Medishield life premiums to increase/ made compulsory to help SG govt save money?

[cherry6]

Medishield life premiums now increase/ compulsory to help SG govt save money?-- (because govt medifund costs/expenses getting too high)?

Currently, those over 90 years old (& those with pre-existing illnesses) are not eligible (/pay higher premiums) for medishield and so ostensibly might appeal to medifund to pay/ subsidise their medical bills should they be unaffordable. By imposing higher medishied premiums and imposing the inescapable 'no opt out rule', perhaps the govt is intending to control costs by further socialising the cost of healthcare through higher medishield premiums rather than better healthy lifestyle education and other efforts to make Singaporeans exercise more- e.g. road cycling to work.

National Day Rally 2013: MediShield Life to cover every Singaporean, including elderly and those with pre-existing illness
" Elaborating on the changes, he said that universal coverage means there will be no more opting out, with everyone covered including the elderly and those with pre-existing illnesses.
MediShield Life will also give better protection for very large hospital bills, and patients will pay less out-of-pocket, said Mr Lee.
But with better benefts and coverage, this will mean that premiums will go up, he said. “(It) has to be because it has to break even,” he said, but added that the Government will subsidise premiums for those who cannot afford them."
New MediShield Life to provide lifelong coverage: PM Lee | TODAYonline

FRIDAY 15 NOVEMBER 2013
More received help through Medifund in 2012: MOH
14 NOVEMBER
SINGAPORE — More needy and elderly patients received aid through the Medical Endowment Fund (Medifund) last year, the Ministry of Health (MOH) announced today (Nov 14).
MOH said that more than S$100 million in Medifund aid was provided to needy patients in 2012, an increase of about 12 per cent from the S$90 million a year ago.
S$86 million of the amount went to patients in the acute sector while S$16 million went to those in the Intermediate and Long-Term Care (ILTC) sector.
Needy elderly patients received S$33 million in aid, an increase of 19 per cent from the last fiscal year.
Over 587,000 Medifund applications were approved last year, MOH said. About 93 per cent of the successful applications received full assistance. On average, the amount of assistance was S$1,471 for inpatient treatments, and S$107 for outpatient treatments.
Medifund was introduced to assist needy Singaporeans with their medical bills, on top of government subsidies, Medisave and Medishield. In 2012, the Government injected S$600 million into the Medical Endowment Fund, bringing its total size to S$3.08 billion in capital sum, MOH said.
Copyright ©2012 MediaCorp Press Ltd. All Rights Reserved
More received help through Medifund in 2012: MOH | TODAYonline

References:
- 'One Million Diabetics By 2050 as Singaporeans Get Older, Fatter'- "Every one in two people, by age 70, will be diabetic - up from one in three today"(Men's Health, Oct2012, URL)

- '1 in 4 Singapore women do not exercise at all: Survey': "More than 57 per cent of them cited work as the main reason holding them back. Other reasons include family commitments, and not knowing where to start and how to take that first step towards becoming healthier."

Tags: healthcare, insurance, socialism, Singapore, inflation, compulsory, illness, obesity, diabetes, exercise,

 

[PainRack]

Sigh.......

Is it REALLY that difficult to understand that we have more elderly people, life expectancy is going up so more people need more money for longer, thus healthcare expenditure is going up, thus, our utterly inadequate healthcare financing needs a radical revamping?

 

[sunzoner]

Sigh.......

Is it REALLY that difficult to understand that we have more elderly people, life expectancy is going up so more people need more money for longer, thus healthcare expenditure is going up, thus, our utterly inadequate healthcare financing needs a radical revamping?

Is it so hard to understand that the changes they have in mind means pushimg more of the healthcare burden to the people and we dun have enough to pay?

 

[Inix]

I actually don't mind paying more if our out-of-pocket expenses will drop. For EVERYONE. I don't mind paying more, and we could actually have a taxation concept where you pay more if your medisave contributions is more, but just provide more services to everyone

 

[PainRack]

Is it so hard to understand that the changes they have in mind means pushimg more of the healthcare burden to the people and we dun have enough to pay?

How on earth is it shifting MORE of the healthcare burden to the people?

Look. You want a sob story? I tell you one. I have one person now who facing huge problem, because got cancer, can't pay for cancer treatment. He has a good amount of Medisave money, but without insurance, that's not going to be anywhere enough.

And why? Because Medishield as it is assumes he's not worth keeping alive. With Medishield Life, where they keep paying for healthcare after 90, sure, premiums increase, sure, you have less money in Medisave, but that means he's going to be much more able to AFFORD cancer treatment.

So, just EXACTLY WHAT IS WRONG WITH THIS ?!?!?!?!?!?!

Why was the age limit for coverage only raised to age 90 and not for life?



The Ministry regularly reviews the maximum coverage age in line with the ageing population. As numbers are small, it is not possible to retain a sufficient risk-pool and the premiums for ages above 90 will certainly be high.

Those above age 90 can tap on their Medisave and Medifund Silver to pay for their bills. Government has also provided annual Medisave top-ups of up to $450 under the permanent GST Voucher Scheme to help them with their healthcare bills.

This is the government stance RIGHT now. That our basic government insurance should not cover those more than 80/90 years old, because they're too old and not enough to help them.

Does this mean that my premiums will increase so that we can help these people? So what? If the government directly help these people, my taxes will also increase. There's no ****ing, fundamental difference.


