How the Shield was forged

How the Shield was forged
MediShield Life Review Committee chairman Bobby Chin (fourth from left) with some of the committee members - (from left) Mr Abdul Rohim Sarip, Mrs Oon Kum Loon, Dr Tan See Leng, Mrs Hauw Soo Hoon and Mr Patrick Lee.

SINGAPORE - It took seven months, 36 focus-group discussions, considerable burning of the proverbial midnight oil and some fireworks to produce the 116-page final report on MediShield Life.

And the only things the MediShield Life Review Committee chairman Bobby Chin is sure of, he says, are that "the journey has been very tough" and that the final report "does not deliver everything people want" - but is what he and his committee felt was best for all Singaporeans.

Delivering everything people wanted would have been impossible, says Mr Chin, former managing partner of international accounting firm KPMG Singapore and a member of the Council of Presidential Advisers.

The 1,700 people who attended discussions or sent in their views had asked for everything under the sun - reducing or removing deductibles (the portion people have to pay before insurance kicks in), better benefits, no-claims bonus for those who keep healthy, lower co-payment (the patient's share of the bill on top of the deductible) and even death benefits.

"Every single benefit affects premiums," says Mr Chin, and a prime directive was to ensure that premiums remained "affordable".

The 11-member committee comes from a mixed background, with only four with financial experience. The others include heads of hospitals, the labour movement and big business as well as grassroots leaders and welfare practitioners.

So most had a steep learning curve to educate themselves before they could contribute meaningfully to discussions."There was a lot of personal reading up. But within a month, everybody was up to speed," says Mr Chin.

Ms Janet Ang, managing director of computing giant IBM Singapore, recalls: "We needed to read up, but the (Ministry of Health) secretariat was very effective in getting experts to brief us." This included getting academics to talk about how other countries do it.

"All in all, I probably spent close to 100 hours working with this committee," she says, adding that she had put this work as "high priority" and tried to attend as many sub-committee meetings and public forums as possible.

Lawyer Abdul Rohim Sarip, who also spent close to 100 hours on this, says: "There was nothing easy about this job. One has to do lots of reading, firstly to understand the complex health-care system, to make sense out of all the policy decisions, and then to make recommendations."

He adds wryly: "I can say that I spent more time in this one committee in seven months than in all other committees I sit on in a whole year! And I sit on many committees."

The review committee was supported by a 23-member Ministry of Health (MOH) secretariat that provided information, did the number-crunching, typed up reports - and provided breakfasts, snacks and drinks at the 30 meetings held over weekends and evenings. This was on top of the 36 focus-group discussions. Says Ms Sinni Lim, assistant director of finance policy at MOH: "After seven months, we know the coffee preferences of the members."

Friction is inevitable with such intense work, but everyone involved is being diplomatic about it, now that it's a wrap.

Dr Tan See Leng, group chief executive officer of private hospital group Parkway Pantai, reveals: "There were many heated debates and constructive proposals which warranted long hours of consideration and discussions. There were also varying viewpoints but the bonding and camaraderie were exceptionally strong."

Mr Rohim recalls: "Some issues, we agreed on immediately, unanimously. But for some, there were strong debates, even arguments."

Mrs Oon Kum Loon, who is on the boards of shipping conglomerate Keppel Corporation and Singapore Power, describes the sessions as "robust", while Mr Patrick Lee, chairman of apparel manufacturer Sing Lun Holdings and Kwong Wai Shiu Hospital, says: "We had several healthy disagreements and debates."

From the secretariat, MOH's principal finance policy specialist Lee Shiao Wei says: "They did not take anything at face value, (and) were rigorous in scrutinising data, policy rationale and arguments for each proposal."

The CEO-level nature of the committee members' backgrounds proved a factor, with Ms Lee noting that individually and as a group, "this committee brings together a formidable combination of expertise and competencies. They would not simply 'accede'". But she adds that they were not "unreasonable".

Says Mr Chin: "We challenged them. We considered alternatives. We are people of standing. While they (secretariat) offered their views, ultimately, the decision rested with the committee. We must feel comfortable."

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