1. The MediShield Life Review Committee has concluded its review and submitted its report on MediShield Life to the Minister for Health. The Committee’s recommendations for MediShield Life mark a major shift towards universal insurance coverage, with better protection for all Singaporeans, for life.
2. The report lays out the Committee’s recommendations in three key areas:
a. Significant additional benefits under MediShield Life;
b. Universal coverage for all Singaporeans under MediShield Life; and
c. Affordable premiums through various Government support measures.
3. The report also contains the Committee’s recommendations and observations on Integrated Shield Plans (IPs) and other related issues studied by the Committee.
4. In making its recommendations, the Committee has carefully evaluated and balanced the trade-off between MediShield Life benefit enhancements and premium affordability. The Committee appreciates the Government’s significant support in subsidising MediShield Life premiums.
MediShield Life: Peace of Mind for All Singaporeans, at Affordable Premiums
5. Better Protection. Coverage under MediShield Life will be significantly enhanced, with higher claim limits and lower co-insurance rates. This will provide Singaporeans with greater assurance and protection against large Class B2/C hospital bills, as MediShield Life will pay more and patients pay less.
6. For All, For Life. With MediShield Life providing universal coverage, all Singapore Citizens and Permanent Residents will be able to benefit from MediShield Life’s protection even if they have pre-existing conditions. They will also have greater peace of mind with lifetime coverage.
7. Affordable Premiums. To fund better benefits, premiums will have to increase. The Ministry of Health and the actuarial advisor have worked out the new MediShield Life premiums, taking into account the substantial enhancements to benefit features, the community’s share of the cost of universal coverage, and the more even distribution of premiums over our lifetimes.
8. The Committee welcomes the Government’s commitment of premium subsidies for the lower- to middle-income, Pioneer Generation subsidies, and transitional subsidies to ease in the shift from MediShield to MediShield Life. The Government will also bear most of the cost of covering those with pre-existing conditions. With this Government support, the Committee notes that:
a. For Pioneer Generation members, MediShield Life premiums will be lower compared with their current MediShield premiums.
b. In the first year of MediShield Life, with premium subsidies and first-year transitional subsidies, the maximum premium increase will be less than $3 per month for the lower- to middle-income, and no more than $6 per month for the higher-income.
c. Beyond the transitional period of four years, the lower- to middle-income will continue to receive premium subsidies. Compared with today’s premiums, the increases will range from $3 to $11 a month for the lower-income, and $5 to $14 a month for the middle-income. For the higher-income, premium increases will range from $7 to $30 a month.
9. Total household premiums are expected to remain within Medisave contributions and inflows, with no additional cash outlay required. For the few who are still unable to afford their premiums, the Committee welcomes the commitment from the Government to provide additional premium support.
MLRC Recommendations on Integrated Shield Plans (IPs) and Other Issues
10. The Committee’s Terms of Reference do not cover a review of IPs. However, given the significant public interest, the Committee studied IP-related issues. About 60% of Singaporeans have bought IPs, which consists of MediShield and a top-up portion, and will continue to be integrated with MediShield Life in future. The Committee recommends that the Government work with the insurance industry to develop key features for a standardised IP, targeted at Class B1 level coverage. This would give Singaporeans an option for enhanced coverage beyond the basic MediShield Life level in a standardised, affordable and easily understood package. The Committee also suggests that Government improve the current regulatory and accountability framework for IP insurers, including setting clearer guidelines and rules for insurers in the selling and renewing of IPs and enhancing responsible selling requirements.
11. The Committee has also made observations in the areas of public education, managing healthcare costs and employer medical benefits. It has suggested that the Government:
a. Step up outreach and public education efforts on healthcare finance;
b. Explore measures to manage healthcare inflation, including encouraging healthy living and working with healthcare providers and insurers to manage price inflation; and
c. Strengthen incentives to companies willing to provide portable medical benefits for their employees.
12. A full listing of the Committee’s recommendations is in Annex A (‘At a Glance’, MediShield Life Review Committee Report).
13. Details of MediShield Life premiums and subsidies are in the Government press release (“Government Accepts Recommendations of Medishield Life Review Committee; Announces $4 Billion in Subsidies and Support for Medishield Life Premiums”, 27 June 2014). The premium impact for typical households and details of how MediShield Life will benefit patients is in Annex B.
Conclusion
14. Singapore provides good quality and affordable healthcare with our subsidies and 3Ms framework. MediShield Life will enhance our healthcare system further by providing medical insurance to those who are currently uninsured and enhancing protection from large medical bills. It will further strengthen our social safety nets, and is a major step towards a more inclusive and compassionate society.
15. Said Committee Chairman Mr Bobby Chin, “MediShield Life is a major step with far-reaching impact on fellow Singaporeans. My Committee is honoured to have had the privilege of contributing towards this important review. With our recommendations, MediShield Life will provide Better Protection, For All, For Life.”
ANNEX A - At a Glance, MediShield Life Committee Report
ANNEX B - Premium impact on some typical households