The REAL issue I have is that our insurance premiums are based on arcturial tables as opposed to a progressive taxation. If that's your issue with it, fine. But stop denying a much needed, ****, a FUNDAMENTAL HUMAN RIGHT to our elderly.

 

[PainRack]

Meanwhile, let's look at the current recommendations to make healthcare more affordable, more available to Singaporeans.

GPC (HEALTH) REPORT ON IMPROVING HEALTHCARE AFFORDABILITY FOR SINGAPOREANS | Ministry of Health

b) Ensuring healthcare remains affordable

i) For low income Singaporeans by introducing a fixed treatment rate for low-income Singaporeans at CHAS GPs and Polyclinics for certain common ailments and chronic diseases

ii) Expand the standard drug list by including more essential drugs used in the treatment of common conditions

The recommendation is to increase government subsidy. We NEED this.

iii) Ensure Medishield stays relevant by ensuring the continuity of premium payments through guaranteed top ups by government or even through Medifund, considering a reverse premium structure, expanding its coverage to community and social care costs and removing the age ceiling on Medishield

Again. Need. Singaporeans need to lobby and provide support for such actions, instead of saying we can't be behind Medishield life because >>> premiums.

Instead of being against Medishield Life, why not get involved in OurSg conversation or some political lobbying and start arguing for a progressive taxation system?

The current system is unfair to our elderly, who has on average 5k in Medisave a decade ago(current elderly probably has more but faces more healthcare needs/demands). The government is considering for this to be an 'reverse premium', which is, young pay for elderly system and is taking in feedback from stakeholders.

To me, that's not too bad, because hey, healthcare for the elderly! Not my preferred route but its better than the current system.

 

[cherry6]

From the textbook of Stalin.

From the textbook of Stalin.

How on earth is it shifting MORE of the healthcare burden to the people?
Look. You want a sob story? I tell you one. I have one person now who facing huge problem, because got cancer, can't pay for cancer treatment. He has a good amount of Medisave money, but without insurance, that's not going to be anywhere enough.
And why? Because Medishield as it is assumes he's not worth keeping alive. With Medishield Life, where they keep paying for healthcare after 60, sure, premiums increase, sure, you have less money in Medisave, but that means he's going to be much more able to AFFORD cancer treatment.
So, just EXACTLY WHAT IS WRONG WITH THIS ?!?!?!?!?!?!

Hi Pain,
U wanna take bets that medishield premiums will increase, I really don't mind betting that they WILL surely increase for the majority of medishield holders currently enrolled.
2nd, why isn't your sob story friend enrolled in medishield when it was incepted for Singaporeans? Or has he just crossed the 90yrs old mark and the govt kicked him out of medishield- if so, he has already lived a long n fruitful life, most 90yr olds I know just want some pain relief, not some space age standard tumour surgery/ chemo therapy (they would have learnt by now that trying to live forever doesn't solve anything.)

Indeed, a Singaporean with a high medisave balance WITHOUT medishield cover should he quite an oddity- like some antigoverment rebel who OPTED OUT of medishield (when it was introduced in 1990) yet now demands the benefits of medishield now that he finds his horded cache of medisave savings not quite enough to cover for his predicament.

There is something fishy about the 'sob story' you have just disclosed. Total aethist to govt healthcare schemes, having opted out earlier, shouldn't try their luck to exploit loopholes that might occur during this review of the insurance scheme.

Indeed, I have no qualms against a revision of premiums and payouts if the majority of members so choose, but please remember that given the number of opt out cases previously (assuming your friend to be one)- for various reasons- pte insurance schemes/ too poor to afford medishield premiums (which are quite affordable I believe for C class treatments of course)- there has always been medifund available for the very poor (govt says so).

So there is nothing really wrong I believe with the current status quo- asset rich folks like your friend (high medisave balance suggests either high CPF balance or large property purchase)- will just have to unload one property or two, those really penniless and living in HDB rentals will be fully covered by medifund - so there is really no problem with status quo.

All I'm saying is that given the fact that with 1 in 4 women too busy to exercise at all or obesity and diabetes catching up simply because Singaporeans are either to busy or too lazy to exercise, can the solution ever be about throwing in more money? ....

Yes, the government coffers are running dry, yes, medifund is short of cash. Oh, I forgot the inverse logic in place in this case, never underestimate the intelligence of our politicians... more premiums for medishield (life), less money in pockets for Singaporeans to spend on food and gouging, so obesity gets solved, diabetes risk goes down- all problems solved, politicians get donations from medishield pte Ltd to fund election campaigns.

Sounds like a text book lesson from Stalin don't you think?

 

[PainRack]

From the textbook of Stalin.

Hi Pain,
U wanna take bets that medishield premiums will increase, I really don't mind betting that they WILL surely increase for the majority of medishield holders currently enrolled.

Considering that I'm SAYING premiums will increase....... What's your point?

2nd, why isn't your sob story friend enrolled in medishield when it was incepted for Singaporeans? Or has he just crossed the 90yrs old mark and the govt kicked him out of medishield- if so, he has already lived a long n fruitful life, most 90yr olds I know just want some pain relief, not some space age standard tumour surgery/ chemo therapy (they would have learnt by now that trying to live forever doesn't solve anything.)

Oh ********. You're imposing your values on somebody else. Who are you to determine whether someone else should want to live or die? And if the doctor think he's fit enough for treatment for life extension, who are you to think he's not?

