父亲病危抢救，儿子身上仅剩100元，出门借钱却成永别

[Orionz]

i'm confused between the term save and treat described by you. Isn't treatment a process to save life ?

i dont know the exact technical differences but can think of it this way.

If ur building is going to collapse, firefighters will come and provide evacuation and acute support to save ur life.

However, fixing the root cause so that the building wont collapse is bo bao one. Depends on metods, costs, duration and what resources/subsidies u have to fund this.

 

[Autumn.]

is this arrangement done because nothing could be done further medically ?
or
they have no money ?

its all about money in singapore hospital. u are charge like a hotel guest the moment you are admitted. it dun matter if you are wheel to the right room yet, even if there is no room and you are placed in the corridor.

they love to say " its ok , it is all coming from ur medisave account, you cannot take it out anyway"

this was serveral years ago, where my mother was wheel into hosp due to trauma. She was supposed to be in ICU ward. but no room, they charge her ICU rate for the 30 minutes she was waiting for a room. that, is, $400/ day for that 30 mins as it was almost the change over to "next day"

the CSO says, it is coming out of your medisave aunty, why u bother not from bank account. heng that day my sibling managed to apply leave from barracks to argue

 

[Thoreldan]

its all about money in singapore hospital. u are charge like a hotel guest the moment you are admitted. it dun matter if you are wheel to the right room yet, even if there is no room and you are placed in the corridor.

they love to say " its ok , it is all coming from ur medisave account, you cannot take it out anyway"

answer my question directly, are you saying hospital ask you dad to go somewhere else because you couldnt pay the bill ?

Or

because he's more suitable to proceed to a step-down facility from medical perspective?

Bear in mind main-stream hospitals are more for active treatment. Community hospitals are more for rehabilitations.

 

[Autumn.]

answer my question directly, are you saying hospital ask you dad to go somewhere else because you couldnt pay the bill ?

Or

because he's more suitable to proceed to a step-down facility from medical perspective?

Bear in mind main-stream hospitals are more for active treatment. Community hospitals are more for rehabilitations.

Mine was a very special situation. my dad belongs to "no-man" land. technically he is under country care. so to hosp they are not getting payment directly so, yes they need to "get-rid" of him dun matter where he goes

it matters to us where he goes. so we refuse to sign the papers. we needed him to be enroll into a particular hosp with a particular care where we can hv access to him, every other day.

ultimately my dad's bills was over 200k , fully written off by country.
towards your question, it is both. and it was a greyout situation. I was thankful an EDMW troll became very serious and tell me what i need to do what is my rights every step of the way. till date I am deeply appreciative

 

[Orionz]

answer my question directly, are you saying hospital ask you dad to go somewhere else because you couldnt pay the bill ?

Or

because he's more suitable to proceed to a step-down facility from medical perspective?

Now treatment is not alway so black and white one. Many modern treatment methods effectiveness are based on probabilities and have medical/financial trade-offs.

Now the question is who decide on the trade-offs. Leave it up to patients or patient family of course is treat at all cost (most of the time).

Sg system is not as brutal as US where they kick u out immediately if you got no insurance or cash. But its not as social as the europeans where they will treat u at (almost) all costs. Sg somewhere in the middle.

Thee million dollar question is, as sg age and the system becomes more and more burdened. Will we / the govt move more towards US model to cope with costs? and the to what extent?

 

[Thoreldan]

Now treatment is not alway so black and white one. Many modern treatment methods effectiveness are based on probabilities and have medical/financial trade-offs.

Now the question is who decide on the trade-offs. Leave it up to patients or patient family of course is treat at all cost (most of the time).

Sg system is not as brutal as US where they kick u out immediately if you got no insurance or cash. But its not as social as the europeans where they will treat u at (almost) all costs. Sg somewhere in the middle.

the biggest question is, as sg age... will we move towards US model more to cope with costs?

yeah heard about US ... it has become a pure commercial transaction liao.

 

[Autumn.]

Now treatment is not alway so black and white one. Many modern treatment methods effectiveness are based on probabilities and have medical/financial trade-offs.

Now the question is who decide on the trade-offs. Leave it up to patients or patient family of course is treat at all cost (most of the time).

Sg system is not as brutal as US where they kick u out immediately if you got no insurance or cash. But its not as social as the europeans where they will treat u at (almost) all costs. Sg somewhere in the middle.

Thee million dollar question is, as sg age and the system becomes more and more burdened. Will we / the govt move more towards US model to cope with costs? and the to what extent?

we are also heading towards that direction BUT not that extreme.

