Update on Benefits of Community Health Assist Scheme

There are currently around 850,000 Singaporeans on the Community Health Assist Scheme (CHAS) Blue and Orange tiers. Since 1 September 2014, members of the Pioneer Generation (PG) are also able to benefit from special CHAS subsidy. Taking this into account, around 1.1 million Singaporeans can now benefit from the scheme.

In 2013, the Government gave out $31 million in CHAS subsidies to 145,000 Singaporeans. In the first eight months of 2014, $42 million in CHAS subsidies have been given out, benefiting some 260,000 Singaporeans.

Prices charged differ depending on various factors, including the medical condition, treatment provided, medications prescribed, length of consult as well as the operating costs

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of the clinics. The vast majority of our doctors do observe the Singapore Medical Council's Ethical Code and Ethical Guidelines, which state that doctors cannot abuse the doctor-patient relationship for personal gain. MOH also closely monitors CHAS claims submitted by clinics. Clinics have been, and will continue to be, called upon to account for any exceptional claims.

We encourage clinics to display their common charges, such as consultation fees prominently, and to address any concerns that patients may have. This will make the charges more transparent to their patients. We also encourage patients to clarify with their doctors, if they have any queries on their treatment and charges.

Thank you, Madam, and I thank the Senior Minister of State for the answer. If I heard correctly, there are about one million Singaporeans who are eligible for the CHAS scheme, but only about 300,000 have signed up for the scheme. Can I get a clarification from the Senior Minister of State? If so, what can be done to ensure that the other 700,000 or so Singaporeans who are eligible will eventually sign up for the scheme?

My second supplementary question is: can signing up for CHAS be made easier for Singaporeans? And the last question is whether CHAS will eventually be extended to include all GPs because, currently, I think some GP clinics are still not under CHAS.

As I have stated, as at September, some 1.1 million Singaporeans are on CHAS Blue and Orange Cards, or if they are Pioneers, they will enjoy the special CHAS subsidies. Indeed, not all Singaporeans who are eligible are on CHAS. The reason why we need them to step up to apply for CHAS is because we need the household membership data, as well as consent for us to obtain income information on the backend to process their application.

AIC, together with MOH, is working with the grassroots, HDB, VWOs and other organisations to try and target our outreach particularly to the low- and middle-income Singaporeans to get them on CHAS. Regarding GPs, we are also working to get GPs on CHAS. In fact, the number of GPs, as at September, is more than 1,200 now, both dental as well as CHAS GP clinics and we will continue to work on getting more of them on CHAS.

Thank you, Madam. I would like to ask the Senior Minister of State: we will track the claims, but I understand CHAS has a cap per claim. So, is the Senior Minister of State saying that the Ministry will check the total bill of each claim in

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order to ascertain that doctors do not overcharge?

My last question is this. I know of some GPs who, in the past, waived certain fees or charged lower fees for those low-income families. But given, now, with this subsidy, they may then revert to the market rate. So, how would the Ministry treat such cases? Is it overcharging or is it acceptable?

I note the Member's concerns about overcharging. Let me say that, currently, what AIC does is to engage and counsel those selected clinics which have been highlighted by the public on their charging practices. We also objectively monitor and analyse the claims submitted by the CHAS clinics, looking at the bill size claims, whether they are large bills consistently, say, top five for the common claims, as well as whether there are large bill size increases over time, and whether there are any unfavourable audit findings for CHAS audits, as well as for Medisave audits.

Proactively, we will engage these clinics which may have potential overcharging behaviour, even if there are no complaints received from the patients. In addition, there is actually an audit framework for CHAS clinics. So, they have to abide by certain CHAS guidelines and, again, the audit team will go down to audit these clinics on a quarterly basis, and if there are exceptionally high bills, we will, again, engage and counsel them. We are also engaging the large medical groups to ask them to publish on their websites typical bill charges for common treatments, for instance, just consultation fees and, in future, perhaps the total bill, including medications. We are encouraging clinics to get on this scheme, publicise it, prominently display their charges and, of course, to address any concerns with their patients.

We also want to encourage Singaporeans to actually engage the doctors if they do have any concerns regarding charges. Let me again reiterate that, actually, most doctors on this scheme have done it with the right spirit and they have done the right thing, in terms of making primary care more affordable and accessible to Singaporeans through the GPs in the private sector and most of them have the highest standard of profession. But we will continue to monitor this situation and, if we need to refine our audit as well as escalation framework, we will do so to address such concerns.