Wednesday, October 27, 2010

Khaw Boon Wan's $8 bypass....

Khaw Boon Wan is one of the most well liked ministers around.....maybe because most people haven't been means tested or had a severe illness not covered by insurance.

In a recent posting in his blog (mohsingapore.blogspot.com), he wrote that he paid only $8 for his recent bypass. $8 is not even enough to buy a ticket for the movies these days. Recall that Minister Khaw's condition was detected through an expensive calcium test[Link] which ordinary folks probably don't take....so if they have the same condition as Khaw, they probably won't find out about their heart condition until they have a severe heart attack. The reason Minister Khaw paid only $8 because he is covered by both Medishield and a private insurance plan. This is strange right? I really wonder why minister who is paid millions in salary per year needs to supplement his Medshield with a private plan. If Khaw as a millionaire minister finds Medishield inadequate and supplements it with a private insurance plan, what does that say about the Medishield?! These private plans can cost $2k-$3K or higher per year depending on your age and health condition.

Singapore's healthcare system has to be always compared with the those of other 1st world countries. We are definitely better than most developing countries if you're not too poor to afford it. If you look at the % of the healthcare burden shouldered by individuals (vs govt expediture) it is the highest in the developed world even higher than the US which had a healthcare crisis that had to be fixed. Our system is not universal:

"We have been particularly effective in reducing the % of uninsured young Singaporeans, from 45% in 2007 to 17% in 2009" - Khaw Boon Wan [Link]


In the US when they debate the severe healthcare crisis of a 'large' number of uninsured Americans, they number they were talking about was 15.4%[Link]. For a developed country, our uninsured population is huge. After Obama's healthcare reform, Singapore will be the only developed country without universal healthcare[Link].

When I read Minister Khaw's blog, I'm very happy that he acknowledges that more needs to be done:

"........ especially in extending MediShield to include mental illness, congenital illness and neonatal treatment. There were also comments on raising the claim limits on outpatient cancer care, so as to relieve the burden on cancer patients. " - Khaw Boon Wan

I wrote about coverage of children with congenital illnesses many times in my blog and it has been the topic of much debate over the past years. If the system does not take care of Singaporean children who are born sick, can we ever say the system is good? The reason the govt doesn't do this is simply because it doesn't want to allocate money to solve this. But what is lacking in govt is not money but heart. Perhaps Minister Khaw has his heart at the right place because he at least recognise that this is something that has to be fixed. However, he belongs to a political party that leans too far to the right whose basic philosophy is to shift as much burden as possible to the sick and their families. It has been many years, many babies and many parents who struggle to provide care for these children with little help from the govt. The money is there ...we are not a poor country. But helping sick babies is too difficult for this govt to do - we need to wait, debate and ponder over it for decades.....but there are no big deal to just spend $387M on a sporting event or lose a few billion in western banks or spend money on expensive military hardware that has little relevance in a world where the threats have changed from all out war to low intensity conflicts. Minister Khaw needs to ask for more budget to cover those who have no insurance and take care of those who are now left out by the system. ...if we treat healthcare as important as defense, we can only get stronger as a nation because ultimately when the time comes and we are called to serve with our lives, we will remember how well we were taken care of in our time of need.

61 comments:

Anonymous said...

Dont know what's the medical benefit of a minister. However, most sinkapooreans are of the impression that they are entitled to the best of everything, ward, food, specialist, facilities, bodyguards, plane and whatever one can imagine. Maybe, we the citizens, know nothing and have wild guessings and speculations. Minister Khaw may like to correct the people's ignorance by telling us why he was made to pay $8.

TokyoSingaporean said...

I think it is clear as day. You mentioned that the PAP administration lacks heart on basic human rights issues such as universal healthcare. When you extend that logic to Minister Khaw, you can tend see a possibilty that he wants to stretch his dollar even when he is paid HDB flat salary per month. Khaw is also greedy. But he has a pleasant disposition. So it helps to take in the soft poison.

