Stop using that word!
SMA lauds ministry's clarification, criticises ST
Labels: in the news
Well, well. Here's a letter to make angry doc stir from his stupor:
Keep S'poreans small, ban char kway teow?
Letter from GOH KIAN HUAT
I REFER to the report "Beware! Super-sized S'poreans on way" (March 17).
My nine-year-old daughter, classified as severely overweight, has been attending counselling sessions with food nutritionists at the Health Promotion Board for the past two years.
However, her attempts at losing weight have not been successful. It is easy to list the types of healthy foods one should eat, but difficult to find and eat only these healthy items.
I applaud the initiative in asking fast-food outlets to put healthier options on their menus. They should also provide healthy choices for adults.
McDonald's could offer vegetables, fruits or desserts with their set meals and Kentucky Fried Chicken could remove the skin before frying the chicken.
Customers should also be able to choose between soft drinks and ones that contain less sugar.
Health Minister Khaw Boon Wan said he eats char kway teow only three to four times a year, and that if we eat this frequently — five to 10 times a month — there will be trouble. I find this is no different from smoking. Should such unhealthy food be allowed to be sold in the first place?
I suggest that the National Environment Agency ensures that its licencees sell healthy, nutritious food.
The fact is every place that sells soft drinks also sell a drink that tastes exactly like a regular soft drink, but contains only half the sugar and therefore only half the calories.
It's called half a soft drink.
angry doc believes that there are no unhealthy food, only unhealthy meals. (Unless you are talking about poisonous food, and some may include food which contain trans-fat in this category...)
Conversely, there is no healthy food that does not become unhealthy if one consumes too much of it.
A calorie from slice of whole-meal bread is the same as a calorie from a slice of patoto chip, and it is not only what you put inside you that matters, but also how much of it you put inside you.
We may legislate against sale of so-called unhealthy food or their advertising, but as long as oil, starch and sugar remain cheap and available, Singaporeans will continue to have access to cheap calories.
At the end of the day, what and how much we eat is a personal choice and thus personal responsibility, except in the case of children, where it becomes the responsibility of the parents ot guardians. angry doc finds it sad that Mr Goh would rather those choices and responsibilities to be taken away.
An update on the draft MCA:
Draft Mental Capacity Bill to be fine-tuned following feedback
By Asha Popatlal, Channel NewsAsia
SINGAPORE: The draft Mental Capacity Bill will be fine-tuned, following feedback from over 140 people and organisations last year, the Ministry of Community Development, Youth and Sports (MCYS) announced in Parliament on Wednesday.
The changes will address issues such as the definitions of what constitute ill-treatment of those who are mentally incapacitated, and who can be empowered to make decisions on their behalf.
The landmark regulation was first proposed last August, and MCYS has explained that under the Mental Capacity Bill, an individual (or donor) can voluntarily plan in advance for a time when he/she may lose mental capacity to make decisions.
Through a legal document called the Lasting Power of Attorney (LPA), the donor can give another person (or donee) the authority to make decisions on his/her behalf regarding matters related to property, finance, and personal welfare, including healthcare.
The donee can be a family member, a relative, a friend or a professional.
Among the changes proposed, the Law Reform Committee suggested that the ministry define more clearly what constitutes ill-treatment and wilful neglect, which the Act criminalises.
The National Council of Social Services (NCSS) also recommended the original list of disqualifying criteria for donees to be removed.
Originally, the list excluded bankrupts and those convicted of offences involving fraud and dishonesty from acting as proxy decision makers for matters related to property and finance.
It also excluded those convicted of any sexual offence, or offences involving violence or the threat of violence.
NCSS' view was that the donor should be given a choice in who he or she would like to appoint, because sometimes the best person to be the donee is a son or relative who may have committed certain offences.
Taking this feedback into account, MCYS said it will remove the disqualifying criteria for donees, except for bankrupts, from the Bill.
MCYS will also expand the list of excluded decisions which a donee cannot make on behalf of the donor. These are: adopting or renouncing a religion; receiving treatment for change of gender; and making and revoking of any nominations made under the Conveyancing and Law of Property Act where insurance policy proceeds are concerned.
The other exclusions are: consenting to marriage or sexual relations; executing, amending or revoking a will; and making or revoking a CPF nomination.
MCYS will amend the draft Bill based on the feedback, and it will publish a code of practice to provide guidance to caregivers and professionals after the Bill is passed in Parliament.
angry doc finds it interesting that the bill will disallow a bankrupt from acting as a donee, but not someone who has a history of violence or sexual offence. It is as if we expect a criminal to be a friend or family first and a criminal second, and not the other way round, or that we allow people to exercise their judgement when it comes to character, but not if the person being judged is a bankrupt. How odd.
After a long period of speculation, we now know how means-testing for inpatients will take:
Healthier coffers, rising costs
MOH gets 19% budget boost to meet subsidy and manpower needs
Tan Hui Leng
AS Singaporeans grapple with medical costs that shot up by 7.4 per cent last year on the back of imported inflation, the Ministry of Health (MOH) is getting a rare 19-per-cent boost to its budget this year — a necessary prescription to meet the need for more manpower, rising expectations and subsidies to help patients cope.
