Policy on Charging Patients who Choose Different Ward Classes for Different Hospital Stays
Ministry of HealthSpeakers
Summary
This question concerns billing policies for patients choosing different ward classes during hospital stays, as raised by Mr Ang Wei Neng. Minister for Health Mr Ong Ye Kung explained that while downgrading patients receive subsidies based on respective classes, those who upgrade face retroactive subsidy adjustments to prevent the exploitation of lower-class subsidies for expensive initial treatments. He noted that hospitals provide financial counseling and support through means testing or MediFund for patients facing genuine affordability issues. The Minister clarified that subsequent downgrades are permitted via means testing, though patients downgrading from higher classes may still be charged higher rates for medication. These policies are designed to ensure fairness and prevent the deliberate selection of lower ward classes to secure higher subsidies for costly procedures.
Transcript
1 Mr Ang Wei Neng asked the Minister for Health (a) what is the current policy when charging a patient who chooses to stay at different classes of a general ward during each period of stay at a public hospital; and (b) whether a patient can choose to stay at different classes of a general ward when admitted to a public hospital and be charged the respective fee of each type of class.
The Minister for Health (Mr Ong Ye Kung): Mr Speaker, Sir, my response today will also address the oral question filed by Mr Leong Mun Wai, on retroactive charging for upgrading wards, for a subsequent Sitting.
When patients stay in a higher ward class and then downgrade to a lower ward class towards the end of their stay, they will receive subsidies based on the respective ward class. This is fair. In fact, where the request to downgrade is due to unaffordability because of complications or unexpected additional costs, public hospitals will find ways to support these patients financially. This is for downgrading of wards. For upgrading of wards, there is a different consideration.
We have to discourage patients from selecting lower ward classes to secure more subsidies for more costly treatments, such as surgery and the Intensive Care Unit (ICU) at the beginning of their stay, and then switch to higher ward classes once these treatments are completed. Many of these patients are not of lower income and could have chosen the higher ward class from the outset. That is why if a patient upgrades, the level of subsidies will be adjusted retroactively.
Mr Speaker: Mr Ang Wei Neng.
Mr Ang Wei Neng (West Coast): Thank you, Mr Speaker. Thank you to the Minister for the reply. For cases where some of the patients who upgrade, but they are not financially very strong, is it possible for them to appeal not to pay for the entire duration at the higher ward class, if they select just after the operation?
The second supplementary question is, many a time, my residents tell me, when they are in the higher ward class in the previous hospitalisation period, and when they get to the next round of hospitalisation and they request a downgrade, they are often not allowed to. The only time they can escape this is when they are admitted to the Accident and Emergency (A&E), then they can go to a lower ward class. Can the Minister clarify these two points?
Mr Ong Ye Kung: The Member asked, for those who upgrade, later on in their stay, can they appeal. Of course, everyone has the right to appeal, but having said that we are trying to stop a certain behaviour, which we do not think is right. At the beginning of every hospital stay, patients will be counselled financially and they will make those decisions with their eyes open. When a patient medically requires isolation, we will isolate them. And if they have chosen a lower ward class to start with and then require isolation, they will be given higher subsidies, not withstanding being in the isolation ward.
As for those who come back later and wish to downgrade and are not allowed, actually there is a very established process of means testing. So long as they meet the means testing criteria, they can downgrade.
I think the specific cases the Member might have come across, might be a case where they did not manage to meet the means testing criteria. Having said that, for anyone with affordability issues, there is always MediFund as a last line of defence, a last safety net, so that they can always afford a hospital stay in the public health institutions.
Mr Speaker: Mr Leong Mun Wai.
Mr Leong Mun Wai (Non-Constituency Member): Thank you, Mr Speaker. I would like the Minister to confirm – because I have gotten feedback from some residents that when they want to downgrade from a higher ward class to a lower ward class, they are told that even after the downgrade, they will have to pay the price for the medicine of the higher ward class. Is that correct?
Mr Ong Ye Kung: Mr Speaker, the answer is yes. It was covered in my reply just now.