You can't expect male Singaporeans to serve the country with 2 or 2 and half years of their lives with National Service and a lifetime of reservist service, without even covering their universal healtcare cost. Even the US doesn't do this shit. No soldier will be empowered to defend such a country or any country for that matter. A male national serviceman is already paid peanuts and doesn't get any CPF. The average Singaporean male starts his life very late in life. A female singaporean does not serve national service nor reserivsts, earns 2 years of CPF and rise in promotions. The same age Singaporean male has zero CPF, starts his life late, has to wait 3-4 years for a flat and has no CPF to even consider marriage at the age of 26. To make matters worse, the male Singaporean is in debt before he starts working. He needs to pay his university fees. He made to unfairly compete for sinful 99-year rented apartment with other foreigners, including jobs, etc. And you wonder why the birth rate is falling? They have done us wrong. And we let them go on with their wrong policies. The smarter ones have migrated.

Anonymous said...

These are some fundamental human concerns in a first world country. The PAP administration is addressing this concern properly. They have still not gotten it right.

Anonymous said...

I meant they have NOT addressed it properly.

Anonymous said...

I am sure a lot of us would like to have that kind of coverage. Perhaps Mr Khaw could elaborate more to educate the public....not the $8 fee (we all know that now) but the premium to have that kind of coverage.

DareToAct said...

I will like to point out that it actually cost money to buy additional insurance coverage from private insurance company, and that the cost of premium will likely doubled if you want to cover with no excess (I.e. The insurance covers all expenses). Poorer Singaporeans might have to trade off between paying for the extra coverage or paying their kids school fees. On the one hand, I congratulate Mr. Khaw for his concerns with under-insured citizens; on the other hand, I can't help but feel that our Ministers are really quite out of touch when it comes to our citizens' cash-flow situation.

Anonymous said...

Can what Mr Khaw had paid also be the case for an ordinary Joe? If so, what sort of Private Shield he needs to buy and what are the premiums to be paid?

What about employment benefits? This is one area where there may be an "ocean" between a minister's entitlement and benefits and a ordinary Joe's employment benefits.

The report does not mention much, if at all, of the above. Any experts can further enlighten?

Anonymous said...

Private insurance is a silly idea. It didn't work in America. Private insurance companies simply collect premiums from you and when you actually get sick, they hire lawyers to deny you the benefits. Why? Because it's cheaper for them to pay lawyers to fight you in court than to pay doctors to treat you.

Remember that these companies are ultimately businesses motivated by profit making.

Healthcare has to be a public service. There's no way around it. Every sufficiently advanced country has realized this.

Anonymous said...

$8 for a bypass? this coming from a chap who said that if everyone were to be like mrs lee, this place would be heaven? yeah, right.

show us exactly what he was billed, what portion the employer - the civil service - has to pay, and what he has to pay for his private insurances, then we'll evaluate.

otherwise, pass the salt plse.

Anonymous said...

Khaw should really realise that if he were not a Minister, his private insurer would have either denied his claims (by finding fault with nitty gritty details) or dragged its foot on the processing of the insurance claims. This is what ordinary Singaporeans have to face. Khaw is really in a world of his own, and has lost touch with the harsh reality faced by many Singaporeans.

Anonymous said...

how lian lah. just like zorro lim who says "i feel so rich looking at my cpf statement every month."

Anonymous said...

Thing is, he's making millions a year & what's a few thousands extra for medical insurance? I am sure people in his position are fully covered by us taxpayers & they neednt pay much to get a heart bypass or even maybe a sex change! Sorry about the sex change part, but what I am trying to say is that these minsters are already so rich & yet they still get so much benefits; shouldnt more be done for the lower income & less fortunate? I think it's such a joke when he said that it cost him just S$8.00 for his medical, perhaps that amount includes GST too!! Anyway, I doubt any Average Joes could boast of that & not many people could afford the special check up he had. Most times, it's just the usual testing like x-ray or blood test.

Clear eyed said...

Aren't Ministers and elite civil servants, being pensionable, entitled to FREE A-CLASS MEDICAL TREATMENT FOR LIFE? And their spouses too?

Anonymous said...

