System in place for patients to downgrade

MOH’s Reply

Straits Times, 19 Apr 2014

WE THANK Mr Francis Zhan ("Create new 'pioneer patient' category"; Forum Online, March 28), Mr Ng Chee Kheon ("Good to allow easier patient downgrades"; March 28) and Mr David Kwok Ng Kan ("Make it easier for private patients to downgrade"; March 26) for sharing their views on making downgrading to subsidised status easier for private patients.

Patients who are referred from polyclinics, as well as holders of the Health Assist card who are referred by general practitioners under the Community Health Assist Scheme, are eligible for subsidised care at specialist outpatient clinics.

This arrangement allows for better distribution of specialist resources, and more appropriate targeting of accompanying subsidies. When a patient asks to see a specialist of his choice, he would not be eligible for government subsidies.

Requests to switch from private to subsidised care are generally not allowed as such cases would lengthen the wait for other subsidised patients.

For private patients who start to face difficulties with their medical expenses and wish to switch to subsidised care, medical social workers are available at public hospitals to advise them.

Each request is assessed on a case-by-case basis, taking into careful consideration various factors, including financial means, bill sizes and medical conditions. These principles would likewise apply to members of our pioneer generation.

All Singaporeans who need to be admitted into a public hospital can choose to be admitted into subsidised ward classes, regardless of their existing status as a specialist outpatient clinic patient.

As our population ages, health-care needs and expenditure will inevitably grow. The Ministry of Health is committed to keeping health-care costs affordable, especially for lower- and middle-income Singaporeans, while ensuring that the system is equitable and sustainable in the longer term.

We will continue to refine our health-care financing system to ensure that it continues to meet Singaporeans' needs.

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

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Straits Times, 28 Mar 2014

Create new 'pioneer patient' category

DOWNGRADING to subsidised treatment is not the solution to the issue of health-care affordability for senior citizens ("Make it easier for private patients to downgrade" by Mr David Kwok Ng Kan; Wednesday).

During our working years, we are referred by our company doctors to specialists to treat more complex medical problems, making us private patients who are ineligible for government subsidies.

To guard against high hospitalisation costs upon our retirement, we purchase private insurance policies, paying hefty premiums.

My 68-year-old neighbour has paid more than $60,000 in premiums over the past three decades, and made only three small claims. Yet his insurers hit him with a 70 per cent increase in premiums this year.

He has been seeing the same specialists over the last two decades or so. When he wanted to downgrade to subsidised treatment, he was advised against it because he would be assigned whichever doctors were available on his visits, and they might not understand his special needs.

While my neighbour can still afford the consultation fees during his visits, he is finding it hard to pay for the laboratory tests and medication, which are not covered by his insurance.

He is paying more then $4,000 in annual premiums for his hospitalisation insurance ,and is considering giving up his policies to pay for his medical expenses. But what if he were to be hospitalised in future and cannot be downgraded to the subsidised wards?

My neighbour was told he was not eligible for the extra 50 per cent off subsidised bills under the Pioneer Generation Package, because he is a private patient.

Downgrading to subsidised treatment is not the answer. The proper solution is to create a new patient category - pioneer patients - whereby patients pay the full consultation fees but are charged subsidised rates for lab tests, treatments and medication.

In this way, they get to see the same specialists who have been treating them, while paying less.

Francis Zhan

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Straits Times, 28 Mar 2014

Good to allow easier patient downgrades

THE hassle for a private patient to downgrade to subsidised treatment, and allowing only patients referred by polyclinics or accident and emergency departments to enjoy such treatment, may have contributed to the persistent overcrowding at these facilities ("Make it easier for private patients to downgrade" by Mr David Kwok Ng Kan; Wednesday).

Most patients would not mind seeking a referral from private medical practitioners for treatment at specialist clinics in government hospitals, if they can easily downgrade to subsidised treatment after their conditions have stabilised, or when they are hospitalised.

This would help to alleviate the overcrowding at polyclinics and accident and emergency departments, and even out the number of private and subsidised patients at specialist clinics, leading to a shorter wait for an appointment.

Ng Chee Kheon

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Straits Times, 26 Mar 2014

Make it easier for private patients to downgrade

RECENTLY, I was told that there were only two ways for a private patient to downgrade his status to receive subsidised treatment.

He can either be discharged by the health-care institution and re-register with a referral letter from a polyclinic, or obtain approval from a medical social worker - and this applied at all government hospitals.

Given the choice, who would not want to be a private patient and be able to choose his doctor and get priority in booking appointments?

Patients want to downgrade and enjoy subsidised treatment because of a change in their income status.

Can the Ministry of Health make it easier for private patients to downgrade?

David Kwok Ng Kan

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