Offering hope to heal and cope

THE STRAITS TIMES

Wednesday Aug 28, 2024

In partnership with the Ministry of Health

Healthcare financing framework eases money concerns of 92-year-old's caregiver

*Offering hope to heal and cope*

NICHOLAS YONG

er heart dropped when she picked up the call.

It was from the nursing home, calling to inform Ms Vivien Tan, 59, that her mother had fallen and frac- tured her hip.

"The doctor said she will never walk again," recalls Ms Tan, a remittance clerk. One of three daughters, she is the pri- mary caregiver of her 92-year-old mother.

Last September was the second time her mother had fallen in two years, leading to a 10-day hospital stay in a subsidised C class ward.

Then the bill from Ng Teng Fong General Hospital arrived. It was about $9,200. "When I saw the (total amount), I nearly died," said the divor- cee, who does not have pri- vate insurance or significant savings.

Ms Tan, a housewife for many years, had left the family fi- nances to her ex-husband, who had ini- tially bought insurance policies but even- tually closed them due to financial strain. She has three sons aged between 22 and 32.

But a closer look at the bill brought un- expected relief.

The bulk of it was covered by subsidies, MediShield Life, the national insurance scheme that provides basic protection against large medical bills, and her mum's MediSave.

MediSave is the national savings scheme that helps Singaporeans set aside part of their income during their working years to cover their healthcare needs.

In the end, Ms Tan paid only $60 out of pocket.

"I didn't even know that MediShield Life covered this," says Ms Tan. "It was a very pleasant surprise."

Help with healthcare costs

Like all Singaporeans, Ms Tan and her family benefit from Singapore's health- care financing framework - S+3Ms, which stands for subsidies, MediShield Life, Me-

diSave and MediFund (see box).

Singapore citizens and permanent res- idents receive up to 80 per cent subsidies at public hospitals. Patients can also tap MediShield Life and MediSave to pay for their share of the bill.

Around eight in 10 Singaporeans pay about $100 or less in cash for their sub- sidised bills at public hospitals with this framework in place, says Ms Lydia Loh, group director of the Healthcare Finance Group, Ministry of Health (MOН).

Medical social workers like Ms Cecilia Loo of Singapore General Hospital play a critical role in helping patients with finan- cial difficulties get aid for their medical treatment.

Ms Loo, 45, provides advice on financial assistance options and facilitates commu- nication between patients and the medi- cal team. She also guides patients through the process of applying for such schemes.

"When patients come to us, they often want to seek financial assistance for med- ical expenses as they are worried about affordability," says Ms Loo. These patients are often relieved to know "there are dis- cretionary financial assistance schemes available should they need help".

Those who have difficulties paying for medical treatment can turn to MediFund for additional financial aid. There is also targeted assistance for the elderly and children through MediFund Silver and Junior respectively.

"We will continually review S+3Ms to make sure that healthcare remains af- fordable to patients," says MOH's Ms Loh.

Changing landscape

Ensuring healthcare affordability is cru- cial as Singapore's healthcare spending rises.

Already, healthcare expenditure has in- creased from $10.2 billion in financial year (FY) 2017 to about $17.9 billion in FY2023, according to the Finance Ministry.

With advancements in medical technol- ogy and inflation, healthcare bills are like- ly to increase over time, explains Ms Loh. "And as one ages, one is more likely to fall ill and rely more on healthcare services."

She shares that MOH has a strategy to address rising healthcare costs: Moder- ating the growth of healthcare utilisa- tion through initiatives like Healthier SG, which focuses on preventive care, and managing treatment cost increases.

For the latter, Ms Loh cites the example of surgical implants. Last December, MOH introduced an Implant Subsidy List that includes only treatments that are deemed to be clinically proven and cost-effective. With the new list, implants are no longer automatically eligible for subsidy. "This facilitates negotiations with implant manufacturers for more competitive pric- es, which in turn improves affordability

for patients," Ms Loh adds. But MOH cannot tackle this challenge alone, she emphasises. "To keep costs manageable, everyone

needs to play their part," says Ms Loh. She points to the need for appropriate care and reasonable charges from providers, as well as individuals taking care of their health and "consuming healthcare (re- sources) only when necessary".

"We will continue to refine our strate-

gies and engage with different stakehold- ers on these issues," she adds.