Medishield Life: What is clear and not so clear

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The MediShield Life scheme, the details of which were announced on Thursday, is to give Singaporeans peace of mind, a phrase that is being used often by the government.

How far will it go in assuring Singaporeans, especially older Singaporeans, that it is better to die than fall sick? Here we try to break down the scheme to itemise the clear and not-so-clear aspects.

Clear: MediShield Life pays more for large medical bills

You can claim up to $700 (previously $450) for a night in the normal ward and $1,200 (previously $900) for an ICU ward.

If you visit a community hospital, your first $350 (previously $250) is covered.

The new scheme offsets $2,000 (previously $1,100) of your surgical cost. Cancer patients can claim $3,000 a month for their chemotherapy sessions, and up to $500 for each radiotherapy session.

Clear: In return, premiums will increase

Starting from 2015, you may have to pay up to 3 per cent more than your current premiums. If you have pre-existing conditions, you will pay an extra 30 per cent in premiums for the next 10 years.

The silver lining is that the government will provide transitional subsidies until 2019 for all Singaporeans. Additional subsidies will be given to middle and lower-income groups.

Not so clear: Lower income group with pre-existing conditions

The government has yet to address this issue.

What kind of subsidies will be given to those with pre-existing conditions and to those from the lower income group?

An example in TODAY showed a family earning $5,000 a month with two young children and two elderly parents. They will have to pay $140 monthly after receiving subsidies if they are eligible.

Will they be able to afford the additional 30 per cent if the family members have pre-existing conditions? And when the transitional subsidies end in 2019?

Not so clear: Claim limits may pose a problem to more people

The good news is there will be no more lifetime claim limit (previously capped at $300,000).

But Professor Paul Tambyah, an academic physician, said: “The other claim limits in the scheme can be a problem for many people.” [See claim limits here]

MediShield covers only 2.2 per cent of total healthcare cost in Singapore. “If MediShield Life covers double the amount, it would still leave a gap of 95 per cent of healthcare cost, which has to be covered by government subsidies, private insurance and out of pocket expenses.

“There will still be a great need for private insurance to cover deductibles and excess costs over the daily and annual limits,” he pointed out.

He said that while needy Singaporeans can depend on Medifund, the “sandwich class” who do not qualify for subsidies might be at risk.

Medishield Life doesn’t seem to address this point.

Not so clear: Premiums are increasing, but outpatient costs are not addressed

Tambyah noted: “It is true that the most expensive care is inpatient care. But unfortunately, outpatient costs and primary care are not addressed in this round of reforms.”

It looks like patients will have to bear their own outpatient costs, except for those who are seeking cancer treatment.

How would the outpatient costs coupled with the increase in premiums affect Singaporeans?

We will have to wait for more details to find out…