Wednesday, February 29, 2012

Affordable Medical Care in Singapore....

Lots of talk now in parliament of wanting to build an inclusive society, upgrading the bus system, and more help for the old and poor. Last Saturday, The New Paper reported that there will be more help for the poor and carried a story about how a poor family - father, mother and  5 kids - living on an income of $1200 is coping. The mother had a liver operation more than 10 years ago. Not wanting to add to the family's financial burden, the mother has not seen a doctor for the past 10 years even when she got sick:

"The last time I went to see a doctor 10 years ago he said that there were some levels in my liver which were very high.....I hope health care will be cheaper, so I can find out what is wrong with me.
Right now, the thought of hospitals and clinics scares me. I don't know who can help me." -   Tan Miu Muay  (below)[Full Story here]

According to The New Paper report, help for her comes in the form of  "a new GST voucher scheme, a permanent system of offsets to help lower-income Singaporean households". I looked around and found out what this voucher scheme is. You can read about it for yourself here : [Link]. There are 2 forms of GST vouchers - Medisave and U-Save Ms Tan's family qualify for the U-Save vouchers but not the Medisave vouchers as these will  be given to old folks. Her family will get $240 worth of U-Save every year. That works out to be $34 per person in her family per year. or $2.80 per person per month.

Mdm Tan has not seen a doctor for 10 years because she cannot afford it. The govt gives each member of her family $2.80 a month and proudly proclaim this budget to be an inclusive budget. A large part of what the govt is giving to her family was taken away from them in the first place when GST was implemented. Remember the GST hikes were actually implemented to cut corporate taxes and taxes of the highest income earners in our society. When GST was implemented in 1994, the corporate tax and the top marginal income tax were cut by 3%. Poor families like that of Mdm Tan previously did not pay any taxes now have to pay GST to fund the tax cuts for the richest members of our society. The GST paid by the family can be as high as $84 (7% of $1200) and the govt shows its generosity by giving them $20 back per month - this is what the govt means when it says GST is implemented to help the poor, it takes their money first then help them by giving back a small fraction of the amount that was taken.

It was revealed in parliament recently that::

"Last year, there were 136,000 bills outstanding for two months or more, translating to S$48 million in arrears.


......some hospitals may refer the case to an authorised debt collection agency to collect the arrears on their behalf. "[Link]


That is a lot of unpaid medical bills. When bills go unpaid, hospital hire debt collection agencies  to go after the debtors. 


It is not hard to predict what is going to happen in the coming years unless our healthcare system is revamped. The rise in medical cost has outstripped median income growth and low income families cannot even hope to keep up with the pace of increase. Our current system has left many people uninsured or under-insured falling through the cracks. Many Singapore families are just one serious illness away from financial catastrophe. There are important lessons to be learnt from the American healthcare reforms that took place shortly after Obama took office. The 1st lesson is if you wait for to long to do something, you face the risk of the problem becoming intractable. You will be left with only bad options. Singapore has all the elements that result in the healthcare crisis in America - we have a large income gap, we have no single payer system, we allow a large part of our medical service industry to be privatized to serve rich medical tourists for profits,...we allow private-for-profit insurance companies  to supply insurance and we have a large segment of the population without any insurance coverage. We need to put in place universal healthcare to ensure everyone is covered and nobody has to worry about about going to see a doctor when they are sick. We have to contain our aspiration of being a medical hub for the rich when our hospitals are understaffed and overcrowded as resources flow to the private sector to seek profits offering services to rich foreigners. We need a healthcare system that does not further amplify the deleterious effects of the income gap - the rich today have luxury wards in Novena Hospital while the poor don't even dare to go to see a doctor when they are sick. 

37 comments:

Anonymous said...

"We need a healthcare system that does not further amplify the deleterious effects of the income gap - the rich today have luxury wards in Novena Hospital while the poor don't even dare to go to see a doctor when they are sick."
Lucky Tan

Of course this is no good. And not only this but many other things are also no good, especially for the poor.

But taken together, all these are not serious enough to affect at least 60% mandate for the PAP at every election.

If I were a PAP politician, it means that although things are bad, it is well within tolerable limits.

And some more can attract so many foreign talents to come here, cannot be that bad what.

After all, which country has a perfect system, right or not?

Anonymous said...

