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]
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.