Yeah, ministers and top civil servants e.g. perm secs, are entitled to free A class hospitalisation / treatments at govt restructured hospitals. Older pensionable civil servants are also entitled to free govt hospitals, from B1 to A class, depending on salary grade and designation. However, all these does not extend to private hospitals or private specialists. Maybe Khaw had some procedure done that could only be performed by a private specialist? The specialist could be persuaded to operate in a govt hospital, but his charges will be billed separately and need to be covered by private insurance.

As for Khaw's extra private medical insurance (most probably to cover private hospitals), I'm pretty sure that he can claim the premiums from a generous benefits package i.e. unlike lesser mortals, he doesn't feel any loss of $3000 going out every year to pay for a super medical insurance.

After all, many of those working for large US and European MNCs also have complete private hospital insurance cover, paid for by their companies. And senior execs in these companies are also entitled to expensive comprehensive annual health checkups that can catch problems at the early stages.

Of course most (70%) of Singaporeans won't have the privilege to experience such good stuff as above.

Azz said...

Below is from MOH facebook (I don't have sufficient knowledge to comment on the reality of the numbers given but at least I give them credit for replying):


Moh Spokesperson
Some have wondered about the total bill size of Minister’s heart surgery and the eventual $8 out-of-pocket payment. The total bill came up to about $25,000; of which $20,000 was paid by insurance, and $5,000 by Medisave. Minister had subscribed to Basic MediShield (since it was launched) and topped it up with a private Medisave-approved Shield which covers Class A and private hospitals. He did not have any riders.

The insurance premium for someone in his age range (51-60 years old) is about $330 - $662 for a Shield plan targeted at Class A hospitalisation. Presently, one can use up to $800 per policy per year from Medisave to pay for Medisave-approved Shield plans .

We hope that all Singaporeans will subscribe to MediShield. Depending on their preferences, they should choose a suitable Medisave-approved Shield policy. If they have no plan to go into Class A/B1 or private hospitals, then basic MediShield should suffice. The premiums are highly affordable.

Here’s some useful links to more information on the withdrawal limits for Medisave and the various MediShield-approved insurance plans at http://www.moh.gov.sg/mohcorp/hcfinancing.aspx?id=324 and http://www.moh.gov.sg/mohcorp/hcfinancing.aspx?id=11164

Anonymous said...

is this corruption?

Anonymous said...

I am in total agreement with TokyoSingaporean. No matter how hard I try and try to rationalise, I find it hard to tell my sons that they should defend the country woth their lives. Main reason is that I dont see the country taking care of them as pointed out by Tokyo Singaporean.

In the US, they have the policy of not leaving any men behind in the battle field. Somehow under the Singapore system, I dont see that happening. Correct me if I am wrong.

Anonymous said...

he is really a very lucky malaysian.

Anonymous said...

Singapore has a system of every man for himself.

If you fall sick, you die your own problem.

Our govt also encourage bosses to replaces us with foreign trash who are cheaper and faster, but not necessarily better.

Our Singapore market also works in such a way that no matter what happens, rent and utilities will never be reduced significantly. If you want to cut costs, you cut salaries. But never rent nor utilities.

Anonymous said...

Do you all have any idea what the Brotherhood call him?

I think they are just waiting for another cut. Then they will go for him.

Anonymous said...

I have a son who was born with a congenital problem. When this was discovered the paediatrician told us we should have aborted him.

When he was 6 months old, the same doctors gave him only months to live.

We decided to emigrate to another country, totally disgusted by the lack of compassion of our so-called top class Singapore medical professionals.

Our son is nearly 13 years old now, an intelligent boy and very happy where he is, despite his condition, he is accepted by his friends and peers.

People who haggle over saving costs in healthcare do not understand the meaning or the value of life.

God help Singapore because Singaporeans can't seem to help each other.

Anonymous said...

Other than treatment and medication, Singaporeans are lucky that they have the option of Advance Medical Directive. This last measure only goes to show how life is value in this sinful society.

pumpkin said...

I an happy for the minister that he spent only $8 of his own money for such an expensive operation. He truly knows how to take care of himself moneywise.
I hope he would remember that he is the leader who is taking care of the health needs of the people under him. He should make it his mission to ensure that the people under him ,like him,will not be out of pocket for more than $8 for a similar operation.

When this happens, I will be happen for Singapore!

Anonymous said...

