Allow MediShield for rehab care

01 Apr 2009, The Straits Times

Question

Name of the Person: David Lam (ST Online)

Allow MediShield for rehab care

HEALTH Minister Khaw Boon Wan said in Parliament on Monday that his ministry would ensure patients do not lose out on subsidies when they move from public hospitals to community hospitals. This is commendable.

What I would like to highlight is the plight of middle-income families whose aged and sick members receive no health-care assistance, especially long-term residential care, whether at home or in a community facility. Indeed, using his personal income as a yardstick, an elderly patient may qualify for subsidised hospitalisation, yet face a big problem when he needs rehabilitative care in a step-down community hospital. The measure here is means testing, which is based on the combined income of the whole family. Currently, this must not exceed $1,300 per head if an elderly patient is to enjoy some form of subsidy. Let us take an example of an emerging middle-income family. If an elderly patient has an income of $1,500 and his three supervisor-grade children each earn $4,000 a month, his family would have a combined monthly income of $13,500. If there are nine dependants, he would not qualify for subsidies. Why? His family's per capita income exceeds the $1,300 ceiling by $200.

Without a subsidy, a bed in an eight-room ward in a step-down facility costs at least $85 daily, excluding treatment and consumables. So a month's stay with no emergency treatment can easily cost up to $3,000. No small beer, even for a middle-income family. Given the extensive care needed and the debilitating nature of diabetes and dementia, just to name two examples, a working family could face an insurmountable mountain of debt for many years to come.

Such families should be allowed to use MediShield - at a higher premium - to help defray the increasingly prohibitive cost of rehabilitative care here.

Reply

Reply from MOH 

MediShield  does cover costs of rehabiliation at community hospitals

Mr David Lam asked the Ministry to “Allow MediShield for rehab care” at the community hospitals  (ST Online, March 28, 2009).

MediShield  already covers costs of rehabiliation at community hospitals. In fact, most bills at  community hospitals can be fully paid for under Medisave and MediShield.

While our healthcare subsidies are principally targeted at lower income groups , middle-income groups are not left out.   For example, Singaporean families with household incomes of up to $5,200 per month (for a family of 4) can get as much as  25% government subsidy for bills incurred at community hospitals. For lower-income Singaporeans,  they will qualify for as much as  75% subsidy and there are safety nets like Medifund to help those with additional financial needs.