Hell Health Minister Khaw Boon Wan said he paid only $8 for his heart bypass surgery. This is all by his Medishield and a private Shield supplement, while Medisave took care of his co-payment. I know this is old news, and I am only now talking about this because I haven’t really been catching up with the news lately.

With the General Elections just around the corner, perhaps Khaw intends to showcase just how superbly Medishield (which came into effect in 1990) has done its job. However, when one take a closer look one will realise that Medishield will only look good as long as everyone has the money to pay the premiums for coverage, which in turn will demonstrate its flaws and inadequacy.

Let me explain.

First of all, Khaw is short on details how he managed to attain his ‘healthcare nirvana’. I certainly don’t understand how that worked out to $8. Lee Lilian from the Workers’ Party did a breakdown in her blog post and she couldn’t work out how the $8 is derived. Perhaps Mr Khaw should go into the details of his Shield supplement and enlighten us how he managed to achieve this. Everyone (or perhaps no one) knows the basic Medishield is really inadequate if one has a large bill or require medical attention outside a public hospital. From what I understand (I could be wrong), a basic Medishield plan will only cover up to $3000, and the less fortunate among us will definitely be unable to afford a heart bypass.

While I don’t know how much Khaw paid annually for his medical insurance coverage, I know for a fact we (and we alone) paid for our Medishield, and whatever private Shield supplement we can afford out of our own pockets. That’s right, we pay every single cent out of our own pockets even when that money comes out of Medisave. Comparatively, in Taiwan the employer pays 60% and the government gahmen pays 10%. That works out to about USD30 a person per month per person. An ex-legislator of Taiwan mentioned that under Taiwan’s medical insurance, he only has to pay roughly NT$20,000 (approx. S$1000) in a bypass surgery out of his own pocket while the rest are covered by medical insurance. Based on Lee Lilian’s breakdown, that is still far less than Khaw has to pay out of his Medisave.

Now, I am not bringing up the comparison to say Taiwan has a better system but rather to point out that we bear the burden of our medical insurance all alone. In fact, without a Shield supplement, the basic Medishield coverage will be grossly inadequate and the balance amount will be staggering. A single heart bypass will easily wipe out one’s Medisave, if not a substantial amount of his own personal savings. In other words, it is absolutely certain a Shield supplement is required for everyone. Thus, the affordability of the Shield supplement comes into question as what kind of Shield supplement to get will be dependent on one’s income.

Before I proceed further, let’s reminded there is a S$800 cap on Medisave which can be used to pay for medical insurance. This simply means one needs to start paying more in cash as they aged while their earning power and fitness to work continue to deteriorate. For e.g. my 72-year-old father needs to pay an annual premium of $2000 for his medical insurance, which would include a Shield Supplement which will take care of any medical bills above $3000.

As a result of the $800 cap, I will need to fork out around $1200 in cash annually to keep my dad covered. He was recently hospitalised and the bill came up to around $4000 (including 4 day stay at the NUH, two endoscopy and health supplements. After all the reimbursement from his medical policies, I still had to pay S$1000 out of my Medisave. That’s right, S$1000 which an ex-legislator in Taiwan has to pay for his heart bypass. Perhaps I should say I paid $0 since Medishield + Shield supplement + my Medisave ‘took care of everything’.

In short, Khaw has definitely painted a surreal image of Singapore’s healthcare system, and one that doesn’t reflect the reality of the burdens one must bear to achieve it. We need to set money aside to afford it, and it is just a portion of the numerous burdens we have to bear to ensure we don’t end up as ‘statistical foul ups with no one but themselves to blame’ in the Tali-PAP’s utopia. Some of these burdens just add up and is it a wonder why more of us are simply not getting married, or even when they are married they are not having babies at all?

Now, I am not asking for handouts, because I don’t need the gahmen to raise any taxes to foot the bill. But I would simply ask that I be allowed to use my Medisave to pay for 100% of the cost to for Medishield and its supplement, which in effect transfer some of the load to my employer since my employer contributes 20% of whatever that is put into the CPF. It would also leave us with more cash on hand which we can thus spend and indirectly drive domestic demand – no matter how significant – which will also increase revenue in the form of GST for the gahmen.

At the very minimum, the gahmen should raise the cap on how much of our Medisave (maybe up to 50% of our annual contribution) we can used on our medical insurance. It is after all our money and I am not asking to use it for hedonistic purposes but rather to fulfill my filial duties to my parents.