Friday, January 11, 2008

Means Testing - The means to pay for what?

You wake up one day with a pain somewhere and go to see your doctor. The doctor refers you to the hospital for a check up. You're means tested : "How much you earn? What type of housing do you stay in?". Base on this criteria, they decide whether you can afford to pay for your medical bills.
But how can they decide whether you have the means to pay for your bill without knowing what the bill is? A person living in a executive flat can afford a 3-month stay in ICU with surgery amounting to $200K?...A person living in a 3-room flat cannot afford a $200 scan?

What is the meaning of the word "affordable"? HDB flats are affordable, last week City View units were sold at prices up to $700K. Affordable means you can pay the monthly instalments after you get into debt?

Singapore is a medical hub and up to 410,000 medical tourists come here for treatment in 2006. The PAP govt actively promotes Singapore as a medical hub it now says that it is worried there is not enough resources for subsidized "C" wards for the poor.
Insurance ....get as much of it as possible to cover yourself. How high can insurance cost get? When the govt is no longer obligde to provide subsidised care to a large part of the population, there will be less incentive for them to keep cost under control. The problem of medical insurance include:

1. The introduction of a middle man whose primary motive is to maximise profits. Why did the govt privatise insurance? Now there is someone there to introduce complex products with various fine prints ....remember how Aviva used pre-existing condition to deny claims.

2. There is a tendency for a system that relies alot on insurance to see cost spirals . You may think that the amount you pay now is affordable....that was what the Americans thought now 40M of them are uninsured because of the high cost of insurance.

3. There are many people who cannot get medical insurance now due to illness or congenital problems. They may fail means testing and be exposed to very high medical costs through no fault of their own.

What is the problem the govt says it is fixing anyway? ....According to the headlines news on Monday - the govt spends $1.5B a year on subsidies. 9% of "C" is occupied by people of the top 20% bracket. The amount of subsidy "abused" by high income earners is $135M. Even if you're a "high income" earner, you get seriously ill you may want to conserve some money for your family. A subsidy that people have to get sick to "abuse" isn't really that easy to "abuse". How much did our govt pump into sick American and European banks last year? $20+B amount more than 100 times that means testing is trying to fix.

Giving middle class Singaporeans a financial break when they are sick and most desperate is a no-no for our govt.


Anonymous said...

The govt is trying to sugar coat this bitter pill. It is the same -how GST will rise from 3% to 7%, ERP gantries will open in the heartlands, but 'no poor person will be denied a place in hospital'. But all middle income will be stripped by means testing, so that middle income can become lower income so that we all enjoy the same misery.

Anonymous said...

Despite what they say about 'no one will be denied a place in hospital', a lot of sick people are going to face the same kind of indignity that made Dover Park Hospice pull out of the medifund scheme.

The government is only interested in accummulating more and more reserves that it can squander around the world while pushing away all responsibilities towards it citizens even on basic things like healthcare. We have been conned big time by the slogan 'more good years'. The worst is yet to come.

Anonymous said...

PAP's Definition of Means Testing:

Before we can test your blood, we will test your means.
Before we can scan your heart, we will scan your Medisave.
Before we can read your blood pressure, we will read your bank account.
Before you can access to a hospital bed, we will have access to all information regarding the job and incomes you are having.
Before we can put you up in the ward, we will need to know what kind of house you put up in.
All these takes time, so your appointment with the doctor and hospitalisation will of course encounter some delay.
As you can see there is a lot of administrative work involved in Means Testing.
As such it would entail higher operating costs which to be fair should be passed on to you the patient.
You should not complain; there are many rich foreigners in the queue who can afford non-subsidised medical care in our hospitals.
Your demand for citizenship privilege is lame.
You are lucky to be Singaporean already to be run by the world's most efficient government.
Otherwise how can you explain the fact that we are the highest paid government in the world.
So do not be a burden to the system.
If you think it is a hassle, feel free rest at home.
Otherwise we can give you a painkiller.
That should numb your pain and distress.
And you can then be free from the hassle of Means Testing for hospitalization.
We run the system. Stop complaining.

Anonymous said...

Erh, Anon 1.05. The better solution is to cull the sick just like they cull the chickens for exercise. Saves all the testing and administrative work.

Anonymous said...