So there is nothing really wrong I believe with the current status quo- asset rich folks like your friend (high medisave balance suggests either high CPF balance or large property purchase)- will just have to unload one property or two, those really penniless and living in HDB rentals will be fully covered by medifund - so there is really no problem with status quo.

And of course, increasing the stress on our elderly by asking them to sell their HDB flat and then arranging to rent a new house, while managing their chemotherapy and cancer is such a good thing, right?

And of course, since the term 'healthy' Medisave account obviously means hundred thousand dollars to you, as opposed to the average elderly person in 2007 who has only 5k Medisave?

Now, he's atypical in the sense that he has no children even though married, but that just shows the gaps in our system.

As for Medifund, again, Medifund kicks in ONLY when you have no physical assets. So, back to this guy. Sells HDB house you bought to retire in, uprooting you and your sick wife. While sick and receiving chemo, have to arrange sell HDB, go find new rental, MOVE in.............


Now. Does it mean that said person isn't receiving healthcare? Nope. He is. But the sheer....... stress, the inadequacy..... its mindboggling sad and unlike char boh, I don't react to this by feeling sad. I get angry.

And the thing is, in the past, can at least say, that's how the system is. **** up, but that's what we have.

Now, government is proposing another option. A choice. Namely, increasing insurance coverage to the elderly without a termination period, the costs? Increased premiums and possibly a reverse premium system.

Do I support this 100%? Nope. I think I will prefer a more progressive taxation system. But I think its important enough that we change and revamp our utterly inadequate, increasingly outdated medical financing system.

simply because Singaporeans are either to busy or too lazy to exercise, can the solution ever be about throwing in more money? ....

Sigh.....................................

1. Everybody in Singapore will get sick at some point in their life.
2. Our current system was designed, and tweaked along the era when inpatient hospitalization was meant to be the main outpost of healthcare.
3. That is no longer true, and the current system is actually doing actual harm by having an inverse incentive towards hospital care.


Now, the GPC and other planned changes are intended to push it out to community care. You keep harping these points as if you think the government isn't doing anything about it, they are, from increased screening to social engineering, however, two hands need to clap.

And if the individual is unable to take actions sufficient enough to mitigate problems down the road, then the community, society has to step in.


And part of that means increasing our social services, having a more comprehensive, effective safety net for those who slip through the gaps.

And yes, I'm also aware of the huge finanicial constraints that will mean, and I'm willing to run with the experiment of alternative funding methods instead of the traditional tax-payer based system to help ensure sustainable funding.

But that's utterly separate and different from saying,"
Hey, we shouldn't help other individuals in our society because what's mine is mine and keep your filthy hands off it."

Here's the thing. I'm NOT a libertarian. I have no problems with socialising the cost of healthcare if this means more Singaporeans GET healthcare.

 

[sunzoner]

How on earth is it shifting MORE of the healthcare burden to the people?
...

I sense much pain in this one...

Why do i think its more of the burden to the people? Because i have seen how CPF life turns out. Or any schemes that was hail as the best thing since the invention of portable toilet.

You must understand that what is the governing philosophy of the incumbent party. If you understand them, you will know no matter how the motherhood statement sound, there is only one source of funding, the people's pocket (not through any form of progressive taxes).

In your sob story, I bet the person will end up still not having access to the healthcare he/she needs because of some strange rules which wasnt covered by the motherhood statement. or because the state's share of the bill is so low, that the person still cant afford the payment without making the family bankrupt.

 

[sunzoner]

......

Now. Does it mean that said person isn't receiving healthcare? Nope. He is. But the sheer....... stress, the inadequacy..... its mindboggling sad and unlike char boh, I don't react to this by feeling sad. I get angry.

And the thing is, in the past, can at least say, that's how the system is. **** up, but that's what we have.

Now, government is proposing another option. A choice. Namely, increasing insurance coverage to the elderly without a termination period, the costs? Increased premiums and possibly a reverse premium system.

...

The thing is, you think the govt is proposing another option. What I think will happen is,
1) GST increase as govt say need more money to pay for increase in healthcare cost.
2) Govt legislate the change to make some form of insurance for all.
3) Govt slowly change the terms until poor need to pay similar amount before they enjoy any form of support.

End up GST increase for close to no benefits for most people and only very extreme cases got limited additional support. Everyone else loses out and only govt wins.

 

[cherry6]

Rich people shouldn't pretend to be poor.

Rich people shouldn't pretend to be poor.

...
As for Medifund, again, Medifund kicks in ONLY when you have no physical assets. So, back to this guy. Sells HDB house you bought to retire in, uprooting you and your sick wife. While sick and receiving chemo, have to arrange sell HDB, go find new rental, MOVE in.............
...

Very long post, very complicated problem, will refer to your post in piece meal way for now...

U say that medifund only helps those with no physical assets, but papers report "Over 587,000 Medifund applications were approved last year, MOH said. About 93 per cent of the successful applications received full assistance. On average, the amount of assistance was S$1,471 for inpatient treatments, and S$107 for outpatient treatments."(More received help through Medifund in 2012: MOH)

So u say the 587,000 successful applications to medifund, minus some duplicate ones- all these applicants had ZERO assets- you claim? Or did these applicants manage to conceal their assets to the medifund department- something again is fishy about the numbers. Regardless of your friend's reasons for opting out of medishield in 1990, the median HDB resale flat prices in 3Q2013 shows there to be sizable number of HDB flats transacted ABOVE HALF A MILLION SG DOLLARS (outliers have transacted above 1million but are not included since 20per type per town is thresh hold to report).