$8 for heart bypass surgery? That's even cheaper than going to polyclinic! Many poor and elderly can't even afford the $8.50 polyclinic consultation fee plus extra charges for medicine, and they just suck thumb & bear with chronic pain and illness. Many working people also just bear with colds, fever etc as they cannot afford to take MC and no such thing as taking time off (down time) to see doctor, as they are afraid of being replaced by younger & cheaper foreigners. There are many sick Sinkies taking panadol or leftover cold medication, and going about daily work in a zombie state.

rookielim said...

Lucky,

You are a very kind person with very kind words for our Health Minister.

My parents do not have health insurance. I have to pay for my parents' health care for the past >10 years. Osteoporosis, cancer, hypertension... It has put a considerable strain on my financial resources. It is my duty as a son.

But, when my turn come and need medical treatments, I will be "mean" tested and have to pay more for my treatments. My kid may end up taking up the suggestion of the Health Minister and send me to a nursing home in JB. This may be the tragic ending of many socially responsible Singaporeans.

I am surprise you have such good words about him. He has spoken what was really on his mind when he asked that we send our parents to JB. His heart is definitely NOT in the right place and he will surely not have a change of heart by paying only S$8.00 for the heart bypass, pun intended.

Anonymous said...

Well, some recovered physical health, but, their spiritual health and conscience are still sick.
These influential people can cause the society as sick as they are in their minds and souls.
Unfortunately, they liked to boast how healthy they are physically, how rich(just cpf statement alone) and how talented they are.
Endless bragging and gloating about their fortunes which many felt they dont deserved.

Anonymous said...

So today, if I place a $8 down payment for a car and take a 10 year long loan payment of $1000 per month. Can I claim that buying a car in Singapore is super cheap?
Does our ministers think before they speak these days?

Anonymous said...

JB for treatment may still be much better than doctors suggesting Advance Medical Directive to kins and relatives of patients.
Dont forget your own kins and kiths can also ask(apply) for AMD if they are not loving of the too sickly patients.

cheap bypass said...

Lucky,
Khaw B W should now proclaim, "the medical attention for Mdm Kwa and the $8 bypass for myself makes Singapore a place like heaven"...

so vote for me so that I can make it like heaven for you too!

Anonymous said...

Bloody sick society run by sick people.

As simple as that.

geelo said...

The moral of the story is don't get sick in Singapore unless you are a minister.

The whole thing reads like a sick joke to me.

Anonymous said...

I kind of understand the philosophy of our gov on being self sufficient. But having the minister 'bragging' about his medical cost is not only in bad taste but unwise(so what if the cost is $800k to save his dear life, he can more than able to afford it.$8 to keep his precious life and laugh himself to the bank is an insult to those who are struggling with the cost of living).
Next time, better to use the average citizen as example of a balanced health care system that actually works to assuage the public.

Anonymous said...

My mother worked all her life first in a shipyard, then in a kitchen. She needed an operation to remove her kidney. It costed 1000 times more. But her pay was 200 times less that a minister's.

Anonymous said...

me thinks it's high time we increase ministers' medical benefits. $2m/$3m folks who have sacrificed so much for the country, should not have to pay for heart bypass, not even $8. tsk tsk

Anonymous said...

My father-in-law, a self-employed professional, bought private health insurance for many years. Upon being diagnosed for cancer and claiming on the first year, the following year he could not afford the increased premiums. Basically, he is uninsured or not insured (same thing) after the first claim. So much for private health cover. He still needs treatment and medication.

There are many anecdotes of such kind amongst the common folks.

A smiling tiger administering soft poison is apt. Insensitive to others and out of touch completely.

Would he now boast that his private health insurance premiums remain the same? And promote the name of this insurance company? And by the way, who pays for the premium? The public? He is as transparent as his sincerity.

BABO

Anonymous said...

The philosophy of the healthcare system in Singapore (taken from the MOH webpage) is...

"Singapore healthcare begins with building a healthy population through preventive healthcare programmes and promoting a healthy lifestyle."

Preventive healthcare means you're not even supposed to get sick in the first place, so that you won't put additional load on the system.

Now, if the Minister of Health himself can't even take care of his own health preventatively, why are we taking him and his health system seriously?

