healthier SG kicks off in July, for instance, Singapore citizens and permanent residents who enrol with a general practitioner (GP) clinic or polyclinic will get $20 worth of Healthpoints upon completion of the first free health plan consultation, Health Minister Ong Ye Kung said in Parliament on Friday.

The 3,000 Healthpoints, available through the Healthy 365 app, can be exchanged for vouchers or credits from participating merchants such as FairPrice or TransitLink.

Those with high chronic medication needs and bills who enrol with a GP clinic can opt for a new Healthier SG chronic tier to access certain common drugs at prices comparable to those at polyclinics from early next year. This is an enhanced subsidy for chronic drugs at GP clinics for Healthier SG enrollees who are Community Health Assist Scheme (Chas) cardholders, said the minister.

Apart from this preventive health strategy, the Ministry of Health (MOH) is also focusing on developing the aged-care system to make it easier for residents to age in the community, instead of in nursing homes, while continuing to increase hospital capacity and build more polyclinics to meet rising needs.

MOH now looks at healthcare as three interlinked systems, Mr Ong said during the debate on his ministry’s budget on Friday.

One is the mature and well-developed acute care system, which treats people who are very sick through hospitals and specialist clinics.

Then there is the population health system, which stresses good health and preventive care through Healthier SG.

The third is the aged-care system that is in its infancy and still developing, but needs to focus on aged care taking place predominantly in the community, said Mr Ong.

The imperative for this transformation is the rapidly ageing population, which he believes is the biggest social development of this generation. 

Mr Ong first described Healthier SG, which seeks to shift the gravity of care from hospitals to the community, at last year’s Budget debate.

Enrolment in the initiative will start in July with those aged 60 and above, but younger residents with chronic illness who are aged 40 and above can pre-enrol from May with their GPs, if their doctors have signed up with Healthier SG. The initiative will be progressively rolled out to those aged between 40 and 59 in the next two years.

The idea is to get residents to build a long-term relationship with one family doctor, who will help them take charge of their health.

Traditionally, many patients with complex chronic diseases prefer to get their medications from polyclinics because of the lower prices. Their current Chas benefits are not enough to pay for the drugs at GP clinics. 

But with the new chronic tier, they will be able to get their supply of chronic drugs from GP clinics at around the same price as at polyclinics, said Mr Ong.

MPs such as Dr Tan Wu Meng (Jurong GRC), Dr Lim Wee Kiak (Sembawang GRC), Mr Ang Wei Neng (West Coast GRC) and Ms Ng Ling Ling (Ang Mo Kio GRC) had asked for updates on Healthier SG.

Most Healthier SG enrollees, however, likely will not need to switch to the new tier.

Mr Ong said that today, Chas already provides significant subsidies for patients who have lower chronic medication needs. They pay nothing or very little for doctor visits and medications for their chronic conditions. 

Remote video URL

Under this new tier, there is no dollar cap attached to the 50 per cent to 87.5 per cent subsidy for a selected white list of drugs, which are those commonly used in polyclinics, such as metformin and losartan. The subsidy level depends on income level.

But there will be a lower yearly cap for the subsidies for consultation, investigations, other non-drug related care and non-white-listed drugs, compared with the original Chas chronic tier, which is for all components of the patient’s bill, including all medications.

Healthier SG enrollees with Chas cards will have the same Chas subsidies for common illnesses. There is no change for Chas cardholders who do not enrol in Healthier SG.

Also, from early next year, enrolled residents with chronic conditions can use their MediSave savings to pay for their full treatment at their primary care clinic, subject to a withdrawal limit, instead of having to co-pay 15 per cent of their bill in cash. 

Dr Tan said the healthcare system must allow sufficient time for consultations, particularly in Singapore’s ageing society.

“If a clinic is too busy and consultation times are too short, it becomes harder to promote health,” he said. “Six sessions of five minutes each are not the same as a half-hour conversation.”

So far, about 800 of the 1,200 GP clinics that are on the Chas scheme are part of a primary care network, which is a prerequisite for Healthier SG. Eligible residents will be invited to register and choose their preferred clinic with the HealthHub app. 

In his speech, Mr Ong also said his ministry is looking into the growing issue of abuse in healthcare institutions, and will share its plans on this later this month. This will help to keep healthcare staff motivated, particularly given how tight the healthcare manpower situation is, even as the nursing and support care workforce is being beefed up.

MOH will also invest in the right IT tools and systems to allow patients’ key health data to be shared across health providers in a safe and secure manner.

Mr Ong said the ministry is supporting GPs in many ways, including offering IT grants and paying annual service fees for the GPs to look after Healthier SG enrollees.

As MOH will be fully funding preventive services such as nationally recommended vaccinations and health screenings for enrolled Singaporeans, GPs will very likely have to deliver more of these services, he said. 

Remote video URL

Join ST's WhatsApp Channel and get the latest news and must-reads.