These retirees sitting on half million dollar homes (and even more if it were pte property) should be encouraged to reverse mortgage their homes to HDB (/banks for pte property) so that such homes can be sold upon their passing so that the younger generation too can aspire to live in such HDB homes in better locations.

I thus think that rather than burden the young with additional premiums mirrored after the Medicare/ Medicaid schemes in USA (which we all know are very much ponzi in their finance structure), the SG govt should ask the followers of Mah Bow Tan ideology to reverse mortgage their high priced HDB to CPF (2.6% interest) up to 70% open mkt property value, to pay for whatever necessities old age might bring these seniors- such as healthcare or a small stipend. Just as good politicians don't come cheap, neither should healthcare costs nothing. Only the seniors whose mortgages hit 70% property value have to downgrade, maybe given 1yr grace period to decide themselves, HDB can advise.

Movement across social strata is already limited in Singapore sampan with a HIGH gini coefficient, there are better ways out then the rich being further subsidised.

A summary of what has just been mentioned is at:
http://forums.hardwarezone.com.sg/c...everse-mortgage-finance-facility-4464289.html
--------------
10:30pm add clarification: larger HDB reverse mortgage will only be allowed for extreme necessities such as medical bills, the smaller the HDB, the more opportunities for reverse mortgage, until of course the owner ends up in rental unit, by then he is on 100% social welfare altogether.

 

[PainRack]

The thing is, you think the govt is proposing another option. What I think will happen is,
1) GST increase as govt say need more money to pay for increase in healthcare cost.
2) Govt legislate the change to make some form of insurance for all.
3) Govt slowly change the terms until poor need to pay similar amount before they enjoy any form of support.

End up GST increase for close to no benefits for most people and only very extreme cases got limited additional support. Everyone else loses out and only govt wins.

You can keep staying in fantasy land. Literally everytime we debated about actual policy, your facts have been proven wrong over and over again, and you retreat into your personal fantasy bubble.

There is no need to imagine just what would happen. We ALREADY seen it happen, when they increase Medishield coverage from 80 to 90 years old. It went off smoothly enough, although the continued reliance on personal resources meant a constant influx of intergenerational resources was used for a portion of the population.

 

[PainRack]

Very long post, very complicated problem, will refer to your post in piece meal way for now...

U say that medifund only helps those with no physical assets, but papers report "Over 587,000 Medifund applications were approved last year, MOH said. About 93 per cent of the successful applications received full assistance. On average, the amount of assistance was S$1,471 for inpatient treatments, and S$107 for outpatient treatments."(More received help through Medifund in 2012: MOH)

So u say the 587,000 successful applications to medifund, minus some duplicate ones- all these applicants had ZERO assets- you claim?

If you have no idea how Medifund work, why the **** are you posting anything about it?

Medifund is a process of last resort. Each application requires an submission in which your access to funds are enquired. The scale of assistance varies, but Medifund purpose is to help keep your healthcare bill affordable. This means that if you have kids who are say living in condo and still give you money, your application can be denied or in good scenario, given partial subsidy only.

Patients who fulfil all of the following requirements may apply for Medifund assistance:
- is Singapore citizen
- is a subsidised patient
- has received treatment from a Medifund-approved institution
-Patient and family have difficulty affording the medical bill despite heavy government subsidies,
MediShield and Medisave

Every Medifund-approved institution has a Medifund Committee to consider and approve applications, and decide on the appropriate quantum of assistance to provide. The actual amount of assistance provided will depend on the patient’s financial and social circumstances, as well as the size of the medical bill incurred.

Ministry of Health: FAQs

Or did these applicants manage to conceal their assets to the medifund department- something again is fishy about the numbers. Regardless of your friend's reasons for opting out of medishield in 1990, the

Or you ASSUMED he opted out.

These retirees sitting on half million dollar homes (and even more if it were pte property) should be encouraged to reverse mortgage their homes to HDB (/banks for pte property) so that such homes can be sold upon their passing so that the younger generation too can aspire to live in such HDB homes in better locations.

Lol, the whole asset rich, cash poor question? Again. Do you NOT understand what you're saying?

You're saying that the home you built your life in, intend to retire in, should
be sold to purchase the healthcare that you desire, just because you don't deserve healthcare.

I thus think that rather than burden the young with additional premiums mirrored after the Medicare/ Medicaid schemes in USA (which we all know are very much ponzi in their finance structure), the SG govt should ask the followers of Mah Bow Tan ideology to reverse mortgage their high priced HDB to CPF (2.6% interest) up to 70% open mkt property value, to pay for whatever necessities old age might bring these seniors- such as healthcare or a small stipend. Just as good politicians don't come cheap, neither should healthcare costs nothing. Only the seniors whose mortgages hit 70% property value have to downgrade, maybe given 1yr grace period to decide themselves, HDB can advise.

Ah.... A libertarian? I haven't debated against one for so long, I almost forgot how often they keep creating strawman positions and evade the point.

1. You created a position which superficially sounds very nice, until you go into the details.

1.1 Our insurance schemes are in nowhere similar to Medicare/Medicaid. For one, Medicaid is targeted at poor people, while Medicare is targeted at the elderly. The definition of Ponzi requires a redefinition of the term but hey, who's counting?

1.2 Reverse mortgage in Singapore is a product that's available through NTUC income. However, it comes with its own risks and problems.

