Greater peace of mind on health care

Coping with health-care costs has been a major worry for many Singaporeans, but recent measures by the Government are helping to ensure that Singaporeans have less reason to fret.

Among the moves announced by Health Minister Gan Kim Yong in Parliament yesterday were more drug subsidies for those who need continuing care after leaving the hospital, and extending the use of Medisave funds and Community Health Assist Scheme (Chas) subsidies to cover a wider variety of chronic conditions.

Seniors aged 65 and above will also be able to use another $200 a year from their Medisave to pay for outpatient treatment, he said in response to calls by Dr Fatimah Lateef (Marine Parade GRC) and Dr Chia Shi-Lu (Tanjong Pagar GRC) for more flexibility in Medisave use.

At the same time, Mr Gan reiterated that Singaporeans will be able to use Medisave to pay for premiums under the MediShield Life insurance scheme, which will cover all Singaporeans for life.

For those who want to add enhanced coverage to cover the costs of a more comfortable hospital stay, the Government is working with private insurers to develop a new standard Integrated Shield Plan. This will be rolled out in the first half of next year, Mr Gan assured Dr Chia and Mr Ang Wei Neng (Jurong GRC), who asked for a progress update during the debate on the Health Ministry's spending plans.

Together, these actions increase the Government's share of health-care spending, make Medisave more useful, and allow more risk-pooling through MediShield Life.

And there is little doubt they will help lessen Singaporeans' concerns about their medical bills. But regular reminders about the importance of staying healthy could also be useful. By the time

something goes wrong with a person's health, it is often too late to do much about it.

That's why Dr Chia's suggestion yesterday for a HealthFuture scheme - borrowing from the new SkillsFuture initiative - was intriguing.

He proposed a HealthFuture account for each Singaporean, to be used for healthy lifestyle programmes such as smoking cessation, weight loss, exercise classes or health screenings.

Just as the SkillsFuture account aims to help Singaporeans maintain their employability through credits that can be used for training courses, the HealthFuture account could encourage them to proactively upkeep their health. Such an account would prompt Singaporeans to "invest in our own health, for now and for the future", Dr Chia said.

He suggested that HealthFuture funds could take the form of contributions by the Government, employers and individuals, or come from Medisave, adding: "We all recognise the importance of keeping healthy and disease prevention, but walking the walk is far more difficult than talking the talk."

Responding to Dr Chia's idea, Parliamentary Secretary for Health Muhammad Faishal Ibrahim reminded the House that "Singaporeans do not necessarily have to spend money to keep healthy".

"First and foremost, investing in health needs to start with our own personal decision to stay healthy," he said. He cited steps the Health Ministry has taken to encourage such a decision, including advertising campaigns for healthy eating and an upcoming health and wellness mobile app.

How effective this has been in changing the behaviour of Singaporeans, however, is difficult to tell. They may need a jolt from a more radical idea like HealthFuture, which has the potential to increase the sense of control and immediacy that people have about their health.

In fact, a similar scheme already exists in the form of national sports movement ActiveSG, which offers a $100 credit for the use of sports facilities to anyone who signs up as a member. It has drawn 670,000 members since its launch last year, a testament to the power of financial incentives.

Building on both ActiveSG and Dr Chia's idea, perhaps those Singaporeans not inclined towards sports could be allowed to use the $100 credit for pre-approved health programmes instead.

To give them a greater sense of urgency, these credits could adopt a "use it or lose it" policy. If not used within a year, the credits would expire.

While such a scheme will involve some initial outlay, it could prove cheaper in the long term if Singaporeans are galvanised into overcoming obesity and smoking, or going for health screenings that could detect any problems early.

This would be one key way to ensure Singapore's health-care system remains sustainable and affordable over time, which was a concern of many of the 19 MPs who spoke during the debate on the Health Ministry's budget.

But, as Dr Fatimah noted, everyone has a role to play in keeping health-care costs down. Patients should keep themselves up-to- date on health issues and have realistic goals, while health- care providers should not "over-service" patients, and policymakers must walk the ground to better understand the issues, she said.

As Singapore's population ages and health-care spending continues to climb - from $9 billion this year to a projected $13 billion in 2020 and even more beyond that - it will be crucial for each Singaporean to take responsibility for his or her health, as early and as regularly as possible.

This article was first published on March 13, 2015.
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