Is the opportunity cost of the land that whatever gahmen's medical facility sits on imputed into the price of our healthcare bill?

If it is, what basis is used to value the land?

Anonymous said...

"If I were a PAP politician, it means that although things are bad, it is well within tolerable limits."
Anon 1/3/12 00:28

Very important. All smart ruling party politicians, no matter what they want to do, must first know the tolerable limits of their respective country.

If not, they will be voted out or overthrown as can be seen from many examples in other countries.

Anonymous said...

"If it is, what basis is used to value the land?"
Anon 1/3/12 00:40

Very simple what. Singapore is very small, so land is scarce. But there is great demand because so many foreigners want to come here to live on the land.

So in basic economics, when things are scarce and there is great demand, the value or price will go up lah.

Of course, like what Anon 1/3/12 00:42 said, it must go up within tolerable limits lah. Then things will be OK.

Lye Khuen Way said...

Sad situation, would you not say for a Country/City-State that is ranked 3rd Richest in the World ?

Too many aspect of our Singapore have gone to the dogs and the sad part is that the ruling party is just testing the limit of its citizens everyday.

Anonymous said...

I whole hearted agree with your article. The gaps are too big. Some how I feel that the Singapore govt is moving relentlessLy towards an American system. Even though the system has failed glaringly. We are riding on the coat tails of the poor. Inside of helping the poor, we are throwing them scraps and expect them to be grateful. I am glad that you highlighted their plight in light of the new budget .

Anonymous said...

Why blame monkey kumar? He is another dick cleaner like another dickhead we know who when sued, we all know what he did - monkeyed up a coconut tree with his yellow backside exposed for all the world to see.(which was censored by TRE).

You(Lucky and others) can repeat your rant for another 7 years, it changes nothing(MOSTLY)) because depending on who holds the power or scissors, the debate or discussion will go something like what you see in parliament.

WP: Blah blah blah blah, fuck you, blah blah blah sounding mostly polite and educated blah blah blah, basically fuck you,blah blah blah

PAP counters: Well, blah blah blah, fuck you back,blah blah blah blah, statistics and data and more state gathered data, blah blah blah, fuck you oh shut up but all nicely dressed in educated and corperate language but to the man in the street it still sounds the same... Fuck you,you mother fucker

WP: (at this point) Silenced or make another one or two more feeble attempt at ...blah blah blah blah, fuck you, blah blah blah and.....discussion or debate over and everyone moves on.

Though there are more social spending by the govt now, but fundamentally, you get the feeling they don't really give a fuck, do they?

You can't accuse them that they have not done "good" but you know they give you enough rope to hang on AND hang yourself too ( fuck you)

In her biography on Voltaire, Hall wrote the phrase: "I disapprove of what you say, but I will defend to the death your right to say it" (which is often misattributed to Voltaire himself) as an illustration of Voltaire's beliefs.Hall's quote is often cited to describe the principle of freedom of speech.

PS: Never trust the people in TRE or TOC either, they are all the same....fuckers with itching ears!

Moral of the story? No such thing as democracy or your democratic rights to change things. It all boils down to who is or are in power. Be it fuckers within the power grid or fuckers outside the power grid, the ground noises will be FILTERED to suit their agenda or yellow backsides - doesn't matter which camp you rally behind or stupid enough to die for or support.

You might as well stick with the PAP fuckers the, right? No fucking difference.....enough rope to hang on but also to HANG YOURSELF

Anonymous said...

To 1/3/12 08:43

no doubt end of day everyone gets fucked (by the maker), but that is no reason to side with the pap fuckers in the mean time. fuck the pap i say, and fuck them to kingdom come in this existence.

Ling said...

Hey Lucky, did you delete the page about Apple?

Anonymous said...

Hahaha.. Very funny analogy. But I still prefer to let WP have a chance to fuck. Sick of PAP fucks.

Anonymous said...

bro,

Salah la. Call me unsympathetic, but she has 5 kids age 5 to 17.

She's 41, had health problem since 28; she has health problem for 13 years.

Yet she could have 5 kids 5 to 17?

Who can she blame?

Anonymous said...

Nair asked Chen Shen Mao where the money for more social & health care is going to come from ?

Just cut down on those vain PAP projects or your bosses bloodsucking salaries, idiot!

