Singapore: Medishield-life= terminal life support for a BANKRUPT healthcare system?
As admitted by Health Minister Gan Kim Yong: “If you look around, our investments in health promotion and diseases prevention, I think... it is actually significantly lower than the amount of money we spend on treating diseases... ... .. We need to take a holistic approach towards health promotion, taking into account how can we empower consumers so that they make the right choice” ['Empower consumers with holistic approach to healthcare: Gan Kim Yong', TODAY, 11 Feb,2015]
The consequence of lifestyle/ preventive healthcare lapse: dire statistics:
- "Singapore has the second-highest proportion of diabetics among developed nations, a new report by the International Diabetes Federation (IDF) revealed...10.53 per cent of people in Singapore...Only the United States fared worse..."['Singapore 'has 2nd-highest proportion of diabetics''; ST, 2nd Dec2015]
- "Last year (2014), about 1,730 people lost the use of their kidneys, up from 1,657 in 2013,... The reason? Singaporeans are getting more obese and more are suffering from diabetes, the main cause of kidney failure when not kept in check." ['A new dialysis patient every 5 hours in S'pore', ST, 10May2015]
The public healthcare costs of this lapse:
- "The Government's expenditure on health care has almost doubled in just three short years - from $4 billion in FY2011 to $7.5 billion in FY2014.... In Budget 2012, Finance Minister Tharman Shanmugaratnam projected that health expenditure would hit $8 billion in five years. Today, it is almost there - much faster than projected. " ['Change mindset to curb rising health-care costs in Singapore'; ST, 18Mar 2014]
From the a/m figures, back of envelope calculation would reveal that between 2011 and 2014, the increase in public healthcare costs ('gahmen expenditure') was $7.5B/$4B= 1.875x. So assuming that the budget has to increase at 1.875x every 3 yrs, then by 2017, the annual expenditure should be $7.5B x 1.875 = $14.06 billion (almost double of Minister Tharman's S$8B projection and frightening considering that Singapore's GDP is around $300B ).
According to a/m chart 'Healthcare financing 2011-2013' found at '20150516 PAP’s Medishield Life – taking care of our healthcare by taking from our Medisave?', the total balance of all medisave accounts in 2013 was S$64.9B.
It is thus not unreasonable to suspect that the real reason for the construct of medishield-life would be to obfuscate (and financially compensate for) the gahmen's (expensive) lapse in preventive healthcare policy provisions, and to prevent such negligence from revealing itself either in the form of a gahmen budget deficit or runaway public healthcare costs.
And so desperate is MOH for $$$/ at avoiding this possibility that they have held Singaporean's personal liberty hostage by making non-payment of medishield-life premiums a jailable offence:"Singaporeans or permanent residents (PRs) who refuse to pay MediShield Life premiums once the universal health insurance scheme is launched later this year could find themselves behind bars if they try to leave the country... .. payment of the outstanding premium to an immigration officer or the police. .. also have to pay a 17 per cent penalty for late payment, as well as any costs incurred in recovering the money." ['MediShield Life: Can pay but won't? Jail, fine on the cards'; MyPaper, 21Jan2015]
The significance of prodigal MOH contradicting founding father of Singapore Lee Kuan Yew by raiding private medisave accounts on the year of his demise is not lost on those who suspect that MOH will be the Ministry to bankrupt Singapore, and return us to the state we were at SG:zero (SG:0),
May we not forget our founder's words that MOH has since unceremoniously disparaged since the onset of compulsory premium payments in Nov2015:
"My major objective in the early days was to make sure that nobody derails the idea of having individual accounts for CPF and Medisave. Whatever you earn, it’s yours.Because once you have that individual account, any suggestion that you put it into a common pool and everybody takes out from it (as with other welfare systems) is bound to lose you votes. ...Are you prepared to put your money into a common pool, having slogged and built up your CPF nest egg? It’s yours and if you don’t use it, you can leave it to your children or your relatives or whoever you like. Why should you put it into a common pool and everybody draws out at your expense, which is what’s happening in some Western countries? The system has collapsed." ~ From Lee Kuan Yew : Hard truths to keep Singapore going. (Eds Han FK, Z Ibrahim, Chua MH, L Lim, I Low, R Lin, R Chan) Straits Times Press 2011 (pg.170)"
The advice from ['Change mindset to curb rising health-care costs in Singapore'; ST, 18Mar 2014]"Bad habits like smoking, binge drinking, sedentary lifestyles, and high sugar and fat consumption are still rampant.
The Ministry of Health is not unaware of this.
The Health Promotion Board was set up to tackle just this problem.
Unfortunately, progress is slow, while poor health will snowball as the population ages with little regard to staying fit.
It would be better if a larger part of health expenditure is spent on prevention rather than treatment, too.
Another shift that is needed is a move towards better and stronger primary and community care, so that chronic diseases can be kept under control and not result in ever-worsening health.
And if those two conditions are to be met, a huge mindset change is needed, as a healthy society means people in their 60s and 70s can remain active contributors.
Then perhaps the increase in health-care spending will not spiral out of control."
Yet it seems that the MOH's sole solution to the problem is to raid private medisave accounts and jail all who do not pay to MOH their dues... Congratulations MOH, U are well versed in the leadership dictates of the DPRK: i.e. North Korea.
- "As we shift “left-of-center”, let’s not overcompensate and lose everything that made Singapore what it is today.": ['ARE SINGAPOREANS BEING SET UP FOR DISAPPOINTMENT?', InsightsHealthAssociates; 13Aug2013]
- Health alert: One in 3 will develop diabetes (The Straits Times, 24February2012, Pg B01)
Source: Health alert: One in 3 will develop diabetes [Link 1 (SGH)], [Link 2]
- “Healthy Lifestyle May Prevent 86% Of Heart Attacks... 'This reduction in risk corresponded to 18% for the healthy diet, 11% for moderate alcohol consumption, 36% for no smoking, 3% for being physically active, and 12% for having a low abdominal circumference,' the authors wrote': [Åkesson, A et al “Low-risk diet and lifestyle habits in the primary prevention of myocardial infarction in Men” J Am Coll Cardiol 2014; DOI: 10.1016/j.jacc.2014.06.1190.]
Disclaimer: not professional statistician, some non-official sources for statistics used.