Fear not, as Singapore improves...with ageing

SINGAPORE - In a light-hearted moment in yesterday's Parliament debate, Dr Janil Puthucheary (Pasir Ris-Punggol GRC) put on his doctor's hat to dispense eight healthy living tips that he said would "guarantee a better life... confirmed".

His prescription list drew equal amounts of laughter and appreciation from a group of the more senior Cabinet ministers, as the House yesterday turned its attention to tackling the very serious issue of an ageing Singapore.

Whether ageing can be an opportunity to be embraced or an obstacle that will slow Singapore down was a theme of yesterday's sitting - the second day of debate on the President's Address - in which 17 MPs rose to share their views.

With the Government unveiling recently a slew of health-care measures from the new Medishield Life universal medical insurance to improved subsidies and schemes like the Community Health Assist Scheme, several MPs raised concerns on health-care financing and consumption.

Dr Chia Shi-Lu (Tanjong Pagar GRC) cautioned that health care should be utilised appropriately.

"This is not just about dollars and cents, but unwarranted health-care use may do us more harm than good," he said.

He cited a state in the United States where people were randomly selected to be given expanded medical insurance through a lottery system. Believing the system would make them healthier, it instead led them to make more visits to the doctor.

Non-Constituency MP Gerald Giam said he hoped the Government would take on more risks in health-care financing by subsidising premiums and removing claim limits under the new Medishield Life universal medical insurance.

But when he said that it was relatively easy to predict medical insurance payouts, he drew sardonic laughter from some members of the House and a swift rebuttal from Dr Puthucheary and Health Minister Gan Kim Yong that it was very difficult to forecast costs, due to drivers like technology, ageing and ease of access.

But beyond the debate on improving how medical costs can be financed, Mr Gan sought to make the House appreciate that ageing is a blessing.

"While we speak of the challenges of an ageing population, we should not forget that ageing and longevity is a blessing. We are all living longer and that is a good thing. But we must plan ahead to help Singaporeans age successfully and meaningfully," he said.

He announced plans to build a "Nation for all Ages" with a national agenda that would enable people to live meaningful lives as they age.

This masterplan will cover education, employment, volunteerism, urban infrastructure, health care, retirement adequacy and research into ageing.

Similarly, Senior Minister of State for Health Amy Khor sought to provide assurances that growing old in Singapore does not need to be feared.

She vowed that there will be improvements to the Central Provident Fund system. Suggestions over the past two days for higher returns, higher contribution rates for older workers, and more ways for retirees to monetise their homes will be considered, she promised.

However it was not just the ageing of Singaporeans that was the focus of the debate, but the ageing of Singapore as a nation and society, as several MPs addressed longevity of another kind.

As Singapore reaches its 50th year of independence, the MPs called on society, institutions and the approach to politics to evolve in order for the nation's maturation not to be a burden but a boon.

Ms Tin Pei Ling (Marine Parade GRC) made a heartfelt plea to keep the system of meritocracy, and not hold back the best and brightest just for "some misguided sense of social fairness".

But this meritocracy must be tempered by compassion and a sense of community, she said.

Nominated MP Laurence Lien said the Government needs to improve its relationship with civil society by having regular strategic dialogues to discuss social problems, and having more transparency over data and research.

Civil society itself must also do more to tackle the root causes of problems and not just their symptoms, he said, and to have discourse that is civil, he added.

A changing political climate also demands evolution in institutions and the approach to politics said a few MPs.

Ms Denise Phua (Moulmein-Kallang GRC) repeated a call for the elected presidency to be scrapped, arguing that voters should have to live with their decisions, and also proposed reforms to strengthen the civil service to prepare for a future of "revolving-door politics".

But she also urged an examination of and agreement on "some fundamentals as a people so that indeed the best days lie ahead", such as the principle of work before welfare.

Dr Puthucheary used the challenges in the medical profession as an analogy to describe the dangers of politics and how debate and disagreement may not always result in the best outcome for the country.

"You don't have to look very far or very hard for examples where short-term policy interest or short-term electoral interest has meant that the long-term health of a nation has not been served, where the attempts to reform a public health-care system for the greater good have been blocked by the pursuit of electoral advantage," he said.

From yesterday's debate, whether it is in health care, the social compact or political contestation, it appears that all MPs agree that as Singapore gets older, the challenges it will face will get more difficult and complicated.

But Dr Khor offered a different perspective as she reflected on her own ageing.

Quoting the late Catholic writer Henri Nouwen, she said: "Ageing is not a reason for despair, but a basis for hope, not a slow decaying but a gradual maturing, not a fate to be undergone but a chance to be embraced".

Similarly, as Singapore gets to 50 and beyond, this ageing should not be cause for despair, but should be embraced as a chance to change and improve.

This article was first published on May 28, 2014.
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