The Community Health Assist Scheme (Chas) is an excellent strategy to improve our health-care system, and I commend the respective agencies for their efforts ("Health help plan crosses half a million mark"; Jan 20).
However, the number of participating clinics has reached a saturation point.
Deputy Prime Minister Tharman Shanmugaratnam said close to half of all general practitioner and dental clinics in Singapore are on the scheme.
So what is stopping the other half from signing up?
First, it is difficult to administer the scheme.
Approval for claims is not automatic. The clinic manager will need to check if the reimbursement is approved and transferred into the clinic's bank account.
Should the submission be rejected, the doctor can choose to make an appeal, absorb the cost or claim it back from the patient. All these options are not ideal and need additional resources and goodwill to accomplish.
Second, the clinic needs to submit the diagnoses along with the claims.
But the suggested list of medical conditions is not comprehensive and free text is not allowed, adding to the doctors' frustration.
Third, the audit is too onerous.
Doctors may be asked questions that would not have arisen if the auditors understood the context or if the online template was better designed.
On the bright side, with more clinics participating in the scheme, Chas can be used to distribute health-care subsidies equitably across all segments of the population and at all public institutions.
The scheme can be extended to cover all Singaporeans. The subsidies granted can be stored in the Chas card and vary according to per capita income.
The subsidies can be adjusted annually after the authorities have reviewed the cardholders' income tax returns. They can also be adjusted more frequently in bad times when retrenchment is high.
The Chas card should cover treatment at primary care, secondary care, tertiary care, and intermediate and long-term care facilities.
Singapore has an excellent tool in Chas. I hope the authorities will maximise its potential for the benefit of all.
Leong Choon Kit (Dr)
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