I REFER to the Ministry of Health (MOH) proposal to use means testing to determine medical subsidies.
While I agree the rich should be subsidised less than the poor, I am unable to reconcile some issues.
- One, how much will MOH save? Resources will be funnelled to implement this project. Will the end results more than justify the costs? Minister Khaw Boon Wan cited the example of a patient earning $10,000 choosing to stay in a Class C ward to get an 80 per cent subsidy on hospital charges. Are there many such people? If his stay is short, would this patient mind paying a few hundred dollars more for greater comfort? If his stay is longer, would he mind paying more so he can recuperate in a better ward?
- Two, how will the middle class be impacted? The sandwiched class seems to get squeezed further. The individual earning $1,000 should be given his subsidy but what of one earning $3,000 but with $2,900 of liabilities, who has to pay for another hospitalised family member?
- Three, treatment of income. Using tax or CPF statement is a backward-looking approach. Those who can return to the same income-generating capacity have no issues. But what of those who may have to change their vocation because of their illness? They may have to settle for lower income or even none for prolonged periods. Does this new proposal add to their financial burden? Again, my concern is not with the rich but with the middle class.
- Four, where will the money saved go? The rich will be subsidised less, but are the poor subsidised more? Will MediShield coverage be improved or its premiums reduced? Will more accessible financial schemes be launched to help those in need?
- Five, repercussions on health-care supply-demand dynamics. If the objective of moving richer patients to better wards is achieved, will it lead to overcrowding in Class A and B1 wards? If the increased demand for these better wards is not met by public hospitals, patients will seek treatment at private hospitals, whose charges will go up. Demand still exceeds supply. It's a reallocation of burden, not a solution.
