Mr Sitoh, say it like this lah

The Straits Times today honoured PAP Sitoh Yih Pin by excerpting his speech in Parliament for its Speech of the Day column. Mr Sitoh spoke about trust between the government and the government. Interesting. A few days ago, ST carried a report on the level of trust between the parties. While Singaporeans trust the G as an institution, they don’t trust the leaders when it comes to breaking bad news. Mr Sitoh didn’t mention the survey carried out by public relations firm Edelman, by the way. My guess is that he probably read the findings.

Anyway, he said the G should be courageous enough to tell the truth, even if it is unpleasant. No one can quarrel with that. Straight talk is always appreciated. Methinks it can be more hard hitting. So I will list his six hard truths – and with tongue half in cheek, rewrite them – and respond to them.

1. We will increase the number of places in universities and polytechnics and 60 per cent of Singaporeans will become PMETs, but some graduates will never stay in private housing or own a car. This is because 85 per cent of housing are HDB flats and only one-third of families have a car presently and these numbers will not change drastically.

Re-written: Hey, I know most of you young people are going to be university graduates, but face it, just because you have a degree, doesn’t mean you get to stay in a bungalow and drive a Ferrari. I mean, for every one of you, there are five others with your qualifications. How to give all a bungalow and a Ferrari? Remember that 85 per cent of people live in HDB flats and one in three families have a car now.

Response: Orh ok. Then I study for what? At least, can make the HDB flat bigger or nicer? And make sure the HDB price is not the price of a bungalow or private property? I don’t need a Ferrari. I don’t mind taking public transport. I hope by the time I start work, the trains and the buses are running properly. I mean, have you seen how jam-packed it is at peak hour? I can’t even get to school on time some days.

2. This country needs to continue to be run as a meritocracy. There is no other feasible alternative. The best will get more. One may rightly question the norms of meritocracy, as in what makes a person more meritorious? One may even ask why there are so many brand-name schools in the more affluent areas in Singapore and not in the new HDB estates. And in the harsh reality of meritocracy, we also expect the meritorious to do what is necessary for meritocracy to remain relevant – they must contribute more than others to the betterment of the society and maximise welfare for everyone living and working in Singapore. Meritocracy cannot be “take and take” by the best and the ablest without any obligation to serve and contribute.

Re-written: Man, you tell me lah, what to replace meritocracy with? If you work hard, you can get far and you get rewarded. That’s how it’s always been here. I think, I’m not sure, I mean… you go figure why the brand name schools are in rich people’s neighbourhood. But just because you are among the best, it doesn’t mean you think you are entitled to all good things in life. So give more of your time to the community, more of your money, more of your whatever…

Response: I can take meritocracy lah. But now I live in an HDB estate, and went to the school near my home. That school ah can’t be compared to the brand name ones, which got swanky buildings and smarter teachers. So these people don’t start from the same line as me, and therefore, can probably run faster and further from me. I get left behind how? Of course, if I become a doctor or lawyer, I definitely will do more for the HDB people, like give free legal advice or free medicine. (Even if I don’t, how can you tell?)

3. Even if we increase our total fertility rate to 2.1 in 2013 suddenly, we will need to import labour to care for the elderly over the next 20 years. The babies born now or in the near future will not be ready to look after the 900,000 baby boomers retiring over the next 20 years.

Re-written: You know, even if every couple have two children from now, we still won’t have enough people to take care of the old. People like your parents, you know how many there will be over 20 years – 900,000! So can stop grumbling about foreign workers and nurses and care-givers or not? You think you can take of so many people by yourself?

Response: You think my parents are what kind of people? They are educated, got degree, got savings, got medical insurance. They know how to keep healthy. Anyway, are you trying to scare me with 900,000 old people? For all you know, they will move to Johor or somewhere not so expensive. They are already complaining its crowded here.

4. Our public hospitals will continue to give good care that is accessible and affordable to all. But we will have to continue to have waiting times and the latest high-tech expensive care options will not be available to all.
Ultimately, health care is a trade-off between affordability, accessibility and quality. Usually, quality in terms of expensive care is of a lower priority, although we will not compromise patient safety. This is true for most developed countries in the world.

