Health — Topics | PAPERCUTS

21 Oct 2013

Payments by MediShield Policyholders for Cumulative Basic Co-insurance

Gerald Giam Yean Song requested a yearly breakdown from 2010 to 2012 of MediShield policyholders' cumulative basic co-insurance payments across five specified ranges.
Health Minister Gan Kim Yong responded that most policyholders had annual cumulative co-payments below $6,000 during the period.
The Minister clarified that co-payment includes the annual deductible and is paid via MediSave or cash after subsidies and other insurance payouts.
The response was presented in a table format and referenced page 175 for the detailed figures.

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21 Oct 2013

Statistics on MediShield Coverage Limits

Mr Gerald Giam asked for statistics on how many MediShield policyholders reached the policy year and lifetime limits in 2011, 2012, and the projected figures for 2013 under the revised limits.
Health Minister Gan Kim Yong replied that fewer than 0.1% of policyholders reached the limits in 2011 and 2012, and the limits were increased in March 2013 to address concerns about ageing and rising claims.
The Ministry will monitor the trend of policyholders exceeding the new limits and continue to provide financial assistance for difficult medical bills, while considering further enhancements as part of the move towards MediShield Life.

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21 Oct 2013

Age Profile of MediShield Policyholders

Gerald Giam asked for the number of MediShield policyholders in specific age ranges from 0-20 to 86-90 years.
Health Minister Gan Kim Yong reported that as of June 2013, 3.6 million members, or 93% of the resident population, were covered by MediShield.
The minister noted that the maximum coverage age was raised from 85 to 90 years in March 2013 due to increasing life expectancy.
He stated that future enhancements under MediShield Life will study providing universal, lifetime coverage for all Singaporeans, including the elderly.
The response referred to a page with the detailed age breakdown, but specific numbers for each age group were not listed in the debate text.

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21 Oct 2013

MediShield Premiums Collected and Claims Paid in Last Five Fiscal Years

Between 2008 and 2012, MediShield claims paid annually doubled while premiums collected increased by about 40%, with a detailed table showing premiums, claims, and required reserve changes for that period.
Claims are expected to rise further due to population aging and the expansion of coverage to psychiatric, congenital, and neonatal conditions from March 2013.
MediShield is a not-for-profit, self-sustaining scheme where premiums are actuarially set to cover current and future liabilities, including claims and premium rebates, and reserves are maintained per MAS Risk-Based Capital requirements to ensure solvency.

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21 Oct 2013

Development of New Senior Care Centres

The government has opened three new Senior Care Centres (SCCs) in the Central, Eastern, and Northern regions, with three more planned within six months and the remaining centres targeted for completion by 2016.
SCC operators are mainly voluntary welfare organisations or social enterprises, selected based on criteria like their proposed care model and track record in aged care.
Locations are chosen based on community accessibility, demographic and demand factors, availability of suitable sites, and public transport with barrier-free access.
The government is also working with existing eldercare providers to expand their services into full-fledged SCCs where space permits.
The overall aim is to integrate day eldercare services such as day care, dementia care, rehabilitation, and basic nursing under one roof.

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21 Oct 2013

Waiver of GST on Medical Consumables for Kidney Dialysis

David Ong asked if the GST waiver on kidney dialysis medical consumables could be extended to all patients, noting that some opt for private dialysis due to limited space or conditions at government-related centres.
Tharman Shanmugaratnam explained that Singapore maintains a broad-based GST system with minimal exemptions to keep rates low, using targeted subsidies and GST absorption for lower- and middle-income patients at government-funded VWO dialysis centres.
The government recently expanded subsidies to cover up to the 67th percentile of households, increasing the number of patients receiving GST absorption by about 40%, and aims to ensure adequate capacity in subsidized centres.
While there is generally sufficient capacity in government-funded VWO centres, the government acknowledges regional demand variations and will work to maintain supply, and VWO providers may offer financial assistance to patients unable to use these centres.

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21 Oct 2013

Goods and Services Tax on MediShield Premiums

Christopher de Souza questioned the rationale for imposing GST on MediShield premiums and asked whether the tax could be waived for the elderly or low-income workers.
Tharman Shanmugaratnam explained that Singapore maintains a broad-based GST system with minimal exemptions to keep the rate low, while offering targeted subsidies and grants to assist lower-income groups.
He noted that the government absorbs GST for subsidised patients in healthcare settings and provides support through GST Vouchers and Workfare Income Supplement, which include top-ups to Medisave accounts to cover MediShield premiums.
Tharman highlighted that a retiree household could receive substantial Medisave top-ups that more than offset their MediShield premiums, and similar support exists for lower-income working households.
He added that with the introduction of MediShield Life, further government assistance will be provided to ensure premiums remain affordable for older and less well-off Singaporeans.

