Tag: Health Care

Random Discourse – $8 Heart Bypass Surgery

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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.

Commentary – Maintenance of Parents Act

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This is a translated excerpt of the Prime Minister’s Baby Lee’s National Day Rally speech (Mandarin):

We Asians pay great attention to filial piety This is a traditional virtue & we must maintain this. Although the government has a duty to look after the aged, and the government will try its best to look after the aged, but to the family members, it’s not only duty, it’s duty plus love. It’s not something the government can provide. The love of the family members, the warmth of the family cannot be replaced by nursing homes & hospitals.

Recently I had a chat with some nursing home operators & they told me that in principle this is correct. But some Singaporeans have not preserved this virtue. Some Singaporeans have abandoned their parents in the homes or hospitals. After they sent their parents to the homes sometimes they disappeared & even changed their addresses on their ICs. When the nursing home contacted them they said: “It’s not my business.” and said that even if the nursing homes were to drive the parents away, they would not mind.

This is something that causes great discomfort to us – a new social phenomenon – and we must deal with it. So the government is looking into how to be more effective in implementing the Maintenance of Parents Act so that the children will fulfill their duty. Besides building more community hospitals the government will look into other measures so it will facilitate people looking after the sick relatives at home. We will do our part. Our whole health care system will be effective but individuals must also carry out their duties

I am not sure whether this was also touched on in his English and Malay speech, but if it wasn’t then it would be really interesting why it is in Mandarin only. It implied that Chinese Singaporeans are the only ones who abandoned their parents in Old Folks Homes.

But I am not surprised if that is true. I have a distant relative who did just that to his own mother and after hearing the exact detail of the events leading to her predicament, I could only gnash my teeth in cold fury (恨得我咬牙切齿). Here’s a summary: One of her three sons, knowing that their mother doesn’t know English, conned her into signing a lawyer letter which bequeath all of their late-father’s estate to him alone, thereby cheating not just his own mother but also the inheritance of his other two brothers. When all of that is done, the mother was so completely devastated, she suffered from dementia. This scum then send her to a home. Failing to understand their mother’s predicament, since she had signed away what they felt is rightfully theirs, the other two sons felt no obligation to bring her home and all three of them left her there till she died a lonesome death. It was a situation as bad as that depicted in Jack Neo’s ‘Money No Enough 2’ except that the three brothers in that movie didn’t con their mother or just left her to die.

When my parents found out about it and went to visit her before she passed away, the old lady (an aunt of mine from the father side) could not recognise any of them. My only consolation was that these sub-human trash didn’t share my family name, and I promised myself that my clan will never forget the debt this family owed and if God is willing, one day I’ll settle this score with them… personally.

The Maintenance of Parents Act is thus an welcomed piece of legislation for me, even though it has came too late for my aunt. However, I felt that the act should not become a piece of legislation which empowers irresponsible parents and allows them to force their kids to maintain them. I can only say parents who have never been their for their children, such as compulsive gamblers or violent, abusive parents who left their children to fend for themselves at a young age, should only deserved what they had coming for them if their children abandons them. While I am not really encouraging an environment of vengeance, I felt no one should be subjected to the word and wrath of the law when they have already suffered long enough in their childhood.

That being said, I must also point out that while the Maintenance of Parents Act will serve as the stick to deal with those heartless beasts who abandoned their parents, there is no carrot for those who fulfill their duties without fail. Certainly, I would like the government gahmen to do more to help those who are fulfilling their duty.

However, I am not asking for handouts from the gahmen, but I would at the very least expect the gahmen to make it far easier for me to pay some of the costs. For e.g. I think it is prudent that everyone of us – especially those who are only child – to get health insurance in place for their aging parents. However, I can only use up to $800 (or was it $880?) from my CPF’s Medisave account to pay for each insurance bill. The rest I would have to foot out of my own pocket. All is fine as long as I remained gainfully employed, but I might have difficulties paying the difference if I am not. As such, I would seriously prefer to be able to pay the full amount from my CPF. Above which, allowing us to have more money would indirectly increase our spending power which would indirectly increase the GST collected by the gahmen, and thus giving it more money to finance any future ‘wealth sharing’ projects.

Is it too much to ask for the cap on Medisave payment for health insurance to be lifted, as some kind of ‘carrot’ for some of us who are doing our duty as children faithfully? I am not even asking for handouts. I am just asking that I be allowed to use this money which is rightfully mine, and it is not as if I am asking to use the CPF for hedonistic purposes.