Yesterday there is a small article in the papers with this headline - "Means Testing: Insurers warn of higher claims, premiums".

Capt_Canuck said...

Honestly, this is a very smart move by the Gov't.

Means testing in conjunction with not having free health care paid through taxes, means that people will buy lots and lots of insurance to make sure that they are protected against getting sick. By doing that, the gov't has created a market for people to get into to hire other people to keep them employed. By having employed people, your unemployment rate is low, meaning that the gov't is not swamped by people complaining "I have no work. How can I live? Why is the gov't so heartless as to not help out it's citizens that are starving with no work?"

Means testing is the way the gov't shows that they 'care' about the people. After all, if you have a house, you have something to sell to cure your illness. After all, which is more important, keeping your child alive by paying for surgery and medical bills, or living in a 5 room flat with 3 generations (grandmother, parents, siblings) and not downgrading to a 2 room flat with the same people packed in. The tighter the living space, the closer and more loving the family is.

So look at all the problems that the gov't is solving with one clean stroke in the medical system? families living closer together, unemployment gone because a new market of insurance is opened AND people are so busy competing for money that they don't see the politicians taking them for a ride.

Truly, the PAP deserve their million dollar salaried.

Anonymous said...

PAP is engineering - through is 700K HDB condos - its own subprime crisis in Singapore for the future, in the service of the big banks now.

GIC and Temasek took our hard-earned money to save the Western banks wobbling from the subprime crisis of the US.

But in future when the same kind of subprime crisis were to hit Singapore's financial institutions, don't expect the Western countries to come to our aid.

The hire-and-fire Americans have never been to deal based on gratitude and reciprocation.

At that time, Mabuk Tan and the other pappies will have to run away like rats from the trouble.

Anonymous said...

basically, after forty years of nation building, one wake up to realize the lofty foundation found on 'confusion ethics' has made TAKERS(not givers) out of almost everybody.

the government is taking from everyone to build their war chests, and the people are taking as much back in terms of paying less for more of services and products.

the inevitable strain of the two extremes will one day severe the tugging rope and raise more body counts.

the root cause goes deep into the value system( in our education system) permeated by white people who claim to be sheeps but are actually wolves.

whether you are rich or poor it doesn't matter now. a greater increasing burden for everyone is their way to go until one can shoulder no more and the light finally dims - for the devourers and the devoured.

but then, you asked for it because you gladly embraced the good parts which also brought along the crap.

chilly craps anybody?

Alan Wong said...

The Gahmen again talk cock!

It is morally not right for those with high income to enjoy the health subsidy given by the Gahmen as this will deprive a place for those in the lower income to be warded in the lower class wards.

Remember just recently LKY even had the audacity to admit that his grandsons are now studying under the Gahmen's scholarships.

So on the other hand, the Gahmen seems to say that it is perfectly alright for those elite who are rich like the our PM & his cabinet ministers to enjoy free tertiary scholarships given by our Gahmen.

Shouldn't these scholarships undergo some form of means testing.

So are they not a bunch of shameless hypocrites!

Anonymous said...

I am against means testing. All that pay income tax are paid based on their income. Low income pay little or no income tax. Income tax is to fund the countries services and including Healthcare. There is no reason to tax middle-income earners Twice (or more).
Yes Scholarships should be means tested and these leaders whose children drain off the nations resources when their parents earn multi million dollar packages they pay themselves should be tested instead. Hypocrites!

Anonymous said...

Be sure to be there and speak your mind.

Date: 18 January 2008 (Friday)
Time: 7.30pm to 9.30pm
Venue: Function Room, Level 1
The Grassroots Club,
190 Ang Mo Kio Avenue 8,
Singapore 568046

Ex-Malaysian citizen, Mr Khaw Boon Wan.

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al said...

high income earner already pay higher taxes and lower income earner pay lower taxes and really low ones pay no taxes. So everybody already pay their dues accordingly to the law and their obligations, so why complicate things - just adopt the concept that everybody paid their dues so everyone is entitled to enjoy the same subsidies....

al said...

per capita income mean testing discourage good income children from living with their parents as it would result in higher per capita income and lower/no subsidy and the retired parents would end up with expensive medical bills - isn't this against the govt wishes for children to stay together with their parents and take care of them?