Debated in Parliament on 5 Oct 2020.
Assoc Prof Jamus Jerome Lim asked the Minister for Health (a) whether there has been any study of the differences, over time, between charges by private versus public healthcare providers; (b) whether this has been appreciably altered by the citizen/PR subsidy; and (c) whether the trend of rising costs has accelerated due to greater access to insurance products that reduce the individual cost-sharing burden.
Between 2017 and 2019, average inpatient bill sizes in private healthcare settings grew by around 7% on a compounded annual growth rate basis. This was about twice the growth rate of 3.4% for average inpatient bills of unsubsidised patients in "A" wards in public healthcare institutions (PHI). Over the same period, average day surgery bills in the private setting grew by 4.3%, compared to 0.6% for unsubsidised PHI patients. As Singapore Citizens and Permanent Residents can enjoy government subsidies of up to 80% by opting for affordable care in the PHI setting, it would not be meaningful to compare their charges with those in the private healthcare setting.
Some insurance products, such as Integrated Plan (IP) riders with full coverage, which cover the entire co-payment under the IP plan, have contributed to the higher growth rate for private sector bills. While such products are popular because no co-payment is required, the absence of co-payment can inadvertently lead to over-utilisation and rising healthcare costs, and ultimately, higher insurance premiums for all. This is why the Ministry had worked with insurers to introduce a minimum level of co-payment for new IP riders in 2018. This was an important move to preserve the principle of co-payment in our healthcare financing system. This measure will take time to bear fruit. All stakeholders, including patients and medical practitioners, must continue to exercise responsibility when choosing and recommending appropriate and necessary care.
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