Singaporeans have to pay our CPF into the Medisave for health.
We then have to pay our Medisave into Medishield, also for health.
When we have to take our Medisave to pay for Medishield, doesn’t that means we have less money to use in the Medisave?
Also, if we are already paying into so many schemes – tax, Medisave, Medishield and Medifund (as well as ElderShield etc), why is it still not enough to cover for our healthcare expenses, that we still have to buy private Medishield plans, accident plans etc from private insurers?
Government subsidies for health only covers for about 30% of total health expenditure, Medisave only 5.5%, Medishield only 2.1% and Medifund only 0.7%. Singaporeans have to pay tax and CPF (Medisave and MediShield) but they cover for less than 40% of total health expenditure. We still have to fork out more than 60% out of our own pockets.
Meanwhile, Singaporeans still have to buy private insurance for health but 40% of Singaporeans are unable to do so.
Medishield is supposed to be the universal healthcare scheme in Singapore but only covers for 2% of health expenditure. This is vastly inadequate.
In light of this, the question is if it’s logical for us to pay such high premiums for a “universal” scheme that pays only 2% of total health expenditure?
Yet, Singaporeans have paid $66 billion into Medisave, but last year, we only used 6% of the total amount.
Singaporeans have also paid nearly $4 billion in premiums into Medishield but we were only able to claim $2 billion.
As such, there is a massive surplus of Medisave and MediShield which Singaporeans have paid out, which have not been returned back to Singaporeans.
In light of this, the question to ask if it’s logical to ask Singaporeans to pay an additional 1% CPF contribution for Medisave and if the increase in Medishield premiums is called for.
Also, what is the government’s permanent plan to pay for the Medishield premiums from government coffers? In 2012, the government had a $36 billion in surplus. In 2013, there was an estimated $30 billion.
Thus several questions stand out:
(1) Why are Singaporeans paying so much into the national health insurance schemes but receiving comparatively much lesser in return?
(2) Why are Singaporeans paying into so much health schemes but these schemes still cover for less than 40% of the total health expenditure?
(3) Why do Singaporeans still have to pay for private insurance and for the 40% who are unable to do so, how will they be able to afford healthcare in Singapore?
(4) We have accumulated tens of billions in surplus in the Medisave and MediShield. Many Singaporeans are today unable to afford healthcare and have had to forgo going to a hospital (some have chosen to die) or sell their homes to pay for their medical bills. In view of the inadequate health protection for many Singaporeans and massive surpluses, should the government expand the use of Medisave and MediShield?
(5) Also, is there a permanent role that the government can build into the Medisave and MediShield to permanently contribute to the Medisave and MediShield of Singaporeans? Short-term interim subsidies from the government will still cause long term anxiety for Singaporeans.
Finally, how are the computations and calculations on the Medisave and MediShield contributions/premiums and payouts done? What assumptions have the government used and what are their long term projections?
For now, Singaporeans do not have access to this information. We have only been told that there will be a 1% increase in our CPF contribution for Medisave and we have to pay more Medishield premiums.
But why? And how are the cost decisions done? This information is not public.
There is an urgent need for the government to be transparent in these calculations and be accountable to Singaporeans on why we have to pay for these increases.
Today, there is a lot of difficulty for Singaporeans to have to pay for things on wages that have remained stagnant, especially for the poor and elderly. Singaporeans would appreciate a government which can be transparent to us on this information, so that we are aware as to why we have to pay from our diminishing wages into these rising costs.
In the eventuality,
(1) It is time the government streamline the national healthcare schemes to simplify them so that Singaporeans are able to easily know how much we have to pay for healthcare. The government also has to simplify the schemes to allow Singaporeans to have a peace of mind when we have to go to a hospital or visit the doctor.
(2) The coverage of these schemes have to also be expanded beyond inpatient care to truly universal care. When we seek healthcare, we do not decide whether we would seek inpatient or outpatient care today, especially for urgent cases. This decision is made by doctors. Singaporeans should not have to worry about the long term implications to our health, simply because we cannot pay the bills and choose to forgo seeking medical treatment.
(3) There needs to be a cap (or maximum amount) as to how much Singaporeans should pay for each visit to the doctor (as in Hong Kong) or in a year (as in Norway), so that we are fully aware of how much we have to pay for each visit or over a year, and be able to seek medical treatment, with a peace of mind.
(4) Companies currently have to pay for 30% to 40% of total health expenditure in Singapore. It is difficult for them to continue to have to fork out these amounts, in light of rising business costs and rents. The government has to step in to manage the costs for businesses.
(5) As such, Singaporeans are already paying significant amount of taxes. The tax that Singaporeans pay, in comparison to how much the government gives back in expenditure, is perhaps one of the lowest among the developed countries. As such, the government has a duty to return more of these taxes back in subsidies. Also, as mentioned, there are tens of billions of surpluses in the past few years. The government has to increase the health subsidies to allow Singaporeans to cope with the rising medical costs. The average that governments of other developed countries spend on health is 70%. In Singapore, the government spends only 30%.
Today, Singaporeans have a stake in our country’s development. The government has to be transparent in their computations and calculations, so that as a whole, Singaporeans can work with the government to look at the long-term projections of health expenditure, how much we should pay to sustain long term outcomes and work together towards a mutually beneficial arrangement for the government, as well as for Singaporeans and businesses in Singapore.
An event will be held at Hong Lim Park on 12 July at 4.00 pm to discuss the issue of CPF and healthcare further.