Correlation between Quantum of Medical Bills and Medical Insurance Coverage
Ministry of HealthSpeakers
Summary
This question concerns the correlation between medical bill sizes and insurance coverage raised by Mr Seah Kian Peng. Minister for Health Gan Kim Yong highlighted that zero co-payment riders contributed to higher bills, with 2019 data showing such bills were 25% higher than those with co-payments. To prevent over-consumption and rising costs, the Ministry of Health introduced mandatory minimum co-payments for new riders in 2018. Minister for Health Gan Kim Yong also noted that MediShield Life claim limits for cancer treatments are under review to maintain sustainability. The Ministry of Health continues monitoring insurance features to ensure healthcare remains affordable and sustainable for all.
Transcript
21 Mr Seah Kian Peng asked the Minister for Health whether there is any evidence to show correlation between the quantum of medical/hospitalisation bills and medical insurance coverage.
Mr Gan Kim Yong: Different health insurance products affect healthcare consumption and bills differently. For example, Integrated Shield Plan (IP) full riders which cover the entire co-payment under the IP plan, have contributed to higher medical/hospitalization bill sizes. For private hospital riders, the average bill size for individuals with zero co-payment insurance coverage is around 25% higher than those with some form of co-payment in 2019. While full riders are popular because patients are not required to make any co-payment, they can inadvertently lead to over-consumption, over-servicing and over-charging of healthcare services, and ultimately, rising healthcare costs and higher insurance premiums for all.
This is why the Ministry of Health 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. All stakeholders must continue to play their part and exercise responsibility in choosing and delivering appropriate and necessary care.
Ensuring that our insurance scheme design encourages appropriate healthcare consumption becomes increasingly important given our rising healthcare costs. For example, the MediShield Life Council recently observed that the rise in cancer prevalence and emergence of higher cost cancer therapies have led to an increase in chemotherapy claims. The current design of a single claim limit catering to the wide range of chemotherapy treatments may need to be reviewed to strike a better balance between providing access to appropriate treatments and keeping claims growth sustainable. MOH will continue to monitor and review various features of healthcare insurance design as necessary, in order to ensure that healthcare treatments remain affordable and sustainable for Singaporeans.