Hospitalisation Bills of Foreign Workers and Medical Insurance for Low-wage Local Workers

Assoc Prof Fatimah Lateef asked the Deputy Prime Minister and Minister for Manpower what options are available to assist with the payment of large hospitalisation bills that exceed the cap payable by employers' insurance policies which are incurred by foreign workers and foreign domestic workers in the course of their employment here.

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Er Dr Lee Bee Wah asked the Deputy Prime Minister and Minister for Manpower given that employers are to provide medical insurance for foreign workers to cover their inpatient care and day surgery (a) what is the rationale for not extending this regulation to employers of local workers; and (b) whether the Ministry will consider mandating employers to provide local low-wage workers coverage for their medical treatment and hospitalisation.

The Minister of State for Manpower (BG [NS] Tan Chuan-Jin) (for the Deputy Prime Minister and Minister for Manpower): Mr Speaker, Sir, may I take the next two questions together?

Mr Speaker: Yes, please.

BG [NS] Tan Chuan-Jin: Employers are required to provide for the healthcare needs of both their local and foreign workers. However, employers face different obligations due to the different context of subsidies available for each group.

The Government does not give any healthcare subsidies to foreigners, including foreign workers. When employers bring in foreign workers for the short term, we must ensure that foreign workers' medical bills do not remain unpaid and instead get passed on to our taxpayers. This would be unfair to our society at large.

Therefore, MOM requires all employers who wish to bring in foreign workers to bear the full costs of employing these workers, including bearing the cost of medical treatment for their S Pass and Work Permit holders, including foreign domestic workers. This condition is stated clearly when they apply for work passes.

At times, employers may face financial difficulties meeting the foreign workers' medical bills and their needs, especially for day surgery or inpatient bills which tend to be larger. Mandatory employer-financed medical insurance for day surgery and inpatient expenses was introduced in 2008, for each Work Permit and S Pass holder employed. The minimum medical insurance coverage was set at a basic level in order to keep premiums affordable for the vast majority of employers. Employers are free to purchase insurance coverage of any higher amount for better peace of mind.

We regularly review whether the minimum medical insurance coverage is adequate. In 2010, in response to feedback from employers, we raised the minimum insurance requirement from $5,000 to $15,000. Where the worker's medical bill exceeds the insurance coverage, or is excluded by the insurance provider, the employer will have to pay the difference.

Employers who still have difficulties in paying medical bills beyond the insured amount may approach the relevant healthcare provider to discuss various options, such as instalment payments. We encourage employers to avail themselves of higher insurance coverage, beyond the minimum requirement, if they wish to have greater protection and peace of mind.

Local workers, on the other hand, are on a quite different and stronger footing with regard to Government subsidies and employer contributions. First, the Government provides heavy subsidies for Singaporeans, of up to 75% for outpatient treatment at polyclinics, and up to 80% for inpatient care at restructured hospitals. Second, employers are required to contribute monthly to local employees' CPF, including their Medisave Accounts. Third, the 3Ms framework, consisting of Medisave, MediShield and Medifund, exists for Singaporeans to provide for their long-term healthcare needs. The Government fully funds Medifund, and also provides top-ups to the Medisave accounts of Singaporeans, particularly for older Singaporeans and those in the lower-income groups. The Medisave component of the GST Voucher package also gives them a regular, annual top-up.

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The Government will keep refining its policies to ensure that healthcare costs are kept manageable for Singaporeans, and that nobody – and I repeat - nobody in need will be denied of medical treatment.

Mr Speaker: Er Dr Lee Bee Wah. Please keep it short. We only have a couple of minutes.

Er Dr Lee Bee Wah (Nee Soon): Sir, I would like to ask the Minister, in the case of foreign workers, there is mandatory medical coverage. But for the same illness, when the workers go to hospital, our local workers, very often, if they are not covered by the employers, they would have to foot the bill themselves. This is the disparity. There is no mandatory medical coverage for the local workers. I would like to ask the Minister whether there is any plan to introduce mandatory medical coverage for local workers.

BG [NS