Urgent need to plug gaping holes in our healthcare system

Written by Ng E-Jay
03 Sept 2009

As our population ages, there is an urgent need to plug gaping holes in our healthcare system in order to ensure that all citizens, especially our elderly who need it most, get access to decent and affordable healthcare.

An ST letter “Multiple tiers of protection for all” (2 Sept) penned by the Ministry of Health suggested that healthcare in Singapore is universal and no one is left behind. Unfortunately, the same letter also admitted that Medishield coverage stops at age 85, making our medical insurance system far from universal. The same goes for similar insurance schemes provided in the private sector.

Our elderly who are above 85 years of age are the ones who require healthcare the most as they are the group most susceptible to chronic ailments and terminal illnesses. If they are uninsurable, then the onus must fall on the Government to provide heavily subsidized healthcare to them so that they are not financially burdened in the final years of their lives and do not have to land their children heavily in debt as a result of financing their healthcare needs.

In just the five years between 2000 and 2005, the number of people over the age of 85 has soared by almost a third, from 17,523 to 22,580. This number will only grow more rapidly over the next few decades.

It is imperative that a more affordable system of healthcare be provided for citizens over 85 years old. At the very minimum, they should enjoy some basic insurance coverage even past the age of 85, regardless of how much savings they have left.

The Ministry of Health’s ST letter stated that the healthcare needs of Singaporeans are met by a multi-tier system comprising of Government subsidized class B2 and class C hospital wards, Medisave, insurance schemes like Medishield and Eldershield, and finally, Medifund for those who have fallen through the cracks.

But is the current approach sufficient for our needs?

People with acute or critical illnesses can still end up being saddled with huge hospital bills despite all of the above schemes because healthcare costs have been rising dramatically over the years which subsidies have thus far been unable to plug.

A recent video by AFP told the story of a woman who had been left destitute after paying for her late husband’s medical bills. What has happened to the supposedly comprehensive affordable healthcare system that we are providing our citizens?

Our much-vaunted Medishield insurance scheme also suffers from severe deficiencies (as do many similar schemes by private health insurers).

Parent Leslie Ong recently wrote an ST letter stating that his first born had been completely denied Medishield coverage because she had been born with suspected cysts in her lungs.

Even basic MediShield coverage with an exclusion for his daughter’s pre-existing condition was denied.

Ironically, it is such babies who are most in need of proper medical coverage and subsidized healthcare because they have a higher chance of developing medical complications later on.

If insurers deem such babies are uninsurable, then the Government should provide complete subsidies for healthcare needs arising from their pre-existing conditions.

To leave the parents in the lurch and possibly enslave them with heavy medical expenses that can stretch a lifetime because they have conceived a child with some pre-existing medical condition is cruel and inhumane. It does not do justice at all to the parents who have taken the effort to conceive and raise Singapore’s next generation.

With the general cost of living so high and medical costs in particular going through the roof, is it any wonder that our birth rate is so low? Many parents must feel the anxiety of having to raise children in such an environment where the Government leaves them to fend for themselves just when they need the most assistance.

Our Medisave system is also in need of an urgent overhaul despite the fact that around $42 billion is sitting in Medisave accounts.

There are some housewifes who do not contribute to Medisave because they want to raise their family and choose not to work as a result. Medisave will provide little or no protection for them in the event of illness.

In such a situation, the Government wants to push the buck of elderly care to the next generation by using laws such as the Maintenance of Parents Act in an attempt to wash its hands clean of the situation. This is coldhearted and mercenery.

While it is right and moral for children to care for their old folks in their golden years, the Government must also provide a more affordable healthcare system to them so that they can live out their lives in dignity and with peace of mind, and avoid having to saddle their kids with crushing debt as a result of healthcare needs.

Clearly, much more needs to be done to improve our healthcare system which is leaving people in the cold just when they need help most.

  1. This is not a rhetorical question, this is a geniune dilema:

    Healthcare costs increase exponentially as the average person advances in years.

    If the cost of keeping the average person alive beyond the age of 85 is equivalent to the cost of educating 10 average poor children a year, is it fair to make it mandatory for everyone to bear the costs (through health subsidies/insurance using taxpayer money) of keeping those above 85 alive?

    In another words. Do people above the age of 85 have a right to live, at the expense of the quality of life of those below the age of 85?

  2. “Do people above the age of 85 have a right to live, at the expense of the quality of life of those below the age of 85?’

    Is this a false dilemma?

    Hypothetical: Does my loved one in ICU have a right to live, at the expense of my quality of life?