Amid the euphoria of the Pioneer Generation Package (PGP) announcements, it is hard to be a wet blanket. In fact, it seems almost churlish to question the package of medical subsidies the Government has committed to giving the "pioneer generation", or those aged 65 and above.
But before the headlong rush into implementing the package, it would be timely to step back and ask whether there are aspects that can be done differently. I do not doubt the Government's sincerity and commitment. At the same time, one cannot help but wonder whether the package will fully achieve its twin objectives of providing our pioneers with not only lifelong medical care but also financial peace of mind.
The great artist and inventor Leonardo da Vinci elegantly articulated: "Simplicity is the ultimate sophistication". For the PGP, simplicity is vital. The scheme targets citizens who are educationally, linguistically and socially diverse. Policymakers have to deliver messages simple enough to be understood and yet powerful enough to resonate.
If one does not understand, it is difficult to feel reassured.
A recent survey highlighted that seven in 10 Singaporeans had heard of the PGP but more than half admitted they did not know or understand the benefits. The statistics among the target group, the pioneers, I suspect would be even more modest.
It is striking that in rolling out the PGP, the Government has found it necessary to establish a task force, helmed by two ministers, which has prioritised communicating the benefits to the intended recipients. Co-chairman of the task force, Senior Minister of State for Health, Dr Amy Khor, described last month plans to train 1,000 front-line staff and said that the Government would be "running through with them the various questions and concerns that Singaporeans may have regarding health-care subsidies and also to help them address some of these questions and concerns to provide reassurance to patients".
Perhaps the challenge really lies in the complexity of the design. From a policy perspective, the PGP sits on top of the existing 3M (Medisave, MediShield, Medifund), Chas (Community Health Assist Scheme) and CDMP (Chronic Disease Management Programme) schemes, which arguably, most Singaporeans do not fully understand anyway. In the proposed system, there are multiple tiers of subsidy depending on whether the presenting disease is deemed "simple" or "complex", whether the disease is included in the CDMP, and so on.
The contrast with many countries with universal health coverage is stark. The message should be simple: At the point you need health care, concentrate on getting well; don't worry about money. In many schemes globally, there are no co-payments required, or if there are, these are in the form of fixed amounts with annual limits. In Singapore, the individual's co-payment can soar while the Government's share (subsidy amount) is capped.
Australia announced in its Budget last week that the government would impose a A$7 (S$8.20) co-payment for each visit to the general practitioner, up to a total of A$70 a year for concessional patients.
No caveats depending on type of disease, no exclusions depending on housing type or income. Just a simple A$7 figure to understand and remember.