Dr Lam Pin Min, the chairman of the Government Parliamentary Committee (GPC) for Health, talks about the new measures to make healthcare affordable to all that were announced at the National Day Rally, and the challenges of implementing the new national medical insurance scheme, MediShield Life.
Q: People have commented on the timing of your GPC report.
We did not want to clash with the release of the OSC (Our Singapore Conversation) report, which was going to receive major publicity. After it was released, we realised there was a window period till the rally. I reckoned that was the ideal time to submit our report to the Health Ministry.
Q: How convinced are you that it's a big shift, as the PM said, for healthcare?
It is a fundamental philosophical shift in healthcare financing by the Government. The current philosophy is that of pragmatism, eclecticism and personal responsibility. The fundamental shift entails the Government taking on a bigger role in providing that social safety net and extending a bigger helping hand to Singaporeans' healthcare needs.
Q: Is this shift enough to put to rest the sentiment that Singaporeans can afford to die, but can't afford to fall ill in this society?
This is always work in progress. The Government needs to carefully titrate the policy tweaks to meet the healthcare needs of Singaporeans and to ensure that our healthcare financing policies remain relevant. However, we should not go down the slippery road of excessive and extravagant spending so much so that it becomes financially unsustainable in the long run.
Q: There's going to be public consultation for MediShield Life. What are the challenges?
One is that of the affordability of the premium. How much increase is fair and manageable for the majority of Singaporeans?
Secondly, how much coverage is necessary and sufficient? You can strengthen MediShield to cover very expensive bills, but that will result in significantly higher premiums. Like what PM mentioned in the Rally, Ministry of Health has combed through all the cases, and those cases where patients incurred really big bills and are unable to afford them, are far and few between.
If the increase is too excessive, low-income and elderly Singaporeans will definitely find it difficult to manage. One way is to seriously consider Dr Amy Khor's (Minister of State for Health & Manpower) proposal to front-load the premium.
However, we need to explain to Singaporeans the concept and rationale of front-loading. Younger working Singaporeans can pay higher premiums so that when they grow old and are retired, the premium quantum can be lowered to a more manageable level. It's like front-loading for your own policy in the future.
At the end of the day, insurance is about risk-pooling. Everybody pays into a big pool and you subsidise one another. About 8 per cent of Singaporeans aren't covered by MediShield due to pre-existing illnesses or for other reasons. MediShield Life will include them, many of whom are in the higher-risk group.
I hope the Government will step in to assist, so that the premium will remain manageable for this group. This leads us to the Pioneer Generation Package which PM announced. I'm looking forward to the details.