 

[Orionz]

yeah heard about US ... it has become a pure commercial transaction liao.

alot of ethical questions.

for example man is 70yo. Prognosis of 5 year survival is 60%. 10 year survival 30%. Price tag of 500k. should state (co)-fund this?

another example. young man 20yo. Prognosis of 5 year survival is 15%. 10 year survival 5%. Price tag 800k. Should state (co)-fund this?

in the end if ownself got $ in pocket + insurance is most safe. u make the call if u wanna buy urself more time or leave more money for ur family.

 

[TiedInsurer]

Now treatment is not alway so black and white one. Many modern treatment methods effectiveness are based on probabilities and have medical/financial trade-offs.

Now the question is who decide on the trade-offs. Leave it up to patients or patient family of course is treat at all cost (most of the time).

Sg system is not as brutal as US where they kick u out immediately if you got no insurance or cash. But its not as social as the europeans where they will treat u at (almost) all costs. Sg somewhere in the middle.

Thee million dollar question is, as sg age and the system becomes more and more burdened. Will we / the govt move more towards US model to cope with costs? and the to what extent?

It does look like we are moving towards US model. Recently the government mandated a change to the list of cancer drugs that are insurable. Basically, only the cheap drugs can be paid via insurance. If you do not respond to the cheap ones, or are allergic to them, you are screwed. The move is supposed to encourage doctors to prescribe the cheaper drugs whenever possible. But I wonder... if they know you can't pay the more expensive drugs, that they know insurance isn't going to cover, will they still give them to you? Or will they give you the cheap ones that don't work well? And there's always the scary thought that even if they DO give you the expensive ones.... insurance ain't gonna cover it. You're going straight to POOR status. Everything you worked hard for all your life will be wiped clean, along with all your loved ones medisave.

 

[Orionz]

It does look like we are moving towards US model. Recently the government mandated a change to the list of cancer drugs that are insurable. Basically, only the cheap drugs can be paid via insurance. If you do not respond to the cheap ones, or are allergic to them, you are screwed. The move is supposed to encourage doctors to prescribe the cheaper drugs whenever possible. But I wonder... if they know you can't pay the more expensive drugs, that they know insurance isn't going to cover, will they still give them to you? Or will they give you the cheap ones that don't work well?

i listened to a healthcare industry talk before. SG is the envy of the world because we get most bang for every buck we spend in healthcare per capita. But this optimization and utiliarianism in healthcare comes with a lot of ethnical and individual tragedies.

basically sg look at healthcare as a consumption good. that means there is a fear of the "buffet" syndrome where if u (over)subsidise, ppl will (over)consume even if they don't have an actual need...

the solution is hence to design a system where market pricing dictates consumption behaviour, believing that this will shape ppl to only consume healthcare when absolutely necessary

this is quite a sad thought

 

[TiedInsurer]

alot of ethical questions.

for example man is 70yo. Prognosis of 5 year survival is 60%. 10 year survival 30%. Price tag of 500k. should state (co)-fund this?

another example. young man 20yo. Prognosis of 5 year survival is 15%. 10 year survival 5%. Price tag 800k. Should state (co)-fund this?

in the end if ownself got $ in pocket + insurance is most safe. u make the call if u wanna buy urself more time or leave more money for ur family.

I guess. My parents are old and have basically no money and no CPF. They have given instructions that if they kena any terminal illness, do not treat. They want to go and not be a burden on anyone else, and leave a bit of money to us, their kids. From a purely pragmatic POV, they would be correct. They are a drain on resources for Singapore, and for us. But i'll sooner be damned then let them have their way.

 

[Orionz]

I guess. My parents are old and have basically no money and no CPF. They have given instructions that if they kena any terminal illness, do not treat. They want to go and not be a burden on anyone else, and leave a bit of money to us, their kids. From a purely pragmatic POV, they would be correct. They are a drain on resources for Singapore, and for us. But i'll sooner be damned then let them have their way.

I know a lot of boomer gen in the same dilemma.

Sometimes i ask myself what is "pragmatism"? Where is the line between sacrificing for the collective good and the collective taking care of the individual?

What's the point of endlessly saving for the non-existent "future generation" when our young has become so stressed or egoistic and decide to break their own lineage?

Higher education, lower birth rate - yes. But Lowest in the world? Something must be wrong.

 

[PaboJames]

has any public hospital kicked a critically ill Singaporean patient to the street because they couldn't afford treatment ?

No because usually Social Services are activated for application to social welfare fund to pay for their healthcare after approval and assessment of their financial status of course.