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21 Oct 2013

Discrimination against Employees with Mental Conditions

Dr Intan Azura Mokhtar inquired about reported discrimination against employees with mental conditions and the extent of such cases over the last ten years.
The Tripartite Alliance for Fair Employment Practices (TAFEP) has received four complaints of perceived discrimination against workers with mental health conditions out of about 1,000 total complaints since 2007.
TAFEP encourages individuals facing employment discrimination to seek its advice and assistance, and employers have generally been receptive to making adjustments to their practices when issues are identified.

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21 Oct 2013

Invitations to Health Screening

Minister Gan Kim Yong outlined that the Integrated Screening Programme (ISP) invites Singapore residents aged 40 and above for affordable screenings for chronic diseases and cancers, with 490,000 invitations sent in 2011 and 200,000 in 2012, and 36,000 and 19,000 attendees respectively, noting higher numbers in 2011 due to a mammogram campaign.
Screening costs are subsidized, ranging from $8 for blood tests to $30 for colorectal cancer tests, with full subsidies for lower-income Singaporeans and enhanced CHAS coverage from 2014, reflecting a shared responsibility model.
The Ministry cites encouraging results from the 2010 National Health Survey, with high screening rates for hypertension, cholesterol, and diabetes, but acknowledges room for improvement and plans to enhance affordability and convenience to boost participation.

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21 Oct 2013

Pre-approved Community Health Assist Scheme (CHAS) for Residents Living in HDB Rental Flats

Irene Ng inquired if residents living in HDB rental flats could automatically receive a pre-approved CHAS card to simplify access to the scheme.
Gan Kim Yong explained that the Ministry of Health currently promotes CHAS through door-to-door visits with grassroots leaders to assist rental flat residents in applying and understanding the benefits.
The ministry plans to continue collaborating with community partners like Family Service Centres to encourage more eligible Singaporeans to join CHAS.
MOH will explore additional measures to target outreach to lower- and middle-income households, including facilitating CHAS enrollment for rental flat residents.

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21 Oct 2013

Preventing Rise in Gambling Addiction

The Minister acknowledged a rise in reported cases but clarified that the national problem gambling rate has remained stable at 2–3%, which is lower than some other Asian jurisdictions and comparable to Western countries.
The increase in people seeking help is viewed positively, as it suggests reduced stigma and better awareness, with various support services available including helplines and recovery centres.
The government will continue to monitor the situation, strengthen safeguards, and enhance public education and counselling services to address problem gambling.

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21 Oct 2013

Update on Implementation of National Mental Health Blueprint 2007-2012

The Minister reported progress on the National Mental Health Blueprint's twin goals of promoting mental well-being and reducing the impact of mental disorders, with over 50 public education initiatives in 2012 and integrated mental health screening in hospitals for patients with conditions like stroke and diabetes.
Community mental health services have been strengthened through multidisciplinary teams, the REACH program for early intervention in schools, and new pilots like Assessment and Shared Care Teams and Community Mental Health Intervention Teams to improve accessibility.
The Ministry has aligned its mental health plan with the WHO's Comprehensive Mental Health Action Plan 2013-2020, focusing on community-based services, promotion, prevention, and strengthening the evidence base, with plans to continue implementing these elements in the coming years.

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21 Oct 2013

Organ Transplant Rates

Singapore’s organ transplant rate has remained stagnant over the last decade, from about 35 per million population in 2004 to 34 per million in 2012, and lags behind countries like Hong Kong, South Korea, and Australia due to limited brain-dead donors and low living donations.
The Ministry of Health has significantly increased public education funding from about $120,000 to $1 million annually over the past 10 years, using campaigns like “Live On” to raise awareness about organ donation under HOTA.
Measures planned for the next two years include integrated campaigns and social media outreach to highlight the benefits of organ transplants and encourage both deceased and living donations.

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21 Oct 2013

Update on Initiatives of Ministerial Committee on Ageing

The Ministerial Committee on Ageing is advancing two main goals to support seniors: keeping them healthy, active, and safe in the community, and enhancing aged care accessibility, quality, and affordability.
Initiatives include nationwide rollouts of the Wellness Programme, new Senior Activity Centres, home modification subsidies via EASE, and community projects like CFAA to create senior-friendly environments.
Capacity for aged care services is being expanded, with targets for more nursing home beds, Senior Care Centre places, and home care clients by 2020, alongside efforts to improve care standards and affordability through subsidy schemes.
A study trip to Japan reinforced the importance of active ageing and early development of home care services, leading to the establishment of a Home Care Workgroup to develop a roadmap for Singapore’s home care sector.

