Reducing Misuse of MediShield Claims by Allowing Claims for Some Outpatient Treatment

Mdm Speaker, right-siting and providing appropriate care are important priorities for the healthcare system to deliver value for our patients and ensure longer-term sustainability. These include initiatives to focus on health promotion and disease prevention, as well as efforts to improve productivity and develop our primary care and intermediate and long-term care facilities in the community.

Over the past few years, the Ministry of Health (MOH) has enhanced Government subsidies for outpatient services and drugs. Patients can receive up to 70% subsidy at Specialist Outpatient Clinics (SOCs) and up to 75% subsidy for drugs and medication. Additional support is provided for Pioneer Generation (PG) patients who receive a further 50% off their subsidised outpatient bills.

We have also expanded MediSave use for outpatient treatments, including outpatient scans and chronic disease treatment. Singaporeans who are 65 years and above also have the flexibility to use up to $200 of MediSave every year to pay for their outpatient treatments at public healthcare institutions and participating Community Health Assist Scheme (CHAS) and general practitioner clinics.

MediShield Life currently covers a number of costly outpatient treatments, such as kidney dialysis and chemotherapy treatment for cancer. Day surgery is also covered by MediShield Life and MediSave. Beyond Government subsidies, MediShield Life and MediSave, MediFund assistance is also available for low-income Singaporeans who require further financial support to pay for their outpatient bills.

MOH will regularly review the scope of MediShield Life's coverage, but the focus should remain on protecting Singaporeans against large hospital bills. It is important to bear in mind that expansions in MediShield Life coverage will lead to higher premiums for all policyholders. And with an ageing population, we need to carefully consider the trade-offs to ensure that the schemes remain affordable and sustainable.

Madam, I thank the Minister for the reply. I would like to ask the Minister if it is true that there are some more vulnerable families or poorer families who simply cannot afford outpatient services and who have no choice but to ask their doctors to admit them into hospitals so that they will have a bed and can then claim their inpatient insurance.

If this happens, does it lead to a misallocation of beds? And is it something that the Ministry is looking at and thinking of ways to solve the problem?

Madam, I thank the Member for his supplementary questions. As explained in my answer, right-siting is an important priority for our healthcare system, because we do want to make sure that patients receive appropriate care at the appropriate location that is most suitable for their medical condition. So, if the patient requires inpatient services, then he or she rightly should be hospitalised. But if the patient does not require that, then outpatient treatment would be more appropriate.

We do need to look at our financing scheme – how the incentives are being set to ensure that we are able to support right-siting, which is a key part of ensuring a more sustainable healthcare system. For the low-income families that Mr Ong Teng Koon spoke about, the best way to help them is really to make sure that there is a safety net, and this is what we provide through MediFund.

So, for low-income families, after the Government subsidy has been applied, and after MediShield Life and their own MediSave, if that is still not enough and they need further assistance, they can apply for MediFund through the medical social workers. That is something that we have at the hospitals and polyclinics, whether it is for inpatient or for outpatient treatment.