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Posts Tagged ‘Healthcare’

If you thought polyclinic fees are low, wait till you read this….

In News Reports, Society on October 30, 2014 at 7:49 am

Sorry! I thought of trying out this new-fangled way of telling stories these days. In any case, my headline is probably far better than the two I read today in MSM regarding the use of Medifund.

TODAY: 30 % rise in Medifund applications approved

ST: Medifund disbursements rise 27 % to $130m last year

My first thought was, wow, a lot of money. So are more people getting sicker, medical bills getting heavier or what? The applications rose from 587,000 the previous year to 766,000 last year, ST said adding that it reflected the wider range of people getting help, such as children from poor families. Then came this line that inpatients get about $1,579 and outpatients get $103. Outpatients? Since when? I turned to TODAY and realised that Medifund was extended to polyclinics last June. And that there were 68,000 approved applications for polyclinic patients. My goodness! That’s a lot of people who cannot afford $100 in polyclinic fees! What did they do in the past about their medical bills? With Pioneer Generation Package and all, I sure hope the figure will come down.

Still on health, I did a double take when I saw the headline 9% of woman have HPV infections: Study. I read it at first as HIV! But what in heaven’s name is HPV and is it serious? A line below the headline said that although the body naturally clears the virus, some women risk getting cervical cancer. The report said half of this group of HPV-infected have the high risk strains that are associated with cervical cancer. I go on reading about the state of HPV in Europe and Africa and how cervical cancer is among top 10 cancers for women and how 200 women here are diagnosed with it every year and one woman dies of it every three days……..and I am getting more and more worried and then! I read one doctor saying don’t worry, the body flushes out the virus naturally and the chances of HPV leading to cervical cancer are less than 1 per cent!

Seems the message is, please get yourself screened for cervical cancer, ladies.

PS. HPV stands for human papillomavirus

Bikini news

Because I don’t like stuffing news in briefs….

  1. The case of the Starbucks seat-hog

I was wondering when MSM would latch on to this kerfuffle that went viral for a couple of days about a kid who was unhappy that her books were cleared away at a Starbucks outlet. Seems she stepped out for half an hour (I would have finished my coffee by then) and returned to find that her belongings were no longer “choping’’ the seat. And instead of feeling chastened, she proceeded to rant on Starbucks FB page or something. Well, the story is in ST today although subsumed in a general trend story which it believes nobody in Singapore appears to know – that students study in cafes. Predictable comments came from café managers and students – good place to study, hard to shoo them away, we’ll move if we told to…you know the variety.

I have been much too annoyed with such students for too long. May I propose that the café staff wear badges when they move through the premises.

Badges can say:

“Stop hogging the seat, you pig!’’ This is the angry badge

“Is that a person or a bag sitting on the chair?’’ or the sarcastic badge

“A cluttered table reflects an untidy mind’’, which is the more erudite sounding one

“Home is a cool place to study too’’, which champions family togetherness

“You’ll fail anyway’’.

Nuff said.

  1. The ball is thrown back to Parliament again

I admire the tenacity of the people who went to court to challenge the constitutional position on gays. But I wonder if they realised that it would be a forgone conclusion. That section 377A criminalising homosexual sex is something for the legislature, the court reiterated. And the constitution never mentioned sex, gender or sexual orientation when it said it would give people equal protection under the law – just race, religion, place of birth and descent. As for the right to “liberty’’, it means the right to not be unlawfully jailed, rather than the right to privacy and personal autonomy. The court sounded almost chagrined when it threw out the challenge. Nothing this court can do, a judge said. The remedy “if at all’’, is in the legislative sphere. Hmm. Looks like Parliament is the last stop. Seems to me that someone should put forward a motion to debate this. OR continue the trend of putting up Private Members’ Bills (we’ve got one on sex trafficking and animal protection after all) to seek an amendment?

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Ee Boh lah! Thank goodness!

In News Reports, Society on August 16, 2014 at 2:02 am

There’s a joke going around about the scare the Nigerian woman caused when she was thought to have brought the Ebola virus into Singapore. She’s been given the all-clear; in other words, Ee boh lah! I suppose the joke is also a manifestation of a relief, given that we would probably be put in a state of panic if it was the case.

