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Written by Ng E-Jay
25 February 2014
Yesterday, we read the sad news in the Straits Times (Breaking News, 24 Feb) that Some kidney patients had refused treatment and had choose to die.
According to the article, some patients are forced to forgo dialysis because they cannot afford it.
For instance, out of the 24 patients at the Khoo Teck Puat Hospital (KTPH) who had declined dialysis treatment in 2011, two were denied treatment because their families refused to bear the cost, and another four turned down the procedure because they did not want to be a burden to their families. Yet another six rejected the treatment because they felt it was too expensive.
In Singapore, privately-run dialysis centres charge fees ranging from $2,500 to more than $4,000 a month. Patients who wish to be treated at subsidized outlets have to be means tested. Means testing is the government’s way of segmenting a portion of needy patients and declaring them ineligible for subsidies based on their financial background. Means testing is a way for the government to escape its responsibility of caring for all citizens.
Is this the kind of society that we want? Is this the kind of society that we can be proud of? When our children see the lack of compassion that we are showing to needy patients, what values will they imbibe as they grow up? How can the government expect the nation to remain cohesive and united when it demonstrates such lack of care and concern for the sick and needy?
Health care costs, like so many other costs in Singapore, have escalated sharply in recent years. The healthcare sector, in particular, has seen a surge in medical tourism, with wealthy foreigners indulging themselves with our services whilst Singaporeans are means tested to prevent eligibility for government subsidies.
The government should use its large surpluses to build a stronger and more resilient health care sector, and keep costs stable. However, it is extremely sad that the government of Singapore spends the least percentage of its annual budget on healthcare compared to the USA and other developed countries in Europe. We spend a lot of money on defence, on building casinoes and golf courses, but we simply don’t spend much on healthcare.
This is greed without compassion. This is a government that has its heart and its priorities wrong. This is a government that has placed greater emphasis on corporate profits and GDP growth compared to taking care of our aged, our sick, and our needy.
How the PAP government exploits Singaporeans economically
Escalating healthcare costs and healthcare means testing is but one area in which the PAP government exploits Singaporeans economically.
Purchasing basic necessities of life is another area. When we shop for our daily necessities at NTUC, when we sign up for another telephone line with one of the telecommunications companies, when we buy petrol for our vehicles, when we take public transport, we are invariably doing business with Government-Linked Corporations (GLCs).
GLCs control more than 60% of our economy and have a stranglehold on the provision of essential services and basic necessities. When we buy food, when we eat at hawker centres or food courts, when we buy gasoline, when we pay our electricity bills, when we take the bus and train, even when we shop at Popular Bookstore for our school assessment books and stationery, we are invariably contributing profits to GLCs as well as business owners with close PAP links.
When GLCs profit from the provision of essential goods and services to Singapore citizens, it is only right that they return some of the profits to the government annual budget surplus to be used for increased social spending and infrastructure development, so that all citizens can benefit.
Unfortunately, the shareholder value that the GLCs accrue is used solely to fatten GIC and Temasek Holding’s coffers. Our two sovereign wealth funds are estimated to be in control of anywhere from $600 billion to $1 trillion dollars worth of assets globally. Why are they accumulating such large assets without giving back at least some of the investment returns to Singaporeans?
Another area in which the government exploits Singaporeans economically is through CPF and the CPF Life scheme. The CPF is the largest lender to the government. It issues special bonds based on the holdings in CPF members’ accounts. The government borrows heavily from the CPF Board to invest in GIC and Temasek, further adding to their already bloated coffers.
The CPF Life scheme, which is supposed to guarantee retired Singaporeans a monthly payout for life, is yet another avenue by which the government makes money from Singaporeans. I have made the relevant calculations in this blog post. My calculations show that in most reasonable circumstances, barring any unforeseen drastic changes to inflation or mortality rates, the government is guaranteed to profit from the scheme.
The government should not be profiting from a compulsory annuity scheme that is supposed to take care of retired citizens for life. Any profits should in fact be returned to citizens and used to enhance the payouts or provide other social benefits.
The PAP government has perfected the corporatist state and turned itself into a gigantic merchant that does business with its citizens for huge profit, but does not return much of those profits to the citizenry.
Our social spending remains lackluster. Our needy patients are being means tested to exclude them from subsidies they desperately need.
Rentals are rising sharply and adding to the business costs of private enterprise, while landlords affiliated to the PAP establishment sit back and make huge passive profits as rent-seekers.
This is no way to run a country.