Subsidy and Other Preoccupations 20
It's not fair, is it? Making angry doc angry on a Sunday morning...
Means testing on track for implementation in January 2009
By May Wong, Channel NewsAsia
SINGAPORE : The government is on track to implement means testing in January next year at all public hospitals.
Health Minister Khaw Boon Wan said preparations are on-going to link up with agencies like the Central Provident Fund Board and the Inland Revenue Authority.
Means testing helps to focus healthcare resources to needy Singaporeans, with low-income citizens receiving higher government subsidies.
Mr Khaw was speaking to reporters after launching a campaign on colorectal cancer on Saturday.
Means testing will ensure lower-income Singaporeans have access to subsidised wards like C-class hospital beds.
This scheme will also ensure such beds are not overcrowded by those who can afford higher medical bills.
Mr Khaw said: "I expect a January implementation which is hassle free and ought to be uneventful. (The) majority will not have a problem with means testing and (for) a small minority of high-income patients, the criteria are very generous, so they'll be expected to pay a little bit more, but not a lot more. (It will be) well within their affordability level. So Singaporeans need not worry."
It doesn't quite add up, does it?
Let's look at the statements angry doc highlighted in turn.
"Means testing helps to focus healthcare resources to needy Singaporeans, with low-income citizens receiving higher government subsidies."
While the statement is technically true, it is misleading: "low-income" citizens are not going to enjoy higher subsidies than they already do now; instead, "high-income" citizens are going to enjoy lower subsidies than they already do now.
As the minster put it:
"a small minority of high-income patients... they'll be expected to pay a little bit more, but not a lot more."
How much more is "a little bit more"?
A patient with monthly a income of $5,201 and above will receive a 65% subsidy for Class C instead of the usual 80%, while a patient whose income falls between $3,201 and $5,200 will receive a subsidy of between 65-80%.
Given that "the scheme will not affect 80 per cent of Singaporeans", this means that (assuming similar bill sizes between the two groups) even if we assume that the 20% of patients who fail means testing all receive only 65% subsidies instead of 80%, we stand to 'save' 6.25% of spendings in terms of subsidies*. angry doc agrees with the minister that this is "not a lot".
If we take into account the fact that some of these 20% of patients would not have chosen to stay in a C-class bed to begin with, means testing or no, then the 'savings' will be even less than 6.25%.
So let's say means testing allows us to "focus" this 6.25% in "resources" to low-income patients; will it "ensure such [subsidised] beds are not overcrowded by those who can afford higher medical bills"?
angry doc doesn't think so, since according to the FAQ on Means Testing on the MOH site:
"Patients will still retain their freedom to choose their ward class. Any patient, regardless of whether they are rich or poor, can choose to be admitted to a Class C or B2 ward. They will still be heavily subsidized, but at different rates."
So they are free to choose their ward class, they are "heavily subsidized", but the MOH nevertheless expects them to *not* choose a C-class bed. Interesting.
And if they are still free to choose a C-class bed (and who wouldn't? It *is* "heavily subsidized"!), will means testing still "ensure lower-income Singaporeans have access to subsidised wards like C-class hospital beds"?
angry doc will leave his readers to answer that question for themselves.
* - angry doc's maths is poor, so do let him know if he made a error there.