Helping the poor stay healthy

7 Feb 2006, Today

Question

Name of the Person: Leong Sze Hian

Helping the poor stay healthy

I REFER to Siew Ngung Chia's letter, "Seek the answer from the patient: Keep money out of the equation, let the patient's wish be the deciding factor" (Jan 26) and the article "Community chest for patients?: Group suggests setting up an integrated medical services fund as 'safety net' for poor" by Lee U-Wen (Jan 12). .The feedback group on health matters has suggested that a new central charity fund be set up to raise and distribute funds to medical charities, to allow "staff to focus on helping the needy and not be distracted by having to raise money, like in the case of the NKF". .At the annual conference of feedback groups in January this year, Health Minister Khaw Boon Wan said: "Singapore has one of 'the best health-care financing in the world' which others are copying and people in the lower-income group don't have to worry, although I know they worry." .According to the Department of Statistics, expenditure on healthcare had the highest increase among all items of household expenditure. .The lowest 20 per cent of households by income spent 6.7 per cent in 2004 compared to 3.7 in 1998. This is an increase of 81 per cent or 10.4 per cent per annum, compared to inflation of only 1.7 per cent. .In contrast, the highest 20 per cent of households saw healthcare costs rise relatively less, from 3.1 to 4.8 per cent of household expenditure. This is an increase of 55 per cent or 7.6 per cent per annum. .According to the Ministry of Health's website (last updated April 2005), total Government health expenditure per person declined by 16 per cent from $584 to $491 from 2003 to 2004; recurrent health expenditure dropped by 16 per cent from $1.9 billion to $1.6 billion, and development health expenditure dropped by 6 per cent from $103 million to $97 million. .Meanwhile, the "% of total Government health expenditure to total Government expenditure" also decreased from 7 to 5.9 per cent. .Has the above declining healthcare spending contributed to the increased healthcare spending of lower-income patients? .As the better-off would typically choose higher class hospital wards and more expensive out-patient treatment and medicine, this apparent disparity is worth examining. .According to the Feedback Unit's publication "Shaping Our Home: Turning Ideas Into Reality", released last month, the Health Feedback Group urged that we "consider new ways of distributing subsidies to the needy. Subsidies for Singaporeans should be made available to those who need it." .The above statistics indicate that more may need to be done in this regard, to lessen the financial burden of healthcare on less well-off Singaporeans.

Reply

Reply from MOH 

Healthcare resources focus on the needy 

In "Helping the poor stay healthy" (TDY, 7 Feb 06) , Mr Leong Sze Hian used FY2003 and FY2004 statistics to conclude that the government is spending less on healthcare. But his comparison is incomplete and misleading. 

FY2003 was the year when Severe Acute Respiratory Syndrome (SARS) hit Singapore when the government had to invest additional funds on SARS-related items as well as post-SARS measures in order to be better prepared for possible re-emergence of SARS and similar threats. As a result, the total government health expenditure (GHE) in FY2003 was significantly higher than normal. 

The correct approach is to look at the government's spending over a longer timeframe. Actually, Singapore's GHE rose from $0.87 billion in FY1994 to $1.17 billion in FY1997, $1.21 billion in FY2000, $1.53 billion in FY2002 and $1.71 billion in FY2004. 

We share Mr Leong's wish to lessen the financial burden of healthcare on the needy. That is why we have particularly focused our healthcare resources on the needy. 

70% of Singapore's GHE goes to subsidies to help Singaporeans pay for their hospital and polyclinic treatments, nursing homes fees and so on. Healthcare subsidies had been increasing steadily from $560 million in FY1997, to $850 million in FY2000, and further to $1.28 billion in FY2004. 

In addition to direct healthcare subsidies, the government has spent $420 million in recent years to top up the Medisave accounts of Singaporeans, with larger top-ups for those in greater need, especially older Singaporeans. MediShield was also reformed to ensure it covers more adequately large hospital bills, while ensuring that the scheme remains affordable for lower-income Singaporeans. 

The government had also set up the Medifund as the medical safety net to help needy Singaporeans pay for their medical expenses. Last year, Medifund provided financial assistance to 16,400 applicants in financial difficulties to help pay for their Class B2/C hospital bills. They each received an average of $984, double the GHE per person of $491 in FY2004. 

We will continue to refine our healthcare policies, in particular to help the needy.