For one, $1.9 billion will be spent over the next five years to grow the pool of doctors, nurses, pharmacists and allied health professionals by 40 per cent.
"Our doctors and healthcare professionals are overworked and at some point, they need a life too," said Health Minister Khaw Boon Wan, noting how director of medical services K Satku was "sleeping less and less", juggling between surgeries and meetings, while younger doctors were "working day and night to meet the needs for increasingly more demanding patients and relatives".
Apart from overseas recruitment — last year, 438 doctors came from abroad, nearly twice the 230 who graduated locally — the bigger budget allows for twice the number of scholarships for allied health professionals this year, plus a new overseas degree-conversion scholarship for Nanyang Polytechnic graduates.
More competitive salaries, too, are needed to retain those enticed by competitive posts abroad and even from the booming local hospitality sector.
But the bulk of the $421-million increase in the MOH's coffers will go towards subsidised patients. Indeed, direct subsidies for class B2 and C ward patients will likely exceed $1.7 billion this year, said Mr Khaw, who unveiled the finalised details of the means-testing scheme to kick in next January at public hospitals.
Sporting "more generous" criteria following feedback from public dialogue sessions and Members of Parliament (MPs), the scheme will not affect 80 per cent of Singaporeans — including all housewives, retirees and children living in HDB flats as well as lower-annual value private properties.
Patients with a personal monthly income of $3,200 or less will continue to enjoy the full subsidy of 80 per cent in class C and 65 per cent in class B2 wards. The higher up the salary scale one is, the smaller the subsidy entitlement.
"We will be flexible at the margins to help those who may appear to be of high income, but who have exceptional financial liabilities," said Mr Khaw.
Similarly, at the other end of the income scale, many of the people in need "end up paying nothing" after some help from Medifund, he said to Nominated MP Siew Kum Hong's suggestion to give an even bigger subsidy to such patients.
And while the minister acknowledged that — as some MPs pointed out — per capita household income was a better gauge of financial ability than personal income, this would be costly to implement and "intrusive to every patient". Should one feel unfairly treated, a thorough means-test can be done upon appeal.
Rising costs will continue to be a worry as health spending goes up from 4 per cent of GDP to as much as 6 per cent in the medium term, said Mr Khaw.
"Last week, (MP) Dr Ahmad Magad related a personal experience during which his daughter was hospitalised in a private hospital. He said he almost fainted when he saw the bill of $2,300 for a two-day stay."
But what is contributing partly to cost increases are Singaporeans' higher expectations. Take the 11-per-cent jump in attendance at emergency departments last year, said Mr Khaw, which creates the need for prices to be adjusted to deter non-emergency patients.
Likewise for subsidised wards, the continual upgrading of services is drawing more higher-income patients — hence, the need for means-testing.
But while the MOH's bigger budget will result in improved clinical care and hopefully shorter waits for medical services, Mr Khaw had some words of caution. Don't expect "on-demand service" like that in five-star hotels. And beware that it does not lead to a vicious cycle of even higher expectations and more cost spikes.
Non-constituency MP Sylvia Lim asked if the MOH shouldn't in fact moderate such expectations. Mr Khaw responded that even as he would be "the last one to be fanning expectations", he could not ignore the growing demands for better public healthcare standards.
For instance, one such improvement will see the bed-to-patient ratio, which stands at 1.6 per 1,000 population now, improve to 1.8 by 2015.
The news article on the CNA site gives more details, and tells us that:
"Higher income earners will get subsidies on a sliding scale of one percentage point, depending on their income range. This is capped at 65 per cent for Class C wards and 50 per cent for Class B2 wards for those earning more than S$5,200.
Economically inactive patients will also receive full subsidies unless they live in a property with an Annual Value exceeding S$11,000.
As for those who feel the simplified approach has treated them unfairly, a thorough means-test will be conducted upon their appeal and will be based on the approach that is currently used by nursing homes."
angry doc must say that he is impressed by this new scheme. It leaves a large proportion of patients unaffected, and still gives those who earn more than $3200 a month a substantial amount of subsidy (essentially they may pay B2 prices for a C class bed, or B1 prices for a B2 bed).
There are still a quirk or two in the system, like say how a family with the father as the sole bread-winner earning more than $3200 may be better off if the mother or a child fell sick since they will enjoy full subsidy, than if the father fell sick, since he will not pass the means-test and it will at the same time leave the family without income.
The actual savings in terms of subsidy not given out will probably not amount to much, especially if those who find themselves faced with a large bill and failing the means test can appeal for a 'thorough means-test'. angry doc also notes that the actual amount of money the ministry expects to save is never mentioned in any of the news articles on the subject.
At the end of the day, angry doc suspects, this scheme is probably not aimed so much at reducing government healthcare expenditure by subsidy saved alone but - despite what the minister said - a way to 'moderate expectations'; if this step in introducing the concept that one's inpatient subsidy entitlement is tied to one's wealth is accepted, then it may in the future be easier to implement it in other levels of healthcare, as it has been for nursing homes.
Whether that is a good thing or not will depend on your point of view.