Integrated Shield Plan Coverage for Inpatient Hospice Services

10 Dr Tan Wu Meng asked the Minister for Health (a) which private insurers cover admission to inpatient hospices as part of their Integrated Shield Plans; and (b) whether the Ministry will consider requiring all private Integrated Shield Plan insurers to cover inpatient hospice admission, just as they presently cover restructured hospital admissions.

The Minister of State for Health (Mr Chee Hong Tat) (for the Minister for Health): Mdm Speaker, hospice care, or end-of-life care, is available in an inpatient hospice or in the home setting. Together with MediShield Life, the Integrated Shield Plans (IPs) are designed mainly to cover large hospital bills. Hospice care is covered under some riders, such as Great Eastern's Total Health Riders or AXA's Home Care Riders. So, we do have some riders that are covering hospice care today. The Ministry of Health (MOH) does not require IPs to cover hospice care, as an expansion of IP benefits will, inevitably, result in higher premiums for all policyholders.

In assessing whether palliative care should be covered by IPs, we also need to look at whether the services are affordable for most Singaporeans. Based on data collected by MOH, hospice care is affordable through a combination of Government subsidies, charity dollars and MediSave. About eight out of 10 inpatient hospice bills did not require out-of-pocket cash payment while about nine in 10 home palliative care patients did not have to make out-of-pocket cash payments for their care. Needy patients who require further assistance can receive financial support through MediFund.

MOH regularly reviews the amount of Government subsidies and MediSave used for hospice care to ensure it remains affordable for patients and also sustainable for providers. We are also working with community partners to enhance accessibility to palliative care services by increasing capacity for palliative care across the inpatient, home and community settings.

Mdm Speaker: Dr Tan Wu Meng.

Dr Tan Wu Meng (Jurong): I thank the Minister of State for his answer. Would the Minister of State agree that there is a group of patients who may fall into what some of us term the "sandwich class", who might not qualify for as many subsidies as lower-income patients but, at the same time, would still want to take advantage of the benefits provided by their IPs purchased from the private sector when they were healthy?

Would the Minister of State agree that, at the moment, the present system makes it somewhat unfortunate that these patients can access their IP benefits in a restructured hospital but cannot, should they choose to seek end-of-life care at an inpatient hospice?

Mr Chee Hong Tat: Mdm Speaker, I thank the Member for his supplementary questions. Today, Government subsidies for hospice care, both inpatient hospice care as well as home hospice care, are extended up to the 67th percentile. In addition to Government subsidies, the other important source of support for our patients would be charity dollars. This is an area where we work closely with voluntary welfare organisations (VWOs) and charities, and they bring more than financial support. They also bring care and concern, and service from the heart, which is very important for end-of-life care.

The point about IPs and riders, we do have riders that are available, as I explained in my answer. The important point is that this is something which we will have to regularly review. We just started MediShield Life from 1 November last year. It is important for us to focus the scheme on the original intent in which it was set up to do, which is to cover large hospital bills. This is something we can review on an ongoing basis to make sure that MediShield Life is able to meet the needs of Singaporeans.