The most important pitfall is property prices. Namely, your house cannot have its value decline too much, or the loan will hit its target of 80% and you stop receiving cash. In fact ideally, your property needs to have its price increase so that you can service the interest......... Hmmm, no wonder you quote Mah Bow Tan.

But hey, its 300k or more right? So even 80% is like 240k and more. Oh, its a monthly cash payment?
Let's talk real data here.
Moneytalk: Couple sue NTUC Income over reverse mortgage deal gone sour

So, 2.1 million dollar house. How much money did they get?
2k a month.

The median Singaporean hospital bill is around 1.2k for a C class patient, after subsidies have been paid. So in the 'best' scenario imaginable, where you're paying for relatively CHEAP hospital bill and is basing off mortgage for a 2.1 million dollar house, you're left with 800 dollars as income.

Wow!

I hate to imagine how the typical Singaporean whose HDB flat is worth anywhere between 200-500k can get.

But.... But.... You get a lump sum of cash too!
So, instead of simply having adequate insurance to provide against castrophic costs, you should....... have the means of borrowing money to pay for healthcare, a basic human right. Right........

2. None of this of course address the MEAT of the issue. Cherry has been trying to claim that we SHOULDN"T do this. We shouldn't 'socialise' healthcare costs.
Just WHY shouldn't we?

To him, its more a moral principle than anything based on ethical or practical considerations. Its just bad to do so,mmmkay?


To me, Inix, and even Sunzoner, we have no qualms with increasing the socialization of healthcare costs if it means more healthcare access. We might disagree about the means, but the end goal is a desirable one. However, cherry here disagrees. Why?

Movement across social strata is already limited in Singapore sampan with a HIGH gini coefficient, there are better ways out then the rich being further subsidised.

Lol. I find it funny you claim that the 'rich' are subsidized. I mean, its not as if the elderly in Singapore are cash poor, right? They just have high 'asset' value, which interestingly enough, was one of the reasons why Mah Bow Tan insisted that he cannot reduce HDB flat prices.........

 

[cscs3]

How on earth is it shifting MORE of the healthcare burden to the people?

Look. You want a sob story? I tell you one. I have one person now who facing huge problem, because got cancer, can't pay for cancer treatment. He has a good amount of Medisave money, but without insurance, that's not going to be anywhere enough.

And why? Because Medishield as it is assumes he's not worth keeping alive. With Medishield Life, where they keep paying for healthcare after 90, sure, premiums increase, sure, you have less money in Medisave, but that means he's going to be much more able to AFFORD cancer treatment.

So, just EXACTLY WHAT IS WRONG WITH THIS ?!?!?!?!?!?!




This is the government stance RIGHT now. That our basic government insurance should not cover those more than 80/90 years old, because they're too old and not enough to help them.

Does this mean that my premiums will increase so that we can help these people? So what? If the government directly help these people, my taxes will also increase. There's no ****ing, fundamental difference.


The REAL issue I have is that our insurance premiums are based on arcturial tables as opposed to a progressive taxation. If that's your issue with it, fine. But stop denying a much needed, ****, a FUNDAMENTAL HUMAN RIGHT to our elderly.

For some people, anything come from government is bad, But if the same plan to sold by any of the insurance company, the answer is likely to be ok and good.

 

[Inix]

With Christians like cherry6, who needs anti-christ. I'm truly insulted to be a fellow Christian with people like you around.

I won't really be bothered to debate with you TS as you're not worth my time, but let em just point some stuff out;

1: It is possible to be enrolled in Medishield and yet have extremely high Medisave rates. Medishield is cheap, up to 60 years old, people who are working for someone consistently at a decent wage will eventually fill up their Medisave, and spill over to Special Account.

2: Medishield till now, is not all encompassing. Anyone with pre-existing illnesses can get rejected. Are you saying they do not deserve treatment? Are you saying they deserve to die simply because they have some illness in them?

3: These pre-existing illnesses includes people who were born with them. People like my friend's daughter who has a hole in the heart, got rejected at birth. By your logic, we should blame their parents for having bad genes?

4: Most people will die with SOME Medisave outstanding in their account. This is to be of no fault to them. Even at the last moments, you are not allowed to withdraw everything from Medisave for treatment. To prevent over-treatment, the government enforces some form of co-payment in cash one way or the other.

Only until you pass on, than will Medisave be automatically deducted for the last treatment. People who fought ailments for long periods of time will suffer the most. Seeing money in Medisave yet can't touch them because they are there for "rainy days" when its pouring cats and dogs for them now. My father in law is one of them. He died after 20 years of Diabetes treatment with 16K in Medisave a while ago. Why? Because most of the treatment he gotten was forced upon us via Cash. He was within Medishield, and the only time Medisheild came into the picture was when he suffered from Renal Failure requiring Dialysis.

5: Anyone, including those who live a healthy lifestyle, can get sick suddenly. I know of people who don't drink, who don't smoke, and they suddenly get some form of cancer. I wonder how do we actually segregate them by your logic.

I'm seriously appalled by some of your logic. There will be people who game the system. It is up to the policymakers to reduce them. But not at without first doing our collective responsibility to protect everyone else, from a healthcare disaster which can bankrupt anyone in this country.

 

[Inix]

For some people, anything come from government is bad, But if the same plan to sold by any of the insurance company, the answer is likely to be ok and good.

