Online Only -- Make Medifund criteria public
09:00 PM Sep 29, 2009
**Letter from Leong Sze Hian**
I would like to highlight some possible gaps in the multi-tier
system of Medisave, MediShield and Medifund, to ensure that
healthcare remains affordable and accessible to all
Singaporeans.
I have tried to ask many medical social workers for the criteria to
qualify for Medifund, but have been told that it is
confidential.
As I understand it, all family members' Medisave, as well as the
bulk of their savings, must be depleted, before one can qualify for
Medifund. What this may mean is that by the time one qualifies for
Medifund, the entire family may in essence be left with almost
nothing already.
Therefore, I would like to suggest that the Medifund criteria be
made public, so that Singaporeans may not have a false sense of
complacency, that if they cannot pay for medical costs, they can
always rely on Medifund.
For example, some important information that Singaporeans may need
to be made aware of, are that as I understand it, about one out of
five patients who apply may be rejected, Medifund generally cannot
be used for polyclinic out-patient treatment and medicine, patients
who are referred by a general practitioner cannot select subsidized
Class C and B2 hospital wards and medical treatment and thus cannot
qualify for Medifund, the maximum Medifund subsidy for B2 is 60 per
cent, etc.
The last time the question was asked in Parliament, the success
rate after means testing for patients who requested for
down-grading to subsidized C and B2 ward and treatment, was only
about one per cent.
Recently, it was announced in Parliament that less than one per
cent lapse their MediShield.
However, as I understand that there are about one million on
MediShield, does it mean that about 10,000 every year lapse their
cover because they cannot afford the premiums?
How many Medisave accounts have zero or less than $500? The last
statistic given by Madam Halimah Yacob, chairperson of the
Government Parliamentary Committee on Health, was that about
750,000 do not have any form of medical insurance.
For those parents whose children were born with medical conditions
which resulted in their MediShield being rejected, the stark
reality may be that the entire family's Medisave and savings may
have to be almost exhausted, before they can rely on
Medifund.
Our healthcare system may be one of the most cost-effective in the
world with GDP spending of only about four per cent, and about 75
per cent by private individuals and 25 per cent by the state.
But, for those who may fall in between the gaps in our multi-tier
system, described above, is it any wonder that practically every
study or survey have Singaporeans saying that the affordability of
healthcare is one of their greatest concerns?
URL http://www.todayonline.com/Voices/EDC090929-0000290/Online-Only----Make-Medifund-criteria-public
FYI
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Online Only - MOH: "Medifund criteria are public"
Updated 07:00 PM Oct 07, 2009
Letter from Karen Tan, Director, Corporate Communications Division, Ministry of Health
Mr Leong Sze Hian suggested that we "Make Medifund Criteria Public" (TODAY Online, Sep 29).
We do. The general eligibility criteria are published on the Ministry of Health website at http://www.moh.gov.sg/mohcorp/hcfinancing.aspx?id=346 .
In addition, the hospital Medifund committees assess each case very carefully and are free to exercise discretion in evaluating the merit of each case.
Mr Leong claimed that one out of five patients who apply for Medifund is rejected. This is incorrect. The approval rate is 99 per cent.
Mr Leong also claimed that patients referred from GPs cannot opt for Class B2 and C wards. This is also incorrect. All Singaporean patients who require admission are free to choose their ward class.
URL http://www.todayonline.com/Voices/EDC091007-0000218/Online-Only---MOH--Medifund-criteria-are-public
Copyright 2009 MediaCorp Pte Ltd | All Rights Reserved
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Online Only - Has policy been changed?
10:40 PM Oct 18, 2009
Letter from Leong Sze Hian
I refer to the Ministry of Health's (MOH) reply "MOH : "Medifund criteria are public"" (Oct 7) to my letter "Make Medifund criteria public" (Sep 29).
It states that "We do. The general eligibility criteria are published on the Ministry of Health web site".
The MOH web site merely says that the criteria is that any Singaporean
who has received subsidised medical treatment and is unable to pay for
the medical charges incurred, may approach the medical social workers at
the relevant medical institution who will help to assess eligibility for
Medifund, and can guide you in filing out the application form if required.
In other words, it is akin to saying that anyone who cannot pay can enquire.
There is no information as to what criteria is used to assess the
eligibility for Medifund.
As to "The (Medifund) approval rate is 99 per cent", with about 360,000
approved Medifund applications in a year, this refers to the approval of
applications, and not the approval rate of patients who apply.
For example, a patient who has 12 medical treatments in a year may be
counted as 12 approved applications. Whereas, the approval rate in terms
of the number of patients who apply has never been disclosed. It was
reported in 2008, that 301,126 approved applications were made by about
20,000 to 30,000 patients.
In this connection, the number of rejections increased dramatically by
2,900 per cent from 210 to 6,456 in 2006, and then declined dramatically
by 79 per cent from 6,456 to 1,266 in 2007.
What about those who were told that they do not meet the basic criteria,
which is not public information. In 2008, Madam Halimah Yacob,
chairperson of the Government Parliamentary Committee for Health,
expressed some concerns that the conditions for Medifund was too
stringent, some procedures are excluded, and that for some ailments, B2
is the lowest class of ward available which only gives a maximum
Medifund subsidy of 60 per cent.
With regards to "All Singaporean patients who require admission are free
to choose their ward class", it has been the policy for many years that
patients referred from GPs cannot opt for Class B2 and C wards.
So, when was this policy changed?
Was this change ever announced to the media or the public?
URL http://www.todayonline.com/Voices/EDC091018-0000093/Online-Only---Has-policy-been-changed