Anonymous said...

the general idea is that if you don't take care of yourself, the gahmen will not waste taxpayers money to take care of you.
but for those who tried and still fall through the cracks, pls refer to the "other social services" or gahmen plan b,c,d etc but.... these are not classified under welfare but social services.

in other words, you won't die lah.

Anonymous said...

My basic Medishield premium is annually deducted from my Medisave. Due to my Senior Citizen status (over 55 years) & my poor health it is not advisable to pay additional premium to a private insurer for additional benefits, the charges will be astronomical! For people like me, we are always caught in the co-payment rule whereby, the patient has to pay a certain percentage of the bill before claiming from Medishield. What happens is that the entire bill is shouldered by ourselves. Effectively, for majority of us, we pay Medisave & we pay Medishield premiums. As one ages & enters an older age group, the premium also increases. I have noticed that Medishield premium is regularly revised upwards. Am waiting to see new revision but with - ELECTIONS?? - so far no revisions yet. Be patient, they will soon be unveiled for average jane & average joe to pay & pay till perhaps their Medisave sucked dry? Can happen, if cannot work, cannot contribute to Medisave.

Anyway, Lucky, I'm very glad you blog. Thank you very much indeed. Keep up your good blog. GOD BLESS YOU & YOUR FAMILY.

Anonymous said...

gahman plan is for the next generation lah.it is to warn them now..better set aside monies for old age and not splurge on gucci and prada when you don't earn that much...and stay fit and eat right etc etc.

if you follow those rules and live responsibly, the next generation will have fewer social casualties lah.

meanwhile, for old birds, turn to social services if you think you are about to die from all your unwise spending or if you have not lived wisely when you are young lah.

message is...no welfare but got other kind of social services to help foolish or very suay people lah.

like that also don't understand...tsk tsk tsk

Anonymous said...

To: Anonymous, 28.10.2010, 17:48.

I wonder if next gen still got $$$ for Medisave. More likely $million hdb flat suck their old age savings dry...

Anonymous said...

Holy Crap! Lim Bo Heng, the no-portfolio minister, who is supposed to look after old age issues, has said that Singapore may need to increase retirement age to 68!!

Looks like old fart's statement that there should be NO retirement is becoming true. But how come that Lim Peh so yahyah dare to shoot his mouth off when GE is just around the corner?

Anonymous said...

Lim Boon heng YOU anyhow suggest TO RETIRE retirement to 68 yEARS DID YOU CONSULT SINGAPOREANS I am sick and tired of this nonsense from PAP i hope singaporeans will teach you a lesson in the next election

Anonymous said...

works until 60 years old???
Yes u can, if u are preapred to be UPGRADEd to be a taxi driver or cleaner even if u hv a phd.

Anonymous said...

aiyoh,everything I explain,how can.pap never pay me you know. use your phd,your phd....

Anonymous said...

If $8 is all that it cost for a major operation, such as heart bypass, done on one of the world most "richestest" ministers, why do we need means testing?

Anonymous said...

These bloody priviledged fuckers can get anything for free if they wanted to.
They are using their own case egs to con the outside world and gullible Singaporeans that Singapore is paradise. Yes it is paradise to these priviledged fuckers but it is hell to ordinary Singaporeans.

Anonymous said...

As usual a thoughtful and insightful commentary, thank you Lucky.

Vast majority of us prefer to have an easy life and be told what to do until it hit our pockets or living standards.

Maybe with the new global economic reality, "biflation" - what you have is worth less than what you need; we have have to become more discerning about whom and who we put our trust. Personally definitely not be a fancy Wall Street suit type.

Interesting if you compare the outcome and cost of a similar procedure in different countries or cities and then normalize to PPP or average annual income.

Which axiom is more appropriate
"Too good to be true?" or "health is wealth?"

Anonymous said...

If it sounds too good to be true, it probably is!

Anonymous said...

You need to wait 5 years to get a HDB flat now. A woman incur higher risk when they delay having a child. Imagine the common scenario that is happening right now: 33-year-old Singaporean male plans to marry his girlfriend who is 28. But has to wait 5 years to get his flat made. By the time they actually get their nest and have a child in their homes, the girl would be 34-years old and the father is 38, almost hitting his 40s.

