Debated in Parliament on 14 Nov 2012.
Mr Gerald Giam Yean Song asked the Minister for Health given that the maximum entry age for MediShield coverage will be removed from 1 March 2013, how does the Ministry intend to encourage the 35% of elderly Singaporeans aged 76 to 85 who are not insured under MediShield to enrol in the scheme.
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Mr Speaker, Sir, we recently announced the lifting of the maximum entry age for MediShield, which will take effect from 1 March 2013, along with other MediShield enhancements. This change was in response to feedback received during the public consultation on the proposed MediShield changes.
We will encourage eligible, uninsured Singaporeans to apply for MediShield coverage through public outreach efforts, such as the public talks run by the CPF Board. MOH will also be tapping on the Health Ambassadors' network of the HPB and other grassroots organisations to spread the message within the community about the benefits of MediShield through our various activities, including those targeted at our older citizens. We also encourage children to apply on their elderly parents' behalf.
Beyond MediShield, the elderly can also receive help for their healthcare costs. All elderly Singaporeans will continue to enjoy Government subsidies of up to 80% for subsidised healthcare treatment at our public healthcare institutions, regardless of their insured status. Under the GST Voucher scheme, the Government will also provide annual Medisave top-ups for the majority of elderly Singaporeans to help with their medical expenses. Those who still face difficulties can approach the medical social workers at our public healthcare institutions for financial assistance, including through Medifund Silver, which is a targeted assistance scheme for the elderly. Since 2007, Medifund Silver provided about $61 million to help elderly patients with their healthcare expenses.
Sir, what are the main reasons why such a high percentage of this age group is not insured? We are looking at 35% of them who are not insured compared to only about 8% of the general population.
The Member was asking why they were not insured. There are a variety of reasons. Some of them have their own insurance schemes and some of them may have pre-existing conditions where insurance may not be feasible or may not be the most efficient protection for them, because insurance, including MediShield, operates on a risk-pooling basis. When the total pool of the insured becomes smaller, especially those like the elderly group, the risk pooling may not be effective. Among those in the elderly group, a significant number of them may already have pre-existing conditions. Even if they are included in the MediShield, these existing conditions may be excluded from the coverage and, therefore, it may or may not be efficient for them. So, it is on an individual case-by-case basis. We make MediShield available for the elderly beyond 75 years old primarily because of the feedback that some of them may be healthy and they may want to opt in. We open up the scheme to allow them to opt in to MediShield but some of them may already have pre-existing conditions that make insurance not practical for them. We will look at how we can help these people who may not be covered by MediShield in a different way. As I mentioned, we provide assistance and generous subsidies in our public healthcare institutions for all patients, including the elderly. On top of that, we have introduced the Medifund Silver specifically targeted at these elderly, as we understand that they have specific needs, to help them with the medical expenses.
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We help these elderly patients through a variety of ways – some through insurance; some through Government broad-based subsidy and some through specifically targeted programmes to help them.
Mr Speaker, I have two supplementary questions for the Minister. With MOH's intention to extend the maximum age of MediShield coverage from 85 to 90, there will be a corresponding rise in the premium for those above 85. Will MOH consider raising the upper limit in Medisave quantum for paying the premium for this group of elderly such that there is no need for out-of-pocket cash payment? Secondly, I would like to ask the Minister for an update on the public consultation on MediShield for congenital diseases.
Mr Speaker, I would like to inform the Member that we are, indeed, looking at adjusting the Medisave withdrawal limits to be in line with the adjustments in the premiums to make sure that adjustments in the premiums will continue to be affordable to Singaporeans. With regard to the congenital and neo-natal conditions coverage under MediShield, we have considered it at length and we feel that it is part and parcel of our efforts to provide healthcare protection for our children. It is also part of our overall effort to encourage marriage and parenthood. That is why we have surfaced this for discussion at Our Singapore Conversation, to allow Singaporeans to participate in the discussion on what kind of a healthcare system we want for the future, and what kind of protection we like for our children. We will also be discussing this as part and parcel of a debate on marriage and parenthood. In due course, at these various avenues, we will discuss the issue before we make a final decision.
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