Means Testing for Patients at Community Hospitals and at Acute Care Hospitals

17 January 2012

Question No. 17

Name of person: Mr Gerald Giam Yean Song

Question

To ask the Minister for Health (a) whether means testing for patients at community hospitals and other step-down care facilities employs a different set of criteria from means testing for acute care hospitals; and (b) if so, what are these differences.

Answer

1. Means-testing is used to determine a patient’s eligibility for government subsidies, taking into account his ability to pay. It helps the Government to be more targeted in channelling government subsidies to those in greater need.

2. The intermediate and long term care (ILTC) sector which includes community hospitals and nursing homes uses per capita family income as the criteria for means-testing. This is an equitable basis as it takes into account the patient’s family circumstances. For example, a sole breadwinner supporting his wife and children would require more financial support than a bachelor earning the same level of income and who has no dependants. On the other hand, an elderly patient who has no family support is less able to pay for his bills than another who is receiving financial support from his children.

3. In the acute hospitals, we have adopted a simpler means test based on a patient’s individual income from work, and does not take into account the rest of the family members. If the patient is economically non-active, the means-test will be based on the annual value of his residential property. This is more practical and easier to administer given the much higher patient volumes and short stays at acute hospitals. However, hospitals do have the flexibility to assess the patient based on the per capita family income approach similar to that used in ILTC sector, if specific patients feel that the simplified approach based on individual income is disadvantageous to them.