Health Ministry Shares Details on Key Policy Shifts to Alleviate Medical Costs

Health Ministry shares details on key policy shifts to alleviate medical costs 
Part of new healthcare financing framework which emphasises collective responsibility

1.    Today, Health Minister Gan Kim Yong shares details on key policy shifts to give Singaporeans greater assurance over healthcare costs. Even as each citizen and his family continue to do their part to stay healthy and save for their future, we will strengthen collective responsibility for healthcare costs, with Government doing more to keep healthcare affordable for Singaporeans.  The two key thrusts in this package of measures are – cheaper outpatient care, including preventive care, and MediShield Life, to provide enhanced, life-long coverage to all Singaporeans.

2.    The Minister’s announcement follows months of policy reviews and engagement sessions.  In March 2013, Minister Gan had indicated that the Government would increase its share of healthcare spending so as to take on a greater burden of rising healthcare costs.  Minister Gan had then also reiterated the need for “healthcare policies to evolve as we prepare for the future and the new challenges”, but noted that what will not change is the emphasis on individual responsibility for one's own health and the principle of co-payment.  The Ministry of Health (MOH) has received useful feedback from Singaporeans via the Our Singapore Conversation process, as well as the Government Parliamentary Committee for Health and Members of Parliament. These included suggestions to make MediShield compulsory, extend Medisave to cover more chronic diseases and ideas on adopting a healthier lifestyle.

(A)  Cheaper outpatient care

3.    Outpatient costs will be made more affordable through the expansion of Government subsidies and Medisave use, to reduce cash outlay for patients. Key initiatives (details in Annex) are:

• More Singaporeans to benefit from Community Health Assist Scheme (CHAS).  From 1 Jan 2014, the qualifying age for CHAS (40 years old and above) will be removed.  This will enable all Singaporeans in lower- and middle-income households to access subsidised medical and dental care at over 800 private clinics. In line with the latest data, MOH has also updated the income and property Annual Value criteria for CHAS.

• Better coverage for chronic diseases, via CHAS and Medisave use.  Medisave use will be extended for the outpatient treatment of five more chronic conditions under the Chronic Disease Management Programme (CDMP), bringing the number of chronic conditions under CDMP to 15. The additional conditions covered are: osteoarthritis (degenerative joint diseases), Benign Prostatic Hyperplasia (enlargement of the prostate gland), Anxiety, Parkinson’s disease, and Nephritis/Nephrosis (chronic kidney disease).  In line with this, treatment of these 5 new chronic conditions can also be subsidised under CHAS, at up to $480 per year.  This will enable chronic patients to reduce their cash payment, and will also take effect from 1 Jan 2014.

• More subsidies for recommended screenings, via CHAS.  From 1 Jan 2014, CHAS cardholders will be able to enjoy subsidies for the recommended screening tests under the Integrated Screening Programme (ISP). They will also be able to enjoy subsidies for consultation with a GP for the screening, and to review the screening test results. The recommended screening tests under ISP are screening for obesity, diabetes, hypertension, lipid disorders, colorectal cancer and cervical cancer.

• As part of an ongoing review, Medisave use will be extended for the following vaccinations and outpatient screening on 1 Jan 2014, subject to the prevailing withdrawal limit of $400 per Medisave account per year:
  

- Pneumococcal and influenza vaccinations for high-risk groups, such as the very young, elderly, persons with chronic medical conditions and those with poor immune function.

- Recommended neonatal screening tests for newborns.

4.    MOH will also lower charges at Specialist Outpatient Clinics (SOCs) in public hospitals by enhancing subsidies for lower- and middle-income groups.  Details will be announced in the first quarter of 2014.   

(B)  MediShield Life for greater assurance and a more inclusive society

5.    To provide all Singaporeans with greater peace of mind and assurance against large bills, and in line with the shift towards a more inclusive society, MOH is considering enhancements to MediShield:

• Enhanced MediShield benefits to better cover large bills.  This will be achieved by raising claim limits, and reducing the co-insurance borne by patients for large bills.   MediShield will remain as a catastrophic insurance scheme with focus on covering large bills.

• MediShield to provide life-long, universal coverage.  The maximum coverage age of 90 years will be lifted, to provide lifetime coverage.  All Singaporeans, including those who are currently uninsured, will also be brought under MediShield coverage and enjoy the assurance of protection against large bills. 

 
6.    The enhanced scheme will be renamed MediShield Life.  To ensure that premiums for MediShield Life remain affordable, even as benefits are enhanced and payouts rise, additional Government support including for the less well-off will be provided.  For the current elderly, the Ministry of Finance and MOH will consider how they can be supported for their MediShield Life premiums through a Pioneer Generation Package.  MOH will also review how premiums can be better spread over one’s lifetime, to help moderate premium increases after retirement. 

7.    MOH will hold a public consultation in the fourth quarter of 2013 to seek feedback on the proposed major shifts for MediShield Life. We will be reaching out to Singaporeans via several channels ranging from dialogue sessions, focus groups discussions, web chats and online polls.  The Ministry will also be engaging key stakeholders including private insurers, who administer Integrated Shield Plans.

Summary

8.    These measures aim to strengthen basic protection for all Singaporeans, and improve affordability of outpatient services, especially through CHAS.  With the removal of the age floor for CHAS, and subsidies to cover five more chronic conditions and recommended screenings under the scheme, more Singaporeans, including younger family members of current Health Assist cardholders, will stand to benefit.  The changes answer the calls made by many Singaporeans and MPs through their feedback to MOH and during the OSC process.  We will strengthen the role of all partners – the individual, his family and the community, and the Government – in ensuring peace of mind for Singaporeans.

9.    MOH will continue to partner with Singaporeans as we work on other measures to strengthen our healthcare financing framework, including exploring further changes to Medisave use and contributions and the affordability of long-term care. 

MINISTRY OF HEALTH
29 AUGUST 2013

Annex: MORE AFFORDABLE OUTPATIENT SERVICES