YOU want the five Cs - car, condo, cash, credit card and country club membership. If the demand for C class hospital beds is anything to go by, such beds may well be the sixth C.
The question is, if you already have the five Cs, do you still deserve to be considered for the heavily subsidised C class bed?
The answer, from Health Minister Khaw Boon Wan, even after means testing is introduced later this year, is a qualified yes: You will retain the freedom to choose which class you want to be warded in.
'Rich or poor, they must be able to choose class C or class B2 ward if they wish,' said Mr Khaw at the Ministry of Health 2008 Healthcare Dialogue yesterday.
C class beds enjoy 80 per cent subsidy from the Government and B2 beds, a 65 per cent subsidy.
These two heavily subsidised wards also attract a sizeable number of patients from households whose earnings were in the top 60 per cent of people here.
Mr Khaw's assurance provides a measure of relief to those in the middle to upper-middle income group who have been choosing subsidised hospital wards so far.
In the most recent patient profile study done by MOH in 2004, four in 10 patients in C class wards come from households whose earnings were in the top 60 per cent.
As Mr Khaw pointed out, hospital costs are high and patients who require prolonged hospitalisation, especially in the intensive care units, or the chronic sick who need frequent hospitalisation, do worry about their ability to pay.
Last year, health subsidies to Singaporeans exceeded $1.5billion.
While this is not a small sum, and while the Government will continue to increase the quantum, funds are not unlimited, said Mr Khaw.
It is a question of fairness.
A middle or high-income patient occupying a C class bed does prevent another low-income patient from using that service.
Are such middle and high-income earners freeloaders taking advantage of bigger subsidies meant for the very poor?
Not necessarily.
Take the case of Madam Ng Gek Chiang, 74.
She has liver cirrhosis and has been hospitalised five times in the past seven months.
Cirrhosis is a condition where the liver becomes scarred, fibrous and filled with fat, reducing its ability to function.
She has severe water retention on her legs, stomach and body.
A couple of weeks ago, she fell and broke her right thigh bone.
One of the two daughters who look after her lives in a semi-detached house in a good area.
The other, a social worker, lives with Madam Ng in a fully paid-up 3-room flat.
Both decided to put their mother in a C class ward.
Why?
They were not being stingy.
They love their mother.
The way they see it, they have a logical reason for choosing a C class bed: They are bracing for future hospital bills and want to be prepared.
Said Madam Ng's daughter, Mrs Christina Lim, 51, a housewife: 'I may live in a semi-detached house. But it was bought by my businessman husband who is the breadwinner. He does not get on with my mother, so I don't feel good asking him for money for her.'
So far, she and her younger sister, Ms Angeline Lim, 36, have been pooling their resources to look after their mother.
'I am very pleased with the C class ward,' added Mrs Lim, who has a 25-year-old son in university.
'There are only 10 beds and nurses walk in and out all the time, so my mother does not feel lonely. It is also airy and breezy.'
Indeed, the increasingly marginal difference in ward facilities was highlighted by Mr Khaw.
The differences used to be stark.
C class wards used to be 40-bedders.
But as public hospitals are being re-built, such differences between the wards are being significantly reduced.
One example is the new Khoo Teck Puat Hospital, where communal toilets for B2 and C class wards will be moved into the wards.
MARGINAL DIFFERENCES
'With such marginal difference in ward facilities, while fees in B1 class are more than double those in B2 class and four times those in C class, we expect many patients who would normally choose B1 class to now choose B2 or C,' he said.
'This will further reduce the lower-income patients' access to B2 and C facilities.'
Hence the need for means testing. That would lessen the subsidy for the more well-off should they choose B2 or C class wards.
From the first day that Madam Ng was warded seven months ago, doctors have told her daughters that she will need to be in and out of hospital very often.
'We don't want to spend all our resources on non-subsidised healthcare and run out of money before my mother dies,' said Mrs Lim.
On top of looking after her mother, she has her own health issues to deal with. She is a colon cancer survivor who still needs a stoma bag.
'Every day I need to change the bag two or three times. Each bag costs $3. My husband gives me a monthly allowance of $1,200, out of which I have to keep house and pay for things such as my stoma bags,' she said.
Her husband has also been topping up her Medisave, so she now has about $15,000 in it.
That, plus her younger sister's Medisave account have been paying for Madam Ng's care.
So far, each hospitalisation has cost between $800 to $1,000.
Ms Lim's Medisave has taken care of it. But she has only $13,000 left in her Medisave.
Said Ms Lim, who earns over $1,000 a month: 'The money that we have will not last forever. We must conserve it to make it last as long as possible.'
She and her sister are hoping to be able to get more subsidies for their mother when she is discharged to a nursing home.
Said Mrs Lim: 'That costs $80 a day. More expensive than the C class ward which costs $35 a day.
'If I have unlimited resources, I will put my mother in a better class. But the reality is I have limited resources.'
Yes, she is worried about means testing.
'On paper it may look like we are okay and generally we are.
'But if you dig deeper, there are all sorts of issues that each family faces which I hope means testing will be able to address,' she said.
