Posted by admin at 2:19 AM | Labels: healthcare policy
Several local health care issues were raised at a prior blog post. The truth of the matter (I am refraining from using the much-abused "hard truth") is that it is better if health care is not brought up as an election plank, beyond cheap soundbites about sending the former Health Minister to JB. It is a complex issue that is well beyond the scope of a 10-day campaign period.
The cost of health care will only go up in the next several years, no matter whether PAP sweeps the House or several GRC's fall to the opposition. This is because of an aging population, the advance of medical technology and influx of new, expensive drugs for chronic diseases and cancer. Keeping health care expenditure at 4% of GDP (note that the government's share is only about a third of this) is well-nigh impossible in the medium term, as health care costs outstrips GDP growth.
Some, including fellow bloggers at SingaporeMD, have argued that it is necessary for individuals to take greater personal responsibility for their own health. This is certainly a persuasive line of thought, and the government has never held back from promoting this point of view, election or no. The whole business of cost-sharing and "health care subsidies" is an attempt at avoiding moral hazard and indirectly driving home the point of personal responsibility. Yet in all fairness, we recognize that personal responsibility can only go so far. Catastrophic illness can occur even if one lives a life of moderation. For lower- (and perhaps even middle-) income families, circumstances prevent many from leading healthy lifestyles. The health care system is also not structured in a way that promotes health, i.e. focusing on primary and preventive medicine, even though efforts are underway to do so.
Catastrophic illness, as the term suggests, can be devastating not just for the patient, but also for his/her family. If one depends on the 3M's, one cannot avoid paying far more than $8 for any major operation or hospitalization. Private insurance plans are available that can cover hospitalization and even outpatient treatment costs, but these are less well advertised and perhaps the majority are still unaware that anything other than the 3M's are required - until it is too late to apply. Or perhaps the cost of the premiums is too much of a burden in addition to the other costs of living.
What policies can we adopt or tweak that can reduce the burden of chronic and/or catastrophic illnesses on the lower- and middle-income households? Without becoming a welfare state or raiding the reserves, that is?