Let me guess: Have a child in your parents' home then. The government is DAFT. It is harming the Singaporeans' future now. Spread the message: It's time to bring down the greedy empire.

Anonymous said...

i don't think you should compare us and singapore directly purely based on stats, given that the population size is vastly different? just a point though

Anonymous said...

If u look around, u will find that yr friends / relatives who are older hv "dropped out" of the job market one by one in the past few years.

Is it the so called "results" or "achievement"? Is this a good "performance" or "under performed"?

Anonymous said...

I second your call to have compulsory cheap insurance for ALL Singapore children, regardless of their pre-existing conditions. When the govt finds it in their heart to take care of HER children, then I believe the national service done by our Singapore Boys are worth it! You protect your own children, even those diseased ones.
http://theonlinecitizen.com/2010/10/nourishing-the-people/

Anonymous said...

Although I have many gripes with the current govt system in Singapore, there is one thing which I agree that we should NOT embark on - and that is free healthcare for all.

Let me explain to you why.

I lived in the UK for more than 5 years, where there is free National Healthcare for everybody in the country. Sounds good on the surface, but in reality there are many deficiencies in this system, e.g. incompetent doctors, extremely long waiting lists, people who exploit the healthcare system for their own selfish means, etc...

The reality is that many who CAN afford it, end up paying for better, private healthcare out of their own pockets when they want to be assured of better medical attention or faster waiting time.

The other reality is that it's the taxpayer's money that funds this NHS (National Health Service). Do you know how much UK taxpayers pay in income taxes??

Let me enlighten you:

For income between £0 to £37,400

They pay 20% (non-savings income)
20% (savings)
10% (dividends)

For income between £37,401 to £150,000

They pay 40% (non-savings income)
40% (savings)
32.5% (dividends)

For income over £150,000

They pay 50% (non-savings income)
50% (savings)
42.5% (dividends)

LOL do you now see the difference between countries with national healthcare and Singapore, which does not have national healthcare but at least have pretty affordable alternatives for low-income patients like Medifund, free clinics like Thong Chai, etc??

Why don't you all state here how much you pay in income tax every year, and say honestly whether you'd welcome an increase to 40-50% income tax in order to pay for other people's medical expenses?? Not only that, but our GST is only 7%, whereas the UK's is 20%!!!

Anonymous said...

Agree with the tax thing. The minister might be an insensitive jackass, but universal healthcare = fierce taxes. And which developed countries' govs are broke now and have to cut spending all over the place, including education and healthcare too? Mostly those with universal healthcare.

Anonymous said...

universal healthcare....broke... no universal healthcare, poor ppl can pay for it. the root of the problem seems to be: there are just to many people in this world and not enough resources to go around...

Anonymous said...

I would like to share with you your entitlement as Singapore Citizen/Permanent resident without using cash.

1) Are you aware that you can use your Medisave account to purchase a Healthshield Plan with high coverage of S$600,000 per policy year and no lifetime coverage limit?

2) For the above comprehensive coverage, are you aware that the amount you need to invest is much lesser than the 4% interest earned on the Medisave account?

For your information, the annual premium payable for the above coverage (if you are between age 31-40) is at S$214.10 from your Medisave account.

I am a Financial Service Consultant representing AIA. With the increasing medical costs, having a comprehensive medical coverage is very important for yourself and your loved ones. Do drop me a note if you have any queries.

From Deryk Lee, AIA (HP: 96813366)

Anonymous said...

Not even sure AIA wont be bankrupt for a second time! Got money to pay out or not??!

Ann said...

We are seeing the richest getting the most subsidy and benefits here. What does this speak of the policy of means-testing so that the poorest get the most subsidy and richest get the least subsidy? It sucks.

YUKIKO said...

Hi Everyone,

I believe that a senior minister would have A hospitalisation bill. This applies to those working in civil service. He may only have to pay $8 because he had company insurance. $8 probably falls under his exclusion. Then again I believe that the bills with GST would already cost a few hundreds for such a major operation? I wonder if ministers get special GST rebates for medical bills

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