Review of Coverage Adequacy of MediShield Life and Advisory Support to Minimise Buying of Unnecessary Coverage

17 Ms Jessica Tan Soon Neo asked the Minister for Health (a) whether there will be a review on the coverage adequacy of MediShield Life to ensure that patients get appropriate treatment; and (b) whether more advisory support can be provided for policyholders, especially seniors, in the selection and scope of coverage for Integrated Shield Plan to minimise unnecessary coverage and to ensure that they have adequate health insurance coverage to pay for their medical bills when they need it.

The Minister of State for Health (Ms Rahayu Mahzam) (for the Minister for Health): Mr Speaker, MediShield Life is our national health insurance scheme which protects Singaporeans against major healthcare episodes. It is designed to cover the vast majority – nine in 10 – of subsidised bills.

The MediShield Life Council is currently undertaking a comprehensive review of the scheme. The key objective is to ensure that it continues to protect Singaporeans against large medical bills, amidst rising bill sizes and the evolving healthcare landscape. This means that coverage may broaden and claim limits may need to go up, to give Singaporeans greater peace of mind should they encounter a major health episode. More details will be available when the review is completed later this year.

Notwithstanding the review of MediShield Life, many Singaporeans will still choose to buy additional private health insurance. These are called Integrated Shield Plans (IPs). IPs provide greater coverage on top of MediShield Life, mainly to cover expenses for unsubsidised care in public hospitals or in private hospitals. Some will also choose to buy riders, which can further reduce cash outlay.

However, many people pay for protection that they do not use. To illustrate, about half of patients with IP and rider protection end up using subsidised public healthcare for hospitalisation or day surgery. These patients may not need IPs or riders, because MediShield Life is generally sufficient for such episodes and will be further enhanced after the major review this year. In addition, premiums for IPs and riders charged by private insurers are getting more and more expensive.

We will do more to help consumers understand their needs and choose the right health insurance to buy. Today, the Central Provident Fund (CPF) website and MoneySense, Singapore’s national financial education programme, already have educational articles on what to consider before buying an IP. The Ministry of Health (MOH) also began publishing a comparison of indicative lifetime premiums across IPs this year. This is in addition to existing resources on MOH’s website which compare the benefits, features and premiums of IPs. We can support individuals in making more informed health insurance decisions and will be working with CPF Board and the Life Insurance Association Singapore to achieve this.

Mr Speaker: Ms Jessica Tan.

Ms Jessica Tan Soon Neo (East Coast): Mr Speaker, I do have two supplementary questions for the Minister of State. I thank the Minister of State for covering the points and answering the questions I had.

As the Minister of State has mentioned, people will still buy IPs and it is not just for private healthcare. Many of my residents have shared with me that they buy IPs because of sometimes long wait times and capacity, and to give them that choice to be able to shorten the wait times. Because the care at our restructured hospitals and our public hospitals are actually very good, but the demand is also very high. So, the capacity issue does incentivise them to want to buy IPs in order to have that ability to shorten some of the wait time, not just to see a specialist but also for scans and tests.

So, what can be done on the other end to help people who do not actually want IPs but have MediShield Life, to be able to get more timely care in terms of tests, scans and all that, given the capacity at our public hospitals?

The second question is with regard to the advisory on IPs because as rightly pointed out, IPs are very complex. Apart from the information that is published, would there be any possibility for additional help in terms of an advisory panel that people can call up, besides the agents that they are buying from, to be able to say, "Am I over-insuring myself?"

Ms Rahayu Mahzam: I thank the Member for the supplementary questions raised and the hon Member makes very valid points. I acknowledge the concerns on the consumption of the public healthcare services, and the limitations and the capacity of the same.

As Members are already aware, there are a lot of efforts that we are making in trying to improve the capacity in the public healthcare institutions. Firstly, there are several ongoing projects to increase bed capacities in the various public hospitals. Secondly, we have been working on the manpower to make sure it is augmented and there is support in this front. And thirdly, we are also looking at right-siting so that we do not tax the acute healthcare sector.

All in all, there are multiple issues relating to the healthcare sector and there are a lot of issues people are concerned with and we are taking a multi-pronged approach, focusing various efforts on various fronts.

So, I think the key thing is also related to the second point, it is in creating awareness and understanding of the choices for people to make because what we are seeing right now is that they are over-insuring and I think that is where the cost issue arises.

So, it relates to the Member's second point in that we really do need to enhance consumer education. There are already platforms now and the exercise of CPF Board to provide information, comparison between different IPs. I think more can be done in the community also to create such awareness.

I will take note of the feedback and point that the Member has suggested in the advisory committee, but I think the resources currently available are quite extensive and will actually help guide people in making decisions. Perhaps community partners can also step up to assist and support in enhancing the awareness of some of these resources available to the community.

Mr Speaker: Dr Tan Wu Meng.

Dr Tan Wu Meng (Jurong): Thank you to the Minister of State for the answer. I have residents worried whether insurers sold them insurance premiums, while knowing the plans might rise and be in the long term not sustainable and that the policyholders may actually give up their premiums before making use of the benefits.

Can I ask Minister, previously I asked about making Integrated Shield Plan insurance portable, to give consumers choice and rebalance the relationship between consumers and insurers. Then Senior Minister of State, Dr Koh Poh Koon, had said MOH would study it. Can I ask when MOH might be able to give a further update on this study?

Ms Rahayu Mahzam: I thank Member for the question. The issue of portability had previously been explained by Minister Ong in a different setting. Portability is a very complex matter and it may have unintended consequences. So, we are studying this very thoroughly. Because when each insurer is uncertain about the risk that they have to bear, premiums may actually go up and all in all this may not be helpful.

So, we are really looking into this. And to answer the Member's question, we are intending to share our findings by the end of the year.

1.30 pm

Mr Speaker: Order. End of Question time. Personal Explanations, Ms He Ting Ru.

[Pursuant to Standing Order No 22(3), provided that Members had not asked for questions standing in their names to be postponed to a later Sitting day or withdrawn, written answers to questions not reached by the end of Question Time are reproduced in the Appendix.]