Re-written: When you get sick and go to hospital, you know you can pay your bill. Really! Believe me! Okay, so you have to wait a bit to see a doctor, and maybe that expensive drug or machine cannot use Medisave to pay for. But what to do? Everywhere else, the same.

Response: Touch wood! I don’t want to get sick at all. And are you sure I can still pay for medical bills when I get older? I don’t think the Medisave is mine. I mean, it’s mine but I can’t use the money for some things unless the Government says so. I suppose I can buy a lot of health insurance policies or just go somewhere else where it is cheaper to get the drug or medical treatment. Wait a minute! What if I can’t afford the drug? I will probably die? Cannot be.

5. We will make our public transport reliable again and increase capacity. But COEs may never go back to the days of old again. There are limits to our car population just as there are limits to our human population.

Re-written: Face it, kid. You might not even be able to buy the COE, much less the car. You think you can turn back the clock and get $1,000 COE? Fat hope! Anyway, can you imagine how crowded the roads will be? You might as well take public transport. Don’t worry it won’t have so many breakdowns and you will be able to breathe on the bus and train.

Response: You sure bus and train fares will still be cheap? I mean, someone has to pay for the drivers and all that right? COE? Huh, already given up hope.

6. We will limit the influx of foreign labour to Singapore, but we cannot shield our workers from competition. The reality is that our workers will still be competing day and night, 24/7 with workers in China, India or Indonesia

Re-written: We heard you. So we’re going to scale back getting foreign workers in. But, you know what? Don’t think just because there will not be so many of them here, you can sit back and relax and collect your pay cheque every month. Don’t forget that the Chinese, Indians and Indonesians are working very hard in their own countries. If they make your company go bankrupt, then what you do?

Response: Yah lah. Yah lah. How many times you must repeat this?

Go to http://www.breakfastnetwork.sg for the New Normal Labour Market, What’s all this about giving transport operators money and the very minimal explanation against a minimum wage scheme

A healthcare begging bowl

We’re all talking about healthcare these days and whether we can afford to get sick in our silver years. Economists are wondering if the healthcare system should be reformed – why save so much money in Medisave when some of us need it now? Can’t the G share of the bill be higher? And my own favourite question: Has anyone ever been bankrupted by a medical bill?

So I read with interest The Sunday Times story on Medifund, that last safety net in our 3M system. I gather that this is for those who have depleted their Medisave (and those of their immediate family members?) and who didn’t sign up for Medishield. At least, that’s what I think the criteria is since it hasn’t been publicised with the G seeming to prefer a “case-by-case’’ basis.

I have friends who have been helped by Medifund, for which they are grateful to the G. It’s good that people are “grateful’’ but should it be the case that they look to G largesse to foot medical bills. I mean, no one intentionally gets sick. So I read about Health Minister Gan Kim Yong vowing that no one will be denied healthcare because they can’t afford it. He’s said it before, probably more than twice, and so has every Health minister before him. The ST led with this assurance – again, although the news should really be how many people have been helped by Medifund. I can’t help but think that the problem can be fixed at the root, but I will leave that to health economists.

Anyway, Medifund disbursements have increased from$78.7 m in 2011 to $90.8 m last year. Number of applications approved shot up from 480,869 to 518,389. The rise is attributed to greater flexibility to medical social workers to say yes to applications, although I still don’t know what is “flexible’’. As compared to what?

I tempted to say “wah, so generous now…’’ but I won’t. Because the figures are troubling. So many people need help with their medical bills, so much so that there is a “shortfall’’ – Medifund, an endowment fund, paid out more than its income for the first time. There is one more figure which appals me: That 96 per cent of the applications were for out-patient bills. I mean, so many people cannot afford out-patient bills? Something is wrong somewhere no? Especially since an in-patient received $1,295 while an outpatient get $103. So many people cannot pay $100 or so? How come? Is it because the medical problems aren’t covered by Medisave in the first place? Or they really, really are destitute?

I really think we need to look hard at the figures..

