Rationale for Use of Annual Value Threshold for Zero-income Households for Long-term Healthcare Means-testing
Ministry of HealthSpeakers
Summary
This question concerns the adequacy and robustness of the Annual Value (AV) threshold used in long-term care means-testing for zero-income households, particularly those with multiple members requiring residential care. Dr Hamid Razak asked about the assessment criteria following the per capita household income threshold increase to $4,800 and whether AV remains an appropriate subsidy metric. In response, Minister of State Ms Rahayu Mahzam stated that raising the AV threshold from $13,000 to $21,000 from 1 January 2024 allows zero-income households in all HDB flats to receive top-tier subsidies. She noted that while AV serves as an objective proxy for financial means, the Ministry of Health and the Ministry of Finance are reviewing the subsidy framework. She added that families facing financial difficulties or having multiple care-dependent members can appeal through medical social workers for case-by-case assistance and subsidy deviations.
Transcript
7 Dr Hamid Razak asked the Coordinating Minister for Social Policies and Minister for Health (a) what criteria does the Ministry use to assess the adequacy of the Annual Value threshold for zero-income households under long-term care means-testing, following the increase in the per capita household income threshold to $4,800; and (b) whether this assessment considers households with multiple members concurrently requiring subsidised residential care.
The Minister of State for Health (Ms Rahayu Mahzam) (for the Coordinating Minister for Social Policies and Minister for Health): Mr Speaker, the Annual Value (AV) criterion for long-term care subsidies was raised from $13,000 to $21,000 from 1 January 2024. With the new AV threshold, zero-income households in all Housing and Development Board flats are eligible for the highest tier of subsidy.
What the Member is perhaps alluding to is that the eligibility criteria should cater greater financial support to a household living in a lower AV private property, but with significant care needs. This has to do with the current tiering and design of the subsidy framework, which the Ministry of Health and the Ministry of Finance are reviewing.
Notwithstanding the above, where a family faces financial difficulties, there are avenues to apply for additional assistance beyond means-tested subsidies. Medical social workers holistically consider the clients' circumstances on a case-by-case basis, including scenarios where multiple household members require care.
Mr Speaker: Dr Hamid Razak.
Dr Hamid Razak (West Coast-Jurong West): Thank you, Mr Speaker. Appreciate that the Ministry is open to reviewing the threshold criteria for AV, but with our population ageing, would expect that there will be more zero-income households in the near future. Would the Ministry consider moving from debating about the right value, the right number to the right measure, and to consider whether AV will remain to be robust enough for us to level healthcare subsidies, not just in the long-term care setting, but also general medical care?
Ms Rahayu Mahzam: I note the Member's concern. In the absence of household income, actually AV is generally a good reflection of the means of an individual. It is an objective basis, but we know it is not perfect. Per capita household income, as well as the AV measures, are proxies but they are not perfect measures.
Because of that, we do have a mechanism where if there are certain specific situations, parties can actually proceed for an appeal. And in that appeal we can actually consider circumstances and have subsidy deviation, which would then support them. We have also indicated that we are reviewing this, so whatever that the Member has raised are things that we will consider.