Info for article should have been verified: Health Ministry

11 February 2012, The Straits Times

He sold flat to pay kids' medical bills
Reported by Melissa Tan, Additional reporting by Lennard Ong

MR ELANGOVAN, 49, is the sole breadwinner for a family of four. He earns $1,646 a month from his security supervisor job, working the night shift from 7pm to 7am. 

His wife of 21 years, Mrs Yesothi, 48, stays at home to take care of the younger of their twin daughters, who goes to a school for special-needs children and is asthmatic.

Nearly half his salary goes to repaying bank loans that he took last year to buy and renovate his flat. 

Out of the other half, the family spends nearly $350 on food, and the two girls get a total of $180 in pocket money. Utility and phone bills together cost slightly over $200, and the rest goes to transport and other miscellaneous household expenses. 

"Some bills, certain months we pay. Some, we hold them up, then pay next month; and some are still outstanding," Mr Elangovan says. 

"(We have) no savings, we're still struggling to settle all these bills."

The couple's financial strain began when their twins were born prematurely. The older daughter, Ramiya, had to be hospitalised for about 18 months and the younger, Ragavi, for around 31/2 years. 

Their medical expenses came to around $346,000.

To pay the bill, Mr Elangovan sold his four-room Hougang flat for about $300,000 and wiped out his life savings. But it still was not enough. Eventually, a social worker helped him get government aid for the remaining $13,746.

That was not the end of their medical issues. Mr Elangovan suffered a mild stroke last October, requiring five days of hospitalisation and $3,000 in out-of-pocket costs. 

And though he received financial help from his union, employer and friends while recuperating over two months, recurring medical expenses continue to take up a large portion of his income.

Why this issue matters

HEALTH-CARE fees and living expenses are rising rapidly. And according to the latest Department of Statistics figures, some 350,000 workers earn less than $1,700 a month.

The Government has paid increasing attention to this group, tilting subsidies and other cash handouts towards them and introducing the Workfare Income Supplement (WIS) back in 2007 to encourage low-wage workers above 35 to stay employed.

But Mr Elangovan's biggest worry is medical costs: "We need more subsidies for medical and transport costs – they're really too high. It's very difficult."

"The approach to health-care subsidies has traditionally been from the perspective of what is the maximum the Government will dispense rather than what the patient needs," notes Fortis Healthcare Singapore chief executive Jeremy Lim.

"For example, a 75 per cent subsidy... may appear reasonable but the remaining 25 per cent may still be too onerous for a low-income patient." 

What he can expect to get at Budget 2012

EXPERTS say the social safety net will be expanded – including enhancing the WIS, oiling social mobility through the education system, and beefing up community development council (CDC) resources.

The Government also said last month that the Community Care Endowment Fund budget this year is likely to match the $77 million set aside in 2009.

There is also a chance that Mr Elangovan may get a boost in Central Provident Fund (CPF) contribution rates, as Prime Minister Lee Hsien Loong said the Government will have to raise rates for workers in their 50s.

Economic Society of Singapore vice-president Yeoh Lam Keong says that one way of helping the low-income group is to combine "our traditional emphasis on individual and family responsibility more realistically with a higher level of government spending and more extensive risk pooling" in health-care spending.

This should at least match our advanced Asian neighbours like Hong Kong, South Korea and Taiwan "where health-care costs are much more universally affordable", he says. 

Adds Mr Yeoh: "We need to at least double... the cash amounts given out under the WIS scheme just to adequately alleviate day-to-day poverty among the working poor. This costs surprisingly little."

Reply from MOH

We read with concern the report on the challenges Mr Elangovan Govindasamy and his family are facing ('He sold flat to pay kids' medical bills'; Feb 11). The Health Ministry had requested more information from Mr Elangovan through The Straits Times to better understand the background.

The Straits Times has since clarified that the '$346,000 bill' reported in the article was incurred over a number of years and for a variety of expenses, including medical procedures at private hospitals that were unrelated to the children's medical conditions. The newspaper was unable to obtain further details to verify the actual amount and the breakdown of the bills.

There were also other inaccuracies. Contrary to what the article stated, the '$3,000 in out-of-pocket costs' that were apparently incurred by Mr Elangovan during his five-day hospitalisation last year in a public hospital was false.

Our checks revealed that there were no 'out-of-pocket' expenses at all as Mr Elangovan's medical bill was fully covered by his Medisave and MediShield, and government subsidies.

In fact, our records show that Mr Elangovan and his family had, and continue to receive, significant financial support through subsidised care and Medifund. We are surprised that The Straits Times did not verify the facts before publishing the article.

Our health-care policy is based on the premise of shared responsibility with heavy government subsidies of up to 80 per cent in our public hospitals to make health care affordable for Singaporeans.

A review of our public hospitals' recent bills shows that about nine in 10 patients in ward classes B2 and C do not incur more than $500 out-of-pocket expenses.

For Singaporeans who continue to face financial difficulties, additional assistance from Medifund and the hospitals is available.

In 2010, Medifund provided close to $80 million in financial assistance to needy patients. Patients like Mr Elangovan who are facing financial difficulties may approach our medical social workers in the hospitals for assistance.

We are mindful that health-care cost is of concern to Singaporeans and we will endeavour to ensure that our public health care remains accessible and affordable while offering high-quality care; it is, however, important that the public is not misled by inaccurate reporting.

Bey Mui Leng (Ms)
Director
Corporate Communications
Ministry of Health