Anyway we have the Changi Airport people all donned up in white suits to do mock simulations if something so untoward should happen.

The wonder is that this little global city hasn’t yet been breached by the virus. We haven’t started barring people from West Africa and wonder if the airport authorities do more than a pat-down when visitors arrive from Sierra Leone, Nigeria, Liberia or Guinea. Should we be grateful that they number among the poorest countries in the world and can’t afford air travel? Sounds rather heartless, doesn’t it.

(Actually, the authorities should not do a pat-down because the virus is transmitted through bodily fluids. It is not air-borne, like Sars. And what’s worse is that those thermal imaging machines to detect feverish travellers might not work either, since the fever disappears in the late stages!)

There are two articles in the New York Times republished by TODAY which on reading, gave me a sense of déjà vu. These weren’t about what the World Health Organisation is up to or whether the virus came from infected bats or anything so big picture – and which people’s eyes may glaze over. The articles were about the people who were affected.

So Patient Zero, a two year old, died in December after falling ill. But not before infecting his mother, three-year sister and his grandmother. Two mourners at the grandmother’s funeral took the virus home to their villages and a healthcare worker to another. The healthcare worker died, so did his doctor. The circle got wider and wider.

The virus works so quickly. A woman with the sickness travelled to Monrovia, where she vomited in the taxi. The taxi driver who cleaned her up died. She also infected her husband and two year old child. Then there was a doctor in Sierra Leone in the forefront of combating the virus who emailed colleagues worldwide for stuff including chlorine, goggles and body bags. He died before the supplies came.

And there comes the question of burial. Few came to mourn those who died of the virus and burial workers were in protective suits. Funerals were scary.

I got thinking again about the Sars scare and how healthcare workers were falling down like flies when it was unclear how the virus was transmitted. How burial workers masked themselves with scarfs and tee-shirts. And how there was the battle to be waged against fear, prejudice and ignorance, which is pervading West Africa now.

Those far less developed countries are scrambling to put in measures to protect their people. They seem to be going through what we did – deciding how much information to put out, whether measures would hit the economy and what sort of restrictions on movement should be imposed.

I would like to think that our Sars experience has built our expertise against the invasion of foreign viruses. That alerts and processes are in place once the alarm bell is rung. The authorities and healthcare workers probably know what to do, but what about the rest of us? Sars was in 2003 and from what I can tell, the younger generation’s main recollection of the period was that there was “no school’’ and learning was done online. Perhaps, we should be better exposed to the steps taken by the besieged countries so that as a population, we too would be prepared to buckle down to survive. This wouldn’t be alarmist; it would be prudent.

Medicating Medishield for life

In News Reports on June 28, 2014 at 2:49 am

Okay, so the dance of the seven veils has been staged. And more veils have been lifted on Medishield Life, especially the one shrouding the new premiums. They are big increases, but the G is covering it with a $4billion kitty that will last five years. The question is what happens after that?

Anyway, if you’re mightily confused by all the numbers, here’s a run-down on UNUSUAL key points.

Those premiums: Yup, the new ones are high and even higher for the younger people. That’s because people want to be able to pay more when they are working and less when they get older, quite an inversion from normal insurance schemes.

Should this matter? Well, not now because the G is throwing in a load of subsidies, graduated according to age-groups and income.

How? Everyone will get transitional subsidies for four years, while the lower two-thirds will also get permanent subsidies.

Then there’s the 1 per cent rise in Medisave. The one-third group who will no longer get transitional subsidies belongs to the higher-income and that one per cent Medisave increase will cover the higher premiums.

Here’s a gauge:

From next year, if you belong to the two-thirds group, you will pay no more than $3 a month, while the higher income will pay no more than $6.

From 2019, which is when transitional subsidies run out, the lower and middle income will pay no more than $14 a month and the high income will pay at most $30 (which that 1 per cent increase in Medisave is supposed to be able to cover).

Who really will be paying the most? Seems like that group of people of people who are uninsured, because they have pre-existing conditions. It seems that this group number about 65,000 (not really sure about this, sorry). They will be paying 30 per cent more in premiums compared to the rest.

Sounds terrible? Paying more always sounds terrible. But they would be paying sky-high premiums if the G wasn’t footing ¾ of the cost of insuring them – that’s $1.1 billion over five years.