Then I read today in ST about medical centres in the Orchard Road belt. It’s an exclusive by ST I believe, so I’ll just sum it up here: Basically, the Raffles Medical Group wants to convert seven podium floors of Thong Sia building into a medical centre and applied to the URA to do so. As usual, there was a bureaucratic gobblededook response: “We evaluated the new proposed use taking into consideration specific site context, the impact of the proposed use on the amenity and surrounding uses, and the local road infrastructure capacity in that area, and decided to turn down the proposal.” In other words, the URA said no.

The ST has an interesting graphic on all the medical centres in the Orchard Road belt. Go buy ST. Did you know Pacific Plaza is converting the top seven floors of its 12-storey building into 22 medical “suites’’? The private medical centres are everywhere in the shopping district. Raffles wants to use Thong Sia to serve the “significant number of patients who live in District 9, 10 and 11’’ and foreign visitors, its spokesman said.

I don’t know why the URA said no. Apparently no parking space and complaints of residents have something to do with it. I don’t want to be envious, but I am. Nor do I want to say that private sector initiative should be stifled given Singapore’s bid to be a medical hub. But this story coming after the Medifund story really makes you think about the healthcare system in Singapore. Can we look after our needy sick in a better way than have them go with a begging bowl to the G?

Clarity is King

I wish the media would focus on explaining policy changes first before getting reactions from the usual suspects. I had to read ST, BT and Today to get a grip on the changes to get the elderly to “unlock’’ their housing asset. (Okay, I’m stupid) Times like this I just wish the media would put out two boxes on the Silver Housing Scheme and the Enhanced Lease Buyback scheme. Just tell me :

a. Who’s eligible for which scheme and how many of them are in this potential pool. I got a big picture number from BT on the number of elderly households in four and five-room flats who would be eligible for the Silver Housing Scheme, but not for those living in the smaller flats.

b. Take-up rate: applications and approvals which would give an idea of popularity. I gather the Silver Housing Bonus scheme hasn’t been implemented yet despite being announced in February. That’s nice – G listening to feedback ? In any case, why is this scheme better than selling on the re-sale market and then getting a smaller flat?

c. Pay-outs under the current and new scheme. There were 466 cases of people who sold their leases back to HDB. I wonder what they say now about missing out on the “enhanced’’ scheme…

d. Each box accompanied by a case-study, and in the case of lease buyback – a real case (someone who actually did the act then and what he would get if he waited)

I’ve always wondered about getting reactions from the ordinary folk. Their views are important of course but I would wonder about anyone who can give a considered response after a chat on the phone on the implications and complications of the policy changes. If it were me, I would want to look at my CPF numbers first.

Then there was the page 1 story on an exclusive interview with Health Minister Gan Kim Yong. I suppose because it was an exclusive, it was given more prominent play than the housing policy changes. But then again, it’s rather thin on the details no? So the G is likely to take a bigger share of the patient bill. Welcome news indeed! But what are we talking about here? What is the G share of the patient bill anyway? One example would do. Or are we lumping healthcare spending – operational and capital expenditure as part of the G share? Or just pure subsidies and grants that go into a patient’s hospital? Medishield premiums have already been raised – so I guess the patient share has gone up?

Anyway, it’s coming to the end of the year – and we can wait I guess.

Enough in Medifund?

When a policy change kicks in, another must surely follow to keep pace. Now that Medishield changes have been announced with higher premiums and cash upfront before the insurance kicks in, is there enough in Medifund to keep pace?
Health Minister Gan Kim Yong says that the poor who can’t afford the cash up front or deductible can turn to Medifund. The question is: How much does Medifund have? What have the pay outs been like? How much has gone into paying for deductibles and how much for other medical bills? I’m sure there have been past reports, but an update is timely given the new circumstances. Also, is Medifund the ONLY recourse? I believe there are others but signing up for them disqualifies you from Medifund aid.
I have always thought a newspaper has three functions: To inform, entertain and educate. In my view, they translate into news, views, reviews and news-you-can-use. I’d like to see more of the last. Interestingly, there was prominent explanation on U-save being applicable to households rather than individuals. A good newspaper’s job must be to make our lives easier. In this case, it did. But as that old cliche goes, more can be done