Ng Eng Hou said...

It's very sickening to see top politicians defending and justifying themselves to get the world' record breaking pay and to see so many of us living in constant fear of getting sick.

Though they have spent a bit more, but this is still really peanuts when compared to their cosmetic cuts in their still-very-high pay.

Singapore Is Becoming A Place Only For The Rich & So-called Foreign Talents!

Bigcat Sleepy said...

I felt sad when I read this article cos we could throw away so much money on failed foreign banks, ungrateful foreign scholarship recievers, F1, Youth Olympics, PRC table-tennis players & yet, we couldnt spare some loose change for the weak & poor. This doesnt quite make sense to me at all.

The money the PAP is holding belongs to us, that means all of us has a share & say in it, from the richest SOB with the latest Ferrari to the sick auntie fighting for a Coke can at the coffee shop right now! It just makes me feel that the government doesnt care much for these people, in fact, I get the feeling that they are branded as pest or daft!

The ministers are paid millions every year & every other day I am getting news of them screwing things up badly! From overspending on some silly youth games to the infamous limping terrorist escape, nobody is held accountable for anything &, except the regular Joes like us.

Anonymous said...

With 5 kids, she should get the highest national day award.

Which woman leader in Singapore can outperform her? No one.

And the government aid is black comedy. Sinkies need to know what other countries give to their citizens.

Anonymous said...

I remember I read something like this:
http://ohd.moh.gov.my/v2/index.php?option=com_content&view=article&id=17&Itemid=46

Winking Doll said...

Anon at 1/3/12 13:12 wrote: "Sinkies need to know what other countries give to their citizens."

In B.C., Canada, it is currently CAD610/month. A political recently attempted to live 1 whole month on that amount, amongst the community of those down-and-out. He blogged about his experience and real-life lessons learned.
http://www.vancouversun.com/news/Welfare+Challenge+Jagrup+Brar+blogs+about+living+month/5946143/story.html

Now would any of our multi-million dollar minister like to do a similar 1-month challenge in Singapore?

Anonymous said...

Now khoo reck phuat hospital is shorty of bed ? In such a short time ? Did some one up there plan properly ? Not even 5 years has past.

The budget terminal is going to rebuild ? Again ?! In such a short time ? How old is this terminal ? Some one up there did not plan properly again ?

All these are tax payees money down the drain!

I prefer to give these to the people of singapore !

Anonymous said...

"Now would any of our multi-million dollar minister like to do a similar 1-month challenge in Singapore?"
Winking Doll 1/3/12 14:03

For what?

Anonymous said...

Right, and our MP asked for the adjustment for the dental claim.

Anonymous said...

and Goh Chok Tong son is COO of raffles medical group. What do you think it means?

Anonymous said...

Get out of my elite uncaring face.

If you cannot even afford Mount Elizabeth or Raffles Hospital, then you die is your problem.

DavidLKSee said...

1 Most "sickening" PAP word:
"affordable", as in affordable public housing; affordable healthcare; affordable public transport...blah,blah.

2 Most "sickening" PAP mentality:
"you die, your business".

3 A "sickening" PAP Politcal Joke:
In Singapore, if you fall sick, better die quickly.
If the sickness don't kill you, the shocking public hospital medical bill will kill you instead !!!

Anonymous said...

We voted for Opposition in GE 2011
We got an inclusive Budget in 2012.

Vote Opposition again in GE 2016.
And this time we will get an inclusive parliament in 2017.

Vote Opposition.
Talk no use.
Get your friends & family to vote too.

Short-changed singaporean said...

"......some hospitals may refer the case to an authorised debt collection agency to collect the arrears on their behalf. "

We live in a country where we are conscripted to serve National Service to protect the peopple but when the NS and reservists singaporean males fall sick and can't pay his hospital bills, we set a debt collector to pressure him to pay the hospital.

What kind of country is this? And 60% Singaporeans and all the singaporean males sit there and take this.

One word.

DAFT.

Short-changed singaporean said...

"......some hospitals may refer the case to an authorised debt collection agency to collect the arrears on their behalf. "

We live in a country where we are conscripted to serve National Service to protect the peopple but when the NS and reservists singaporean males fall sick and can't pay his hospital bills, we set a debt collector to pressure him to pay the hospital.

