How much healthcare must a Singaporean consume per year to "break even" under SDP's proposed "National Healthcare Plan"?
Under SDP's "NHP", the average Singaporean pays an annual contribution of $600. To offset this compulsory payment, he must consume $600 worth of healthcare to begin with.
However, since the "NHP" covers only 90% of that $600, he has now paid $660 to consume $600 worth of healthcare!
To make up that difference, he must consume another $60 of healthcare, which will mean he has to come up with another $6 out of his pocket, which put him out by another $6, which means he has to consume a further...
(Yes, it's closer to $667, but that number is more dramatic...)
Now you may think that that is a joke (and not a very good one at that), but I will not be surprised if Singaporeans who previously spent fewer than a hundred dollars on healthcare each year mysteriously start chalking up $666-healthcare bills if SDP's scheme comes into effect.
You may ask why we do not already over-utilise services such as the police, ambulance and fire services since we have all already "pre-paid" for them via taxes. Well, for one thing, these payments are hidden in the sense that they are not separate accounts into which you pay, and the prices of these services are also not known, making it impossible to determine where the break-even point is. Secondly, people do in fact utilise them inappropriately, which is why there are penalties for calling the police, an ambulance or the fire department frivolously.
What about the Medisave account that we have presently?
Yes, that is a distinct account into which you are compelled to contribute to, but that money stays in your account if not expended - it is not "forfeited" at the end of the year if not consumed (like those eMart credits - ever seen a reservist buy more pairs of socks than he can wear out just because he has $200 left in his account?). Also, that amount is reserved for your own use or the use of your family, and is returned to your "estate" if sums remain after your death, so there is no incentive to ensure that you use all you can every year of your life while you live so that money doesn't go towards paying for some stranger's illness.
Yet even under those terms, patients still make healthcare choices based on CPF policies instead of medical reasons. For example, they will decide on whether or not to undergo an investigation or procedure based on whether it is "Medisave-claimable". After MOH started allowing Medisave to be used for outpatient chronic care, my colleagues in primary care related to me how some patients would try to make sure their bills exceed the minimum co-pay amount so that they can utilise their Medisave (yes, actually wanting to pay more in total so that they can pay less out-of-pocket!), to the point of asking the doctor to prescribe a longer duration of medication, to not discontinue medications which are no longer needed, or to prescribe vitamins and supplements to bulk up the bill.
Sounds bizarre? Well, don't just take my word for it - ask a friend who is in healthcare if what I wrote in the second part is true, and what I wrote in the first part is likely to happen. Perhaps SDP should have asked some healthcare workers too before coming up with their... Wait a minute...