Govt to keep eye on big bills, large claims

SINGAPORE - The Government will keep a keen eye on health-care bills and claims to ensure that MediShield Life does not get abused.

Addressing the issue of over-consumption and over-provision, Health Minister Gan Kim Yong said health-care dollars must be spent wisely.

"Providers should not prescribe more costly tests and treatments simply because patients are covered by insurance, if these provide limited value," said Mr Gan.

He said the Government will do more and work with insurers to develop a framework to share information on unusually large bills.

The reasons behind exceptionally high claims will also be studied if the ministry observes certain patterns of claims or behaviours by health-care providers.

Endorsing the MediShield Life Review Committee Report in Parliament yesterday, Mr Gan said the hallmarks of a good system are that it is cost-effective, accessible to all and sustainable for current and future generations.

He reiterated that co-payments remain a "cornerstone" of Singapore's health-care financing framework, which would work to impose discipline on both providers and patients, to focus on "the most clinically appropriate and cost-effective option".

While he noted that national insurance schemes with minimal co-payment might seem alluring, he said it might not give the best outcomes.

"With minimal or no co-payment, patients are likely to consume more, or providers supply more - and more does not mean better," he said.

"The costs are ultimately borne by the rest of the people, in the form of higher premiums or taxes."

Mr Gan also explained that the reason behind keeping the deductible - a portion of co-payment - despite calls to have it lowered or removed, was to ensure that the scheme remains focused on providing assurance against large bills, instead of paying for smaller amounts that can be covered by Medisave.

And bearing in mind that it is a constant challenge to balance a finite government budget among competing needs of the nation, Mr Gan said: "This is why we need to ensure that the Government, providers and patients all have a responsibility in paying for and managing health-care costs so that their interests are aligned."

While Members of Parliament gave their support to MediShield Life, some like MP for Marine Parade GRC, Tin Pei Ling, and Nominated Member of Parliament Mary Liew asked how confident the Health Ministry was that the premiums would stay affordable after transitional subsidies end.

Meanwhile, Janil Puthucheary, MP for Pasir Ris-Punggol GRC, wanted to know if the increased burden of health insurance might see costs being cut elsewhere - and whether medical research could suffer.

samboh@sph.com.sg

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