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21 Oct 2013

MediShield's Capital Adequacy Ratio

Member of Parliament Gerald Giam Yean Song questioned the distribution and adequacy of MediShield Fund's $507 million in net assets for 2012, specifically requesting a breakdown of reserves for liabilities and capital for regulatory requirements, year-on-year figures from 2005-2012, and the fund's target Capital Adequacy Ratio (CAR).
Health Minister Gan Kim Yong explained that MediShield is a self-sustaining, not-for-profit scheme where about 65% of the fund on average from 2005-2012 comprised reserves for expected liabilities like claims and premium rebates, while the remaining "net assets" served as capital for meeting MAS risk-based requirements.
The CAR is calculated as net assets divided by MAS risk requirements, with a minimum regulatory CAR of 100% and a warning threshold of 120%, but MediShield maintained a CAR of 165% at end-2012 and targets 200% to ensure resilience against adverse scenarios, in line with industry best practices.

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21 Oct 2013

Health Warnings and Pictures on Cigarette Packs as Deterrence to Smokers

Graphic health warnings on cigarette packs in Singapore are effective, with a 2005 study finding that 71% of smokers reported increased knowledge of health effects and over 50% became more concerned about their health.
The Ministry of Health updates graphic warnings periodically to prevent desensitisation and has introduced additional measures like banning misleading descriptors and adding new text warnings.
The Ministry is considering a ban on the display of tobacco products at points of sale, citing research that such displays influence purchasing behavior and that bans in other countries have reduced smoking rates.

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16 Sep 2013

Use of Medical Subsidy for Haze-related Ailments

Assoc Prof Fatimah Lateef queried the Minister for Health on the number of people who have used the $10 subsidy for haze-related consultations and whether more clinics have joined the scheme.
The Ministry of Health introduced the haze subsidy scheme on 21 June 2013 to support Singaporeans who are elderly, children, or in lower-income groups with a $10 fee for haze-related respiratory or eye conditions at participating clinics.
As of the report, around 8,200 attendances were recorded at GP clinics and 2,600 at polyclinics under the scheme.
The number of participating GP clinics has grown from 200 at launch to over 650 today.

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16 Sep 2013

Surge in Dengue Cases and Utilisation of $10 Subsidy for Dengue NS1 Testing

Assoc Prof Fatimah Lateef inquired about the number of people using the $10 subsidy for dengue NS1 testing and the impact of increased dengue cases on polyclinics and emergency departments.
Minister Gan Kim Yong reported that as of 7 September 2013, 15,774 dengue cases were notified, with over 6,600 subsidised NS1 tests conducted by 16 August 2013.
Polyclinic attendance for dengue or suspected dengue rose 6.5 times in the first six months of 2013 compared to the same period in 2011-2012, while emergency department attendances reached 6,880 in the first half of 2013.
To manage the increased workload, hospitals implemented measures such as adjusting shifts, redeploying staff, and streamlining processes to enhance efficiency and reduce waiting times.
The dengue epidemic led to higher patient volumes at public healthcare facilities, but dengue-related cases remained a small fraction of total attendances, with polyclinics at less than 0.3% and emergency departments at 1.3%.

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16 Sep 2013

Extension of Medisave and Community Health Assist Scheme Coverage to Treatment of Epilepsy

Foo Mee Har questioned if long-term epilepsy treatment could be covered under the enhanced Medisave and Community Health Assist Scheme.
Gan Kim Yong stated that current coverage under the Chronic Disease Management Programme includes 10 conditions, with five more to be added in 2014, and that epilepsy is under consideration for future inclusion.
He added that patients needing epilepsy treatment currently receive subsidies at polyclinics, and the government continues to review expanding Medisave use to more chronic conditions.

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16 Sep 2013

Regulation of Charges by Doctors

Ms Mary Liew raised concerns about monitoring doctor charges to keep healthcare affordable for lower-income Singaporeans.
Minister Gan Kim Yong explained that healthcare costs are rising due to advanced treatments, but public institutions monitor costs and fees to ensure affordability.
The Ministry of Health publishes hospital bill sizes and is considering publishing public sector doctor fees to increase transparency and help patients make informed decisions.
The government plans to provide more subsidies for lower- and middle-income Singaporeans needing specialist outpatient care, with details to be shared in early 2014.

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