Angry Doctor

Friday, June 01, 2007

Subsidy and Other Preoccupations 18 or Edited 3‎

Yesterday Gerald posted the text of a letter he had sent to the ST Forum on the bed shortage situation on the comments section of an earlier post, thinking that they have decided not to publish it.

After reading the letter, angry doc agreed with him - the tone of the letter was... less than complimentary, he thought. But it turns out angry doc is wrong; he had forgotten about the tireless editor of the ST Forum page...


Means test won't resolve social-overstayer issue

I refer to Ms Khalik's [the] article "Means Test the Solution to ease hospital bed crunch" on 25 May 2007. I agree with the Health Ministerthat public hospitals are designed for the acute care of patients, and that patients who are fit for discharge may be better served by step-down facilities such as community hospitals.

However I disagree that means testing is the solution to ease the hospital bed crunch. As currently envisaged, it will apply to everyone [every subsidised patient] staying longer than 5 days, regardless of whether they are fit for discharge or not [1]. As the Minister himself brought up, an elderly patient may need weeks to recover. Is it fair to penalise a patient who needs the bed, but takes longer to recover?

Furthermore, means testing applies only to a subset of patients, namely those who can afford to stay in private wards but choose to stay in subsidised wards. It will not apply, for example, to the destitute old man who qualifies for C class and is fit for discharge, but whose family refuses to bring [take] him home. Means testing will not help free up beds occupied in such a way.

Lastly, inpatient means testing has yet to be implemented, and difficulties are already anticipated. We should concentrate onfulfilling its basic objective (namely to ensure that subsidies go tothose who need them), rather than tack on additional goals.

Therefore I would like to bring to your attention [highlight] a policy that directly addresses the problem of social overstayers and is already in place in our public hospitals. It is available on the he.citizen.gov.sg website, and can be found (aptly) under the "Social Overstayers" heading at http://he.ecitizen.gov.sg/health_dollar_charge_sgh.htm - I quote "Patients who are fit for discharge but insisted on staying on will be charged the full cost of the period of their overstay, from the 7th working day after the hospital has assisted in finding a placement ina step-down care facility."

Rather than use the bed shortage to justify the introduction of means testing, the Health Minister should instead familiarise himself with [we should tap] methods that are simple and already available, and ensure that they are carried out smoothly.

Gerald Chen Zexin

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