What kind of country is this? And 60% Singaporeans and all the singaporean males sit there and take this.

One word.

DAFT.

Anonymous said...

I was taking a cab home today and many cabs rejected me for some reason. There was finally one cabbie who decided to take up my destination. However, another young singapore male in his late 20s took the ride. I kept repeating, "Excuse me, sir" but he intentionally ignored me. In fact, he looked at his cellphone when he got into the cab and pretended to be oblivious to me.

The cab driver told this young man that I was ahead in the queue and that he should stepped out for me. It was fair.

The young man stepped out and I repeated, "Excuse me, sir" and he looked at his cell phone all this while. I know he is not deaf as he's using a cellphone.

The cab driver did the right thing and he told me the young man is a singaporean from his manner of speech.

I told the driver that I was upset not that the young man ignored me.

What upsets me is that when there is a war, I am told to take an M16 and protect that young man's mother. Yet, he would ignore his own singaporean native.

This country has stopped being a nation these past 2 elections.

It is a corporation run by one family. And we are not citizens but employees.

Until the man on the street wakes up to the glaring fact that under this present leadership of government ministers, Singapore is declining,...as a matter of fact, I am not finishing the sentence.

You can finish the sentence for me.

Anonymous said...

I was taking a cab home today and many cabs rejected me for some reason. There was finally one cabbie who decided to take up my destination. However, another young singapore male in his late 20s took the ride. I kept repeating, "Excuse me, sir" but he intentionally ignored me. In fact, he looked at his cellphone when he got into the cab and pretended to be oblivious to me.

The cab driver told this young man that I was ahead in the queue and that he should stepped out for me. It was fair.

The young man stepped out and I repeated, "Excuse me, sir" and he looked at his cell phone all this while. I know he is not deaf as he's using a cellphone.

The cab driver did the right thing and he told me the young man is a singaporean from his manner of speech.

I told the driver that I was upset not that the young man ignored me.

What upsets me is that when there is a war, I am told to take an M16 and protect that young man's mother. Yet, he would ignore his own singaporean native.

This country has stopped being a nation these past 2 elections.

It is a corporation run by one family. And we are not citizens but employees.

Until the man on the street wakes up to the glaring fact that under this present leadership of government ministers, Singapore is declining,...as a matter of fact, I am not finishing the sentence.

You can finish the sentence for me.

Anonymous said...

Sad case.

No citizen should be in this kind of situation.

Something is wrong when the sick cannot afford to seek help.

Anonymous said...

If our national median income is $40,000 per year, then to an ordinary Singaporean,

$100,000 (2.5 x 40,000) is good pay
$160,000 (4 x ) is very good pay
$200,000 (5 x ) is high pay
$400,000 (10 x ) is very high
$600,000 (15 x ) is sky high
$800,000 (20 x ) is extremely high
$1 million (25 x ) is exorbitant
$1.2 million (30 x ) is outrageous
$1.4 million (35 x ) is #%&$@!

If we wish to pay our ministers from sky high to exorbitant pay, then our ministers’ pay should be about 15 to 25 times the median income (those who demand for more than 25 times are not suitable to be a minister). This would be about $600,000 to $1 million annually.

The new ministers’ pay of $1.1 million to $1.76 million (grade MR4 to MR1) is about 27.5 to 44 times the national median income. They are overpaid by more than 80% if we compare the entry pay of $600,000 and $1.1million (1,100,000/600,000 = 183.3%).

Chan Joon Yee said...

There are many reasons why doctors in public service leave for the private sector. It would be naive to think that private practice is like gold mining.

The thing is, in spite of the shortage of clinical staff, many public hospitals do not even make any effort to retain their doctors.

Anonymous said...

This is the evil system that LKY crafted for Singapore. Unlikely that things will ever change so long as the pap is in power. The ultra capitalist monopoly system is too deeply entrenched in the pap.

Anonymous said...

This is another big lie by the papish Leegime. They have shifted the major part of the burden onto the shoulders of Singaporeans. Medical costs is financially crippling many Singapore families at a time when they are under so much stress. The papist Leegime in making lives easier for themselves have drastically increase the stresses on Singaporeans. This must change. Singaporeans can do it. Just think carefully at the next GE.

Anonymous said...

Hope the recent changes help make medial care more affordable to those who need it most.

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