 So will all these changes really help me if/when I get sick? Yes, because you can claim MORE from insurance and reduce the need to dip into your Medisave or put out cash. That’s because the claim limits will be higher and the co-insurance portion that you have to pay will be lower. Remember that this will work for subsidised wards in B2 and C.

A real-life cost-benefit example:

Of those who stayed in a B2/C class ward and got whacked with a bill of more than $10,000, only one in 10 paid less than $3,000. The rest had to dip into their Medisave or cash for more.

But Medishield Life means that six in 10 will pay less than $3,000.

Maybe that old saw about better to die than get sick will die out…In fact, it is good to be above 65 because don’t forget that the Pioneer Generation Package covers them for life.

There are two niggling issues:

First, six in 10 people have already bought Integrated Shield Plans because the current Medishield wasn’t able to cover big bills. How will private insurers react and what will happen to the current IP premiums? Past practice has seen private insurers stack on more when the current Medishield premiums changed. This time, the review committee is telling them to stack the premiums with the same increase, or less – as well as draw up a standardised B1 ward class plan. That B1 ward class plan sounds good because statistics show that seven in 10 with IP plans actually prefer being warded in B1. So here’s hoping the insurers will come up with this, and therefore reduce premiums for such people rather than lump them with uber-rich who prefer private hospital rooms.

 Second, company group insurance and medical benefits which look like a duplication of Medishield Life. Why not use corporate largesse  to enhance Medishield Life and have them move quickly to a portable medical benefits system? This is something the labour movement should take up. A one per cent contribution by companies to employee’s Medisave would go a long way. Perhaps, there should be a systematic shift that will take place over four years, when transitional subsidies run out in 2019.      

I happen to think the Medishield Life review committee seems to have considered many, many aspects of how to cover everyone, including those with pre-existing illnesses. But I wonder how it will enforce “universal coverage’’ since there would those with little Medisave because they don’t have a stable stream of income or are self-employed. Compulsion must mean penalties for non-compliance. Also, it isn’t clear what will happen to Medifund – the last resort for the down-and-out.

But what the review committee can’t do is predict the future, such as whether G largesse can continue, whether the Medishield Life fund will go bankrupt and whether people will pay escalating premiums because everyone wants to have the best of medical technology and healthcare. For all you know, a G craving popularity will forever keep premiums low – and quietly cut benefits.

We can expect to hear plenty of exhortations from the G to be careful about our health and making demands on the medical system just because we think there will be insurance to pay for everything. Looks like everyone has to bear some responsibility to keep the insurance scheme going. It’s not possible (or is it?) for the G to keep pumping in $4billion every four or five years.

There are so many “what ifs’’ especially as we look at how health insurance and retirement schemes run by governments elsewhere have gotten into a mess. Hopefully, health economists will look at the review committee’s suggestions and suggest ways to strengthen the system so it will survive into the future.

Anyway, here’s a toast to our health, the health of our finances – and to review committee chairman Mr Bobby Chin and his team.

Keep politics out by keeping policies simple

In News Reports on May 30, 2014 at 4:12 am

From reading the dispersed parliamentary reports in MSM, I think it was MP Baey Yam Keng who made the most interesting speech yesterday. Now, we’ve heard enough about this word called “trust’’ – the erosion, lack of and how to raise levels and all that.

A lot of it are exhortations to the G (and its civil servants) to do better at emphatising with the lot of the common man, by climbing out of ivory towers and putting their ear to the ground. Then there is the flip side: That trust is eroded because of distortions, untruths and a whole lot of drumming – so can everyone just get their facts right?

But I think Mr Baey hit the nail on the head when he talked about better communications and more importantly, HOW to engage in it. The former public relations practitioner talked about making sure policies are in tune with human behaviour and psychology, rather than micro-calibrated to ensure maximum mileage and minimum wastage. He said, for example, it required 16 spreadsheets to explain the different ERP charges here, while London’s Congestion Charge was a flat ten pounds.

Likewise, the initial euphoria over the Pioneer Generation Package appears to have dissipated because of its intricacies which even those tasked to explain find difficult to articulate.

According to ST, he gave this example:

The Pioneer package subsidises MediShield Life premiums and tops up Medisave accounts but this may not be used by healthy seniors.

