Helping patients look after themselves 'can cut costs'

SINGAPORE - Ageing Asian countries can get patients to look after themselves as a way to slow down rising health-care costs, suggested Health Minister Gan Kim Yong.

Opening the Healthcare in Asia 2014 conference held by the Economist magazine last week, Mr Gan said instead of getting more health-care workers to look after an ever growing number of patients, countries should switch to supporting patients "to administer care themselves" where it is safe to do so.

Citing Sweden's self-dialysis programme as an example, he said nurses there have helped 60 per cent of patients to "operate the dialysis machine, interpret lab values, and document their own care on a report form themselves".

Not only did it reduce the cost, but it also increased compliance and reduced complications, he said at the 1 1/2 day event at Swissotel Merchant Court.

Mr Gan also touched on the need for Asian countries to tap technology: "These societies will need to adopt health-care technologies in a big way, and fundamentally rethink the role of technology and human contact in the delivery of health care and social care."

He shared with the more than 100 regional delegates at the event, the fifth in the series, how Singapore will be introducing universal medical insurance coverage, with help for middle- and lower-income groups.

As the country moves towards universal insurance coverage, Mr Gan said it has to ensure that this remains sustainable.

"We must guard against overconsumption as we and our children will eventually bear the cost," he said. "The challenge is calibrating it right."

This is a problem Japan now faces, said Mr Toshiro Kumakawa, director of Health and Welfare Services at Japan's National Institute of Public Health.

He said Japan "does not have enough budget for sustainable universal care" with its ageing population.

Another Japanese speaker, Mr Shinichi Kitajima, an adviser to Mitsui Sumitomo Insurance, said this was why Japan is raising its consumption tax from 5 to 7 per cent next month and to 10 per cent next year.

A major worry now, Mr Kitajima added, is the widening disparity between the rich and the poor.

Mr Ali Ghufron Mukti, Indonesia's vice-minister for health, spoke of a 200 per cent increase in health-care costs since the start of this year when the country launched universal coverage.

In Indonesia, there is no need for co-payment, as insurance takes care of the entire bill.

The government pays the premium for 6.4 million people who are "poor or near poor", he said.

To get private hospitals to take part, the government raised the amount that hospitals can claim, by 300 to 600 per cent, he said.

As a result, more than 900 private hospitals are now part of the universal coverage network.

As for South Korea, a roadbump to its move into universal coverage was the large number of treatments not covered by insurance, meaning patients had to continue paying for them with cash.

However, Mr Kim Yoon, research head at South Korea's Health Insurance Review and Assessment Service, said Seoul will spend US$13 billion (S$16.5 billion) between now and end 2017 to raise insurance's share of bills from 76 to 86 per cent.

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