"Singaporeans withdrew a total of S$660 million from their Medisave accounts to pay for the direct medical expenses incurred in hospitals, clinics and other healthcare facilities last year.
This was an increase from the S$590 million withdrawn in 2008.
These figures do not include withdrawals for MediShield and ElderShield premium payments which were S$745 million in 2008 and S$875 million in 2009. 52 per cent of the withdrawals in 2009 were to pay for the members’ own direct medical expenses. The remaining withdrawals were to pay for family members: 17 per cent for spouses, 18 per cent for parents, 12 per cent for children, one per cent for grandparents and others”. (“S’poreans withdrew total of S$660m from Medisave accounts in 2009“, CNA , Apr 26)
A years ago, I chatted with a taxi driver who was taking me to work during the rush hour. It was one of those days when I couldn't get up in time to take bus and had no choice but to take the taxi. The cab driver was very friendly and told me he worked close to 14 hours a day so that he could cover the morning and evening rush hour. It was tough but he had no choice as he was badly in need of money. According to him, his wife was bed ridden with diabetes. She lost both legs and her kidney had failed so she needed dialysis. Due to diabetes, his wife also lost her sight. His daughter was also suffering from diabetes. He also told me that his family situation was so pitiful, they once appeared on a documentary and were featured news paper article. He told me he had to borrow using credit cards and eventually sold his home to pay for the medical expenses. I didn't get all the details about his income (taxi drivers earn about $3-4K?) and what type of home he was staying in. However, the financial burden for medical treatment can be heavy (read this case about another family that had to sell their home[Link] ...another about a family whose savings are wiped out by medical expenses[Link]).
The PAP govt insists that Singaporeans shoulder as much of the burden for medical care as possible and they carried this idea to the extreme, making Singaporeans shoulder the highest % of medical expenses among citizens of developed countries:
Taking care of yourself and your family may sound like a sensible idea except that Singapore has the highest income gap in developed world. The cost of good medical care is driven the richer segments of society who will naturally demand the best private care. Because of the income gap, medical cost has been rising much faster than average income and for some in the the lower income bracket it is now unaffordable. The govt has allowed Singaporeans to use Medisave for treatment in Johor[Link] while Singapore is promoted as a world class medical hub for rich foreigners[Link]. About 400,000 adults are uninsured[Link] and face the risk of high medical costs. Without universality of medical coverage, the high burden of medical is passed other family members to keep govt's expenses down. The entire system worsens the inequality in our society by making medical care a heavy burden for those in our society less able to shoulder it.
This is an area where sensible things need to be done such as providing universal coverage. For those who are too poor or unemployed, the govt has to step in to help with the insurance premiums. In some countries, the insurance premiums for govt schemes are based on income to further narrow the inequalities buildup in the society. While PAP ideology prevents them from adopting such schemes, it is not clear how long Singaporeans, some of whom now have to seek treatment in Malaysia, will continue to accept the system and support the PAP. One good thing about being a developed country is that the citizens can stop worrying about something as basic as getting medical care....that is unless you're in Singapore where the burden of healthcare actually becomes heavier for ordinary citizens as the nation becomes more affluent.