Instead, the package could have given pioneers free treatment for common chronic diseases in Class C or B2 wards, he said.

This might cost the Government the same as what the actual package did, but would better reassure the 450,000 pioneer Singaporeans as it is easier to understand.

I think the package was done that way to be “fair’’ – so whether you have chronic illness or not, everyone still gets a top-up.  Also, it looks “better’’ than a direct handout, like free treatment for seniors. Good points, but they also make it “difficult’’ for people to grasp what the G is trying to do.

Or take the CPF system. So many conditions and caveats, different withdrawal sums and uses, different accounts and interest rates  – how can anyone truly grasp what the policy is about or remember every step of what will happen to your CPF once you hit 55? Try reading about CPF Life and see if you can figure out how it will apply to you.      

Thing is, policies have become mightily complicated. They start with a sound objective and then other objectives are later grafted on to them. Then it is engineered such that it is not open to abuse, even if the possibility is small.  Then it is criss-crossed with means testing and criteria to ensure that everyone gets a fair shake according to, say, household type, age group, monthly income, ward class ecetera. Then it is criss-crossed again by how much to give out, for what purpose, time period and so forth.   

It’s just like taxi fares! So many levies, time slots and varying starting charges by different companies that the only thing people remember is “don’t take the big black cab because it is definitely more expensive’’. But, hey, that’s the private sector and we are mere consumers who have to abide by caveat emptor.

But with G policies, it’s different. I reckon there is mistrust when policies become complicated because:

  1. People think the G isn’t really serious about “giving’’ because it is making it so hard for people to do the “taking’’.
  2. People will start looking at other people who also benefit from the policy and wonder if they have been given a fair shake, or whether some discriminatory standards have been applied. In other words, why him and not me?
  3. People who can’t understand one point will seldom bother to find out about it themselves, preferring that others – who can be less reliable – tell them. Remember that most people only read headlines – which might also not be reliable!  
  4. People will add more objectives to policies simply because the policies already have so many – and therefore can afford to have more. The G will have hands full explaining why it can’t do that.

 When policies are so complicated, why is anyone surprised that there is so much misinformation about them? Even The Straits Times can’t explain the Wage Credit Scheme properly (see earlier post). And consultancies have sprouted up to dispense advice on how to use the Productive and Innovation Credit more productively and even innovatively.   

 It’s easy enough to say that people should check their facts before mouthing off. Yes, they should but not everyone can do this, and some might even not be inclined to. We haven’t reached that level of sophistication and even fluency when we can debate effectively with facts at our fingertips although some of us try to.

I happen to think it is good politics to simply try and ensure that policies CAN’T be misunderstood in the first place.  Make it simple.  In fact, make it somewhat “intuitive’’ as well. I would like to add that I am also guilty of asking for more checks and so forth on G policy especially on subsidies and handouts. I wonder especially about the WCS and other grants that don’t seem to have factored in an element of accountability on the part of the receiver.

So the G has to make a call – keep things simple and stand its ground when others lobby for more – or less or risk doing a patch up job and then unravelling everything and going back to basics.

I acknowledge that this will be a tough job.

This is just my one cent worth of opinion in the name of constructive politics.    

A mid-term report

In News Reports, Politics, Society on April 19, 2014 at 3:55 am

ST pulled out its big guns to mull over a mid-term report on Singaporean’s satisfaction with the G. They dissected the views on health, transport and housing and expanded on what they saw as middle class angst over the state of affairs here.

The survey results were generally favourable to the G, noting higher levels of satisfaction over its attempts to fix the housing, healthcare needs of citizens and to alleviate the plight of the old and the poor. Post-2011 GE – and the G seems to have taken into account the woes of the populace. Yet as commentator after commentator pointed out, the disaffected will still say that the measures were too little, too late and the problems were wrought by bad policies, which behoved the G to rectify anyway. Some will point to the small sample size of 500. But students of statistics will allow that a sample, if scientifically picked and polled, would suffice as a more-or-less accurate gauge of sentiment. Far better than the usual street poll, at least…  

In any case, I’d wager anything for comments to surface that the survey was a white-wash, initiated by a pro-G media mouthpiece which sought to present the survey results as the voice of silent majority.

