I THANK Ms Salma Khalik for sharing her thoughts on hospital means testing.

She asked if it was time to introduce 'One subsidised class for all?' (ST, Feb 5), by abolishing C-class ward (while retaining the full C-class subsidy rate of 80 per cent) and setting B2 as the lowest ward class in public hospitals.

She felt it was timely for such a development as 'today, Singapore is a much richer country with more demanding citizens'.

There are serious problems to her suggestion.

First, as she noted herself, such a change will further push up cost for the middle class: 'For the better off, the deal will not be so sweet.'

Second, she also acknowledged that government subsidies would be further stressed, 'since merging the two classes could mean many more people getting an 80 per cent subsidy'.

The reality is that such a suggestion will ultimately come at greater cost to all Singaporeans.

While we will continue to upgrade our health-care facilities, we should always be mindful that the demand for health-care services is potentially bottomless. Every service enhancement has to be carefully and objectively assessed for its value and effectiveness, knowing the additional costs have to be jointly borne by all stakeholders: patients, employers, insurers and the Government.

The United States and some other countries' healthcare systems (with up to 16 per cent of GDP spent on health care) should be a warning to us. If we are not careful, health care will absorb a disproportionately large part of Singapore's income, at the expense of sacrificing important needs, including investments in education and defence, besides burdening our local industry and eroding its international competitiveness.

It is wiser and more prudent for us to make careful and gradual refinements to our health-care system, which has provided Singaporeans with a high standard of health care at a rate (4 per cent of GDP) affordable to all.

It is a daunting task just to maintain this current outcome amid increasingly costly medical advances and the rapid ageing of our population.

The Health Ministry will do its best, but we need the participation of Singaporeans and their understanding that we need to temper expectations and manage demand within the limits of our resources.

Karen Tan (Ms)
Director, Corporate Communications
Ministry of Health

This letter was first published in The Straits Times on Feb 7, 2008.