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Non-constituency MP Gerald Giam on Tuesday made a push for lower co-payments under the national health insurance scheme MediShield, so that patients will not shy away from necessary medical care or cut back on medication.
He proposed an annual cap on out-of-pocket expenses that go towards co-payments, which "can be financially crippling". Any medical bills above this cap would be paid for by the Government, suggested the Workers' Party MP.
His call prompted Health Minister Gan Kim Yong to stress that co-payment remains important in preventing over-consumption of health-care services.
Currently, patients in Class-C wards have to pay the first $1,500 of the bill before they can tap MediShield. The amount, called the deductible, is set at $2,000 for patients in higher-class wards. On top of this, they also pay co-insurance which is about 10 to 20 per cent of the amount claimed.
Mr Giam, who had filed an adjournment motion in Parliament to speak more about health-care financing, noted that developed countries such as Japan and New Zealand limit the amount of co-payments their citizens pay.
In a 15-minute speech, he also pointed to a US study which showed that higher co-payments prompted poorer patients to avoid treatment. In a separate study by Harvard Medical School, he said, more heart attack patients whose co-payments were waived took their medication regularly.
Said Mr Giam: "An annual cap on out-of-pocket payments will limit the financial risk that individual patients are exposed to, and help allay the anxiety of many Singaporeans about uncertain medical expenses."
Last year, more than 2,400 MediShield policyholders made hefty co-payments of more than $10,000 each.
Mr Gan said the current review of health-care financing - which includes revamping MediShield to MediShield Life - aims to reduce co-payments for patients.
MediShield Life, announced in August, will cover all residents for life, including those with pre-existing conditions.
Overall, the Government will do more to enlarge its share of health-care costs from less than one-third to more than 40 per cent, added the Health Minister.
Another idea offered by Mr Giam is a "premium subsidy programme" for vulnerable groups like low-income families to offset higher premiums that would come under the new MediShield Life.
Means testing should also be made simpler, added Mr Giam. For instance, patients could simply give consent for health-care providers to access their income records with the relevant agencies, rather than having to physically submit income documents.
He cited a resident in Bedok with chronic lung disease who gave up applying for financial aid due to the onerous administrative process. Instead, he skipped medical appointments and cut back on medication to save money.
On the larger issue of healthcare costs, Mr Gan said these must be "carefully managed" to avoid higher taxes in the future.
"The health-care financing system in Singapore is fundamentally sound," he said. "But we need to 'future-proof' it so that it remains effective and relevant for many more years to come."
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