Insurance companies need to be led by the government first. Whats more important for me after Medishield life is to ensure that Insurance companies, like the US, now have to cover all pre-existing illnesses for those who are involved.

It can be done via some collective pooling effort, shared by the Govt or Public or higher premiums for them only, but this is the right thing to do.

 

[cherry6]

healthcare, like defence, has become another reason for conscription national service.

Healthcare, like defence, has become another reason for conscription national service.

If you have no idea how Medifund work, why the **** are you posting anything about it?
Medifund is a process of last resort. Each application requires an submission in which your access to funds are enquired. The scale of assistance varies, but Medifund purpose is to help keep your healthcare bill affordable. This means that if you have kids who are say living in condo and still give you money, your application can be denied or in good scenario, given partial subsidy only.
Ministry of Health: FAQs
Or you ASSUMED he opted out.

A bit hard to u'stand why u said he has high medisave but no medishield when by default, 1990, all Singaporean are on it. I never recall answering any questionare/ declaration n by defaut I'm on it since I paid CPF, dunno why your friend finger so itchy must quit, then when problem happens like outstretched hand wan free money...

Lol, the whole asset rich, cash poor question? Again. Do you NOT understand what you're saying?
You're saying that the home you built your life in, intend to retire in, should
be sold to purchase the healthcare that you desire, just because you don't deserve healthcare.
Ah.... A libertarian? I haven't debated against one for so long, I almost forgot how often they keep creating strawman positions and evade the point.
1. You created a position which superficially sounds very nice, until you go into the details.
1.1 Our insurance schemes are in nowhere similar to Medicare/Medicaid. For one, Medicaid is targeted at poor people, while Medicare is targeted at the elderly. The definition of Ponzi requires a redefinition of the term but hey, who's counting?
1.2 Reverse mortgage in Singapore is a product that's available through NTUC income. However, it comes with its own risks and problems.
The most important pitfall is property prices. Namely, your house cannot have its value decline too much, or the loan will hit its target of 80% and you stop receiving cash. In fact ideally, your property needs to have its price increase so that you can service the interest......... Hmmm, no wonder you quote Mah Bow Tan.
But hey, its 300k or more right? So even 80% is like 240k and more. Oh, its a monthly cash payment?
Let's talk real data here.
Moneytalk: Couple sue NTUC Income over reverse mortgage deal gone sour
So, 2.1 million dollar house. How much money did they get?
2k a month.
The median Singaporean hospital bill is around 1.2k for a C class patient, after subsidies have been paid. So in the 'best' scenario imaginable, where you're paying for relatively CHEAP hospital bill and is basing off mortgage for a 2.1 million dollar house, you're left with 800 dollars as income.
Wow!
I hate to imagine how the typical Singaporean whose HDB flat is worth anywhere between 200-500k can get.
But.... But.... You get a lump sum of cash too!
So, instead of simply having adequate insurance to provide against castrophic costs, you should....... have the means of borrowing money to pay for healthcare, a basic human right. Right........
2. None of this of course address the MEAT of the issue. Cherry has been trying to claim that we SHOULDN"T do this. We shouldn't 'socialise' healthcare costs.
Just WHY shouldn't we?
To him, its more a moral principle than anything based on ethical or practical considerations. Its just bad to do so,mmmkay?
To me, Inix, and even Sunzoner, we have no qualms with increasing the socialization of healthcare costs if it means more healthcare access. We might disagree about the means, but the end goal is a desirable one. However, cherry here disagrees. Why?
Lol. I find it funny you claim that the 'rich' are subsidized. I mean, its not as if the elderly in Singapore are cash poor, right? They just have high 'asset' value, which interestingly enough, was one of the reasons why Mah Bow Tan insisted that he cannot reduce HDB flat prices.........

So many words accusing me of straw men when as mentioned, your sob story sounds indeed quite fishy n self contradictory.

BTW, your NTUC mortgagee Mr Chua's in his $2.1M house case, he is a crap guy n I run think his case doesn't fit this discussion since the reverse mortgage was like for him to enjoy life, 2k/mth pocket money n almost 495K bonanza to satisfy previous mortgage-- nothing at all about paying for medical necessities, it was totally about monitising the property and sadly, NTUC was into it too, but that is the risk of being too rich and gambling on pte property, the price swings from 1 -2 million based on market sentiment- pte property owners should be treated as a separate cattle of fish in a city where 90% of citizens still stay in HDB.

I have never advocated reverse mortgaging HDBs for luxury, only for real necessities and those staying in 5rm/ executive should better have done their sums well, otherwise they should downgrade whether Ill or not. In fact, HDB might not even want to undertake the reverse mortgage loan on a 5room unless the individual is in real need- since falling housing prices would place HDB in a dilemma should the mortgage value exceed market price of the unit.

As mentioned, there seems to be a large pool of unlocked value inproperty in Singapore that can allow seniors to be independent (healthcare wise) during their golden years. Singapore is capitalistic in so far that the benifits of high property prices is privatised, so why should the costs of healthcare be so extremely socialised (compulsory premiums)? If healthare is socialised, then so too should property be- I.e., I too should get a guaranteed roof over my head for life as an when I want it, just as an elderly who doesn't take care of his own health stay in hospital every time he feels off weather?

The young already have to serve compulsory NS (that some elderly never served), and now sickness is so prevailent that 587,000 medifund claims per annum also not enough- that medishield has to not just be expanded but actually made compulsory. And when there asset rich elderly pass away eventually, their kids quarrel over who wins the jackpot eventually.
Where we are going is that a person can probably be jailed for not paying his medishield on time (like AWOL NS)... By then, SG would have already become a real police state...

