Health insurance coverage of Singaporeans

18 Aug 2009

Question No:  89  

Question

Name of the Person: Assoc Prof Paulin Tay Straughan

To ask the Minister for Health (a) what is the proportion of Singaporeans who have no health insurance coverage and what is done to ease their vulnerability; and (b) with regard to the Integrated Shield plans (i) what is the proportion not covered by this additional insurance, including those who are excluded because of pre-existing health conditions; and (ii) whether this practice of private agencies willing to insure only the healthy will cause a serious gap in our national healthcare system.

Reply

Reply From MOH

1. MediShield and the Integrated Shield Plans provide catastrophic health insurance for Singaporeans to help take care of major illnesses which may lead to large hospital bills. MediShield is designed for patients who choose Class B2/C wards. It covers 84% of our total population.

2. Integrated Shield Plans are provided by private insurers and designed for those who prefer Class A/B1 wards of public hospitals or private hospitals.  They cover about half of our population. 

3. Singaporeans should subscribe to MediShield at least, and from young.  The premiums are affordable and can be paid out of Medisave.  The uninsured comprise two main groups: the young below 20 years and non-working spouses.  For the young, we have introduced an opt-out scheme for new born babies since Dec 2007.  Almost all new born babies are now covered from birth, at 98%.  We are working with schools to get the students into MediShield at the Primary 1 level. There is now about 96% MediShield coverage of primary students.  For the adults, we are working with NTUC to get their members to sign up for their spouses.  We aim to reduce the uninsured percentage to a single digit. MediShield membership has increased to 200,000 for last year, 2008.

4. Health insurers do not cover pre-existing conditions as this would have the unintended effect of some buying insurance only when they are sick. This would be unfair to the existing policy holders. 

5. Instead, the correct response is for Singaporeans to get insured from young, preferably soon after birth, before any health condition develops.

6. For commercial reasons, private insurers would prefer to only insure the young and healthy, attracting them away from MediShield, and leaving the high-risk members to MediShield.  This phenomenon is known as “cherry picking” in the industry.  That is why we had to restructure the health insurance industry in 2005, requiring all private Shield insurance plans to be integrated with MediShield.  This way, we have protected the MediShield risk pool and enabled basic health insurance to remain affordable for the lower income Singaporeans who use the Class B2/C wards.

7. For those who are uninsurable because of factors beyond their control, our 3Ms framework of regular savings through Medisave, heavy Government subsidies and Medifund, work together to ensure that no Singaporean is denied healthcare due to an inability to pay.