Frankly, I’m not too surprised at the results. Bread-and-butter issues have always been foremost in the Singaporean mindset. People are happy that the problem of affordable housing seems to have been fixed and moves are being made to provide for universal healthcare. Social policies in recent years have been geared towards alleviating the plight of the poor, aided by the G’s constant reminders of the amount of money, subsidies and benefits that go to the group. The Pioneer Generation Package is appreciated. The need to provide medical cover for those who pre-date the CPF scheme and Medisave has been thoroughly welcomed, although experts have noted that the devil is in the details.  

Give us the good life – that’s what we want.

We also want lower COE prices and a train system that doesn’t break down. That’s the biggest bugbear of those surveyed. The G is having difficulty on this front, and no wonder. In housing, it has the levers of HDB and land sales as well as the power to restrict or expand lending through MAS regulations. Its network of polyclinics and public hospitals as well as controls over CPF and Medisave also work as healthcare financing instruments. In transport, besides the Land Transport Authority,road-building and infrastructure, public transport is really in private hands and private enterprises are wily enough to get round private transport curbs. Hence the luckless Mr Lui Tuck Yew.

When it comes to conceptualising policies, this really is a good government, aided by a very able civil service (MDA excepted). Increasingly, a soft touch is being applied to them, which we will probably see more of when Parliament re-opens.

As for the not-as-satisfied middle class and mid-age group, their sentiments have been variously described as conforming to a traditional U-shape for happiness (because this is the segment everywhere which has to deal with the bread and butter issues with car, house, children to support). Or explained as high expectations of an even better life than what they now have.

Now, the G can fix policies to give more people a fair shake, but raising the tide to lift all boats will be a far tougher issue at a time when people are unhappy about life’s stresses and the influx of foreigners needed to fuel the economy.   

How will this translate into votes come election time? There is a chart in the bowels of ST which could shed light. It does not refer to policy issues, but how survey respondents pick their MPs .

Of six factors, national policies and their impact on the individual were rated as “important’’ or “very important’’ for 86 per cent of them; or a mean of 4.1 on a scale of 1 to 5. This bodes well for the G, except that other contrary factors are also at work, such as how about 80 per cent think it “important’’ or “very important” to have checks and balances on the G, especially among the vast swathe of 21 to 54 year olds, and the higher-income. Indeed, a high 35 per cent viewed this as “very important’’. Expressed in terms of averages, this factor scored 4.11.  

There is another statistic: 29 per cent viewed the need for alternative views in Parliament as “very important’’; the same proportion as those who placed such a premium on local constituency issues. The score for alternative views is 4.05. For local issues, 4.02.  

The other two factors are the candidate’s attributes (4.11) and party (4.09).

I wish the survey had ranked the factors as well, so that we know which the people placed the greatest weight on.

Statistics can of course be interpreted any which way. But it is absolutely clear that the People’s Action Party will never go back to the days of a one-party Parliament however it satisfies the people policy-wise. Despite innovations like the Nominated MP scheme, the people’s aspirations for a more diverse Parliament have not been assuaged. In fact, it might have raised expectations instead. You can also expect that some will attribute the G’s performance to the presence of more opposition MPs and the rude awakening call it was administered at the last GE. In fact, it might lead some to think that more opposition would bring about better government.

Of course, the reverse could happen. Those who voted against the current G might feel that it has seen the “error of its ways’’ or the benefits of social policy are felt widely enough for more people to feel that the G has done right – and will continue to do right – by them.  

How the G does in the rest of parliamentary term will be critical. Can it consolidate its gains and ride the 50th anniversary feel-good tide?  Can it “fix’’ the current pre-occupation of residents – rising cost of living?

Truth be told, I am a little uncomfortable with its shift towards more “social’’ governance. Methinks it would lead to greater expectations on the part of the people and invite a greater role for the G in the people’s lives.

But it is so very important to satisfy the people, isn’t it?

  

 

Mr Sitoh, say it like this lah

In News Reports, Politics on March 7, 2013 at 4:36 am

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

In Money, News Reports, Society on February 25, 2013 at 2:02 am

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

In News Reports, Politics, Society on December 28, 2012 at 10:37 am

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?

In News Reports, Society on July 23, 2012 at 1:02 am

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