Help for Singaporeans to Obtain Subsidised Rates at Public Hospitals after Expiration of Employer-provided Healthcare Insurance

10 Dr Tan Wu Meng asked the Minister for Health what are the measures available to help Singaporeans who are on non-subsidised rates to obtain subsidised rates at public hospitals if they were previously on employer-provided healthcare insurance which has since expired.

The Minister for Health (Mr Gan Kim Yong): Madam, all Singaporeans who are admitted to public hospitals can choose to be admitted into subsidised ward classes, regardless of whether they had been receiving unsubsidised or subsidised care previously. Hospitals provide financial counselling to patients prior to or upon admission, to help them select a ward class appropriate to their needs.

Patients at the public hospitals who face difficulties with their medical expenses and wish to switch from non-subsidised care to subsidised care, can approach the staff at public hospitals for assistance. Each request is assessed on a case-by-case basis, taking into consideration various factors, such as his bill size, medical condition and any changes in financial means and his ability to pay, including employment status. Patients who request to switch to subsidised Specialist Outpatient Clinic services will also be similarly assessed.

I would encourage patients who are facing financial difficulties to approach the medical social workers in the hospitals to discuss the various options.

Dr Tan Wu Meng (Jurong): I thank the Minister for his reply. Some of my residents have shared that in their working life, they had insurance provided by their employers and, so, took advantage of such insurance to become non-subsidised patients. But having retired and having tried to downgrade to subsidised status, some had difficulties doing so, perhaps, due to the means test.

Moving forward, would MOH consider making it easier for Singaporeans with employer-provided insurance to revert to subsidised status once the insurance lapses, without having such stringent means testing, bearing in mind that such patients, had they not made use of their employer healthcare benefits, would have been subsidised patients all along?

Mr Gan Kim Yong: Madam, I am sure Dr Tan is quite aware that our resources are always limited and, therefore, we have to try our best to target our subsidies and financial assistance to those who genuinely need them. For patients who are genuinely in financial difficulties, the hospitals and MOH will certainly extend our assistance to them, regardless of whether they have been using their employer insurance before they retire.

I would be reluctant to grant special consideration for patients who, just because they have made use of employer's benefits or insurance, to waive means-testing or to make it easier for them. We treat all patients alike. Those who have needs for financial support, we will do so and we will continue to improve our processes to make sure that those who need financial assistance will get them in a timely manner and as much as they need to. But we have to bear in mind that the resources are always limited and we need to make sure that our assistance is targeted and reaches out to those who really need them.

Mr Cedric Foo Chee Keng (Pioneer): As a follow-up, I think the larger question is portability of health insurance. Can the Minister address this question?

Mr Gan Kim Yong: Madam, I thank Mr Cedric Foo for raising the question. It is a very important question. In fact, we have been working very hard over the last few years to encourage our employers to move towards portable medical benefits for their employees so that their employees would be able to continue to enjoy these benefits beyond their employment with a specific employer and beyond retirement. We have made some progress and we intend to continue to push in this direction.

The real portable medical benefit is MediShield Life which we have introduced, because MediShield Life is universal and is independent of employers. We encourage the employers to provide additional contribution to Medisave to help their employees to pay for MediShield Life premiums or to purchase Integrated Plans which are portable. These are the ways that we hope would be able to help our employees to enjoy portable medical benefits.

Assoc Prof Fatimah Lateef (Marine Parade): I support means-testing, but, essentially, when someone asks for a downgrading process to be started at the hospital, they need to see a social worker and there is a latent phase and a period where they have to wait. Sometimes, the waiting period is such that they may have already had another admission where they have to still pay the paying class rate or they may have had another one or two Specialist Outpatient Clinic appointments with a paying class clinic. So, therefore, I was wondering whether we can expedite and streamline the process of a downgrading.

Mr Gan Kim Yong: Madam, we will always try our best to streamline our processes. I must also stress that, again, as I have said in my reply, at every admission into the hospital, the patient is given a choice, whether he would like to be admitted as a private patient or he would like to be admitted as a subsidised patient. Every admission would be treated fresh.

For those who want to switch to subsidised care from non-subsidised care, they will have to work with a medical social worker (MSW) to better understand their needs and tailor our solutions and our assistance, to meet the needs of the patients. I must stress that our MSWs actually go out of their way to help the patients. I have regular dialogues and engagements with the various healthcare professionals and one of the most enjoyable sessions is the session with MSWs, because whenever I meet them, they do not talk about anything else except the well-being of their patients. They always talk about how we can improve the processes, simplify the processes, so that the patients will get the assistance they need as soon as possible.

So, rest assured that our MSWs are working very hard to help the patients to meet their needs and MOH will work with them to see how we can continue to streamline and improve our processes.

Mr Dennis Tan Lip Fong (Non-Constituency Member): Would the Minister consider having communication with the industry with a view to increasing the number of types of possible medical insurance beyond MediShield Life?

Mr Gan Kim Yong: Madam, we are in constant dialogue with the insurance industry. In fact, I just had a session with them last week talking about MediShield Life as well as the private products, Integrated Plans, which ride on MediShield Life. Insurance companies also have other products that are independent of MediShield Life. They are also exploring collaboration with the hospitals, so that they are better able to match in terms of the services provided and the needs of their policyholders. We do have this constant dialogue and discussion with the industries, on the one hand, to better understand how the industry operates because we do have a very large universal scheme of MediShield; on the other hand, to also understand the difficulties and challenges they face in implementing MediShield Life as well as the Integrated Plan and also to get their input on how we can improve the product offering in terms of the healthcare insurance sector.