An then I wonder why Japanese rice farmers live till 120 not having seen a Dr, not even once... Something in what we eat or breathe, or our property prices that is the really problem... As mentioned, this problem isn't a simple one, just that making premiums compulsory seems an extension of NS and maybe making our women all Dr and Nuses for NS might reduce the hospitalisation costs but really, its sad that healthcare, like defence, has become another form of conscription national service in SG.

 

[cherry6]

The bigger picture of a society.

The bigger picture of society.

With Christians like cherry6, who needs anti-christ. I'm truly insulted to be a fellow Christian with people like you around.
I won't really be bothered to debate with you TS as you're not worth my time, but let em just point some stuff out;
1: It is possible to be enrolled in Medishield and yet have extremely high Medisave rates. Medishield is cheap, up to 60 years old, people who are working for someone consistently at a decent wage will eventually fill up their Medisave, and spill over to Special Account.
2: Medishield till now, is not all encompassing. Anyone with pre-existing illnesses can get rejected. Are you saying they do not deserve treatment? Are you saying they deserve to die simply because they have some illness in them?
3: These pre-existing illnesses includes people who were born with them. People like my friend's daughter who has a hole in the heart, got rejected at birth. By your logic, we should blame their parents for having bad genes?
4: Most people will die with SOME Medisave outstanding in their account. This is to be of no fault to them. Even at the last moments, you are not allowed to withdraw everything from Medisave for treatment. To prevent over-treatment, the government enforces some form of co-payment in cash one way or the other.
Only until you pass on, than will Medisave be automatically deducted for the last treatment. People who fought ailments for long periods of time will suffer the most. Seeing money in Medisave yet can't touch them because they are there for "rainy days" when its pouring cats and dogs for them now. My father in law is one of them. He died after 20 years of Diabetes treatment with 16K in Medisave a while ago. Why? Because most of the treatment he gotten was forced upon us via Cash. He was within Medishield, and the only time Medisheild came into the picture was when he suffered from Renal Failure requiring Dialysis.
5: Anyone, including those who live a healthy lifestyle, can get sick suddenly. I know of people who don't drink, who don't smoke, and they suddenly get some form of cancer. I wonder how do we actually segregate them by your logic.
I'm seriously appalled by some of your logic. There will be people who game the system. It is up to the policymakers to reduce them. But not at without first doing our collective responsibility to protect everyone else, from a healthcare disaster which can bankrupt anyone in this country.

Hi Inix,
I'm sorry to hear of your father in law's passing although factually, it does conform to my memory being correct that for adults, if enrolled at inception (1990/ first CPF payment), no declaration was demanded. Renal failure in adults is often associated with diabetes, so your father in law's case shows that he indeed benifited dispite probably having had diabetes when he was first enrolled for medisave.

The $16k left over in medisave that should have been spent rather than coughing out cash, I too cannot understand why, especially if your father in law (FIL) had used subsidised care all the way since I too agree that the full bill for subsidised hospital care should 100% be medisave deductible (" pouring cats and dogs for them now")- you should have seen your MP and had this legislatively sorted out- again, compulsory (/ higher) premiums would do little to solve the problem of Ill considered laws interrupting medisave use for essential medical treatment. Your described spillover of medisave into special account and then underfunding essential medical care is also an obstacle that demands looking into.

Please, I not some mean bean counter courting some "Antichrist" as you so portray, what I was just wondering about is whether another form of compulsory service imposed on younger Singaporeans would indeed solve what seems an obviously deteriorating picture, adjusted for age, of the overall health of Singaporeans- such that 'One Million Diabetics By 2050 as Singaporeans Get Older, Fatter'- "Every one in two people, by age 70, will be diabetic - up from one in three today"(Men's Health, Oct2012, URL)- can the problems liked to obesity and the aversion to exercise be solved by making children work harder to pay the medical bills of elderly- ostensibly the very ones today with the bad lifestyles in the first place, as generation after generation gets fatter by the day?

I thus saw no point filling a leaking bucket with water (bad stewardship of resources). As it goes, I felt that the 587,000 medifund claims granted per annum to a population of ~4million seemed rather generous in proportion- is the situation so dire that we need to commence some new form of national service/ taxation for the next generation? Perhaps we have lifestyle lessons to learn from Japanese rice plantation farmers who spend their days ploughing the fields with rudimentary instruments under the sun- to whom healthcare seems an unnecessary extra?

And the high property prices will eventually create a society of haves and have nots, where social immobility becomes an impossibility- by then, one would have totally lost one's credibility to the younger generation. By then, it wouldn't be the health of an individual we are debating about, it might be the stability of society that would be on life support...

And there's nothing too unchristian about that thought right?

PS: If medishield premiums were to be made compulsory (help the above 90), then perhaps base it 50% on income and 50% on nett asset value (incl. all equity (stocks, property etc)), rather than 100% on income okay?

 

[PainRack]

Healthcare, like defence, has become another reason for conscription national service.

A bit hard to u'stand why u said he has high medisave but no medishield when by default, 1990, all Singaporean are on it. I never recall answering any questionare/ declaration n by defaut I'm on it since I paid CPF, dunno why your friend finger so itchy must quit, then when problem happens like outstretched hand wan free money...

Look. I know you have a reading problem, but I had said explicitly that he was over 80 years old, which was when Medishield stopped insuring him.

So many words accusing me of straw men when as mentioned, your sob story sounds indeed quite fishy n self contradictory.

Only because your bloody ENGLISH comprehension fail.

BTW, your NTUC mortgagee Mr Chua's in his $2.1M house case, he is a crap guy n I run think his case doesn't fit this discussion since the reverse mortgage was like for him to enjoy life, 2k/mth pocket money n almost 495K bonanza to satisfy previous mortgage-- nothing at all about paying for medical necessities, it was totally about monitising the property and sadly, NTUC was into it too, but that is the risk of being too rich and gambling on pte property, the price swings from 1 -2 million based on market sentiment- pte property owners should be treated as a separate cattle of fish in a city where 90% of citizens still stay in HDB.

Do you even know why I brought him up? This is REAL data. You claimed that reverse mortgage would be an effective use of a physical asset to pay for healthcare.

Again. Mr Chua 2.1 MILLION dollar house, gave him 400k and a 2 thousand dollar payment.

This is data to show the scale and scope of the cashflow from a physical mortgage.

You claimed that it's sufficient. Its NOT. You have to assume that the instant cash from the loan will pay off everything and THEN assume that the house itself will be sold at a price adequate to cover the interest from the loan. Otherwise, that debt WILL roll down to your children. But I guess that's ok, right? Because its his young children and not you that's paying.


Reverse mortgage insta cash is around 20% of valued price, so for a typical 200-400k HDB flat, that's what? 40k. Median hospital bill is 1.3k in 2000s for C class, a perusal of most of the median bills for admission is around 1-4k. Assuming you don't intend to use any money to service the loan and assume the property sale itself will cover everything, you have enough for 20-30 hospital admissions from the insta cash.


The concept of a reverse mortgage to pay for retirement is NOT utterly bad, but it does involve a healthy measure of risk and inadequacy that you ignored. Risk that could be simply be insured against with a change in the basic health insurance, indeed, a need that might very well STILL be needed even if you use reverse mortgage to pay for retirement needs. If you're debt free with good cash savings, taking on debt in the elderly years and then insuring against castrophic costs is actually a good retirement plan.

As mentioned, there seems to be a large pool of unlocked value inproperty in Singapore that can allow seniors to be independent (healthcare wise) during their golden years. Singapore is capitalistic in so far that the benifits of high property prices is privatised, so why should the costs of healthcare be so extremely socialised (compulsory premiums)? If healthare is socialised, then so too should property be- I.e., I too should get a guaranteed roof over my head for life as an when I want it, just as an elderly who doesn't take care of his own health stay in hospital every time he feels off weather?

You know what? I WILL support increased subsidies from HDB, say, a better HDB loan or outright housing subsidies instead of the current priced to market bullclap.

Oh. So, what's your point now?

Where we are going is that a person can probably be jailed for not paying his medishield on time (like AWOL NS)... By then, SG would have already become a real police state...

Now you're entering sunzoner fantasy world? We already know what happens if you don't pay your Medishield premiums. Your policy gets terminated after due consideration etc etc etc.

An then I wonder why Japanese rice farmers live till 120 not having seen a Dr, not even once... Something in what we eat or breathe, or our property prices that is the really problem... As mentioned, this problem isn't a simple one, just that making premiums compulsory seems an extension of NS and maybe making our women all Dr and Nuses for NS might reduce the hospitalisation costs but really, its sad that healthcare, like defence, has become another form of conscription national service in SG.

Another fantasy world?

LOOK. Life expectancy in Singapore is increasing. Fact.

Healthcare inflation, while being relatively well controlled, is at 5.5% and might rise at a faster rate in the future. This is faster than the nominal inflation index and definitely faster than rise in wages.

Costs are 'controlled' for in Singapore and its unlikely that any improvement in delivery in healthcare, be it in needed volume or in desired quality can be brought about without further expenditure.

The government has held that its willing to invest in capacity and even current spending, up to 40% of healthcare expenditure, but this increase is divided into capacity and increases in subsidies such as medication list.

Age is an irreversible factor in risks of chronic disease. You can mitigate it and the government is pulling out the stops, but you CAN"T remove the risk factor of AGE! And the costs of doing so include doing stuff like Eldercare centres, dementia daycare centres, reworking HDB estates and etc, the last receive popular support but NOT the first. Even though doing so reduces the institutional costs and improve the quality of life for elderly.


The difference between you and sunzoner is that while sunzoner reduces everything down to simplistic details, you're ignoring anything that doesn't affect you personally.

 

[PainRack]

Insurance companies need to be led by the government first. Whats more important for me after Medishield life is to ensure that Insurance companies, like the US, now have to cover all pre-existing illnesses for those who are involved.

It can be done via some collective pooling effort, shared by the Govt or Public or higher premiums for them only, but this is the right thing to do.

The proposed reforms to Medishield does include covering congenital diseases and a more comprehensive coverage for pre-existing illness since you can't opt out anymore....... although I note that no mention is made of HIV still. Which means that a min of 1/3 of PWA will still receive inadequate care leading to a faster progression to AIDs....................


But then again, with people like cherry around, I guess covering a newborn child with a heart defect is immoral, since their parents can just mortgage their house to pay for the hospital fees, eh? Why should young people have to pay for other people health problem when they have assets still?



Actually. Why do we need insurance? Why should you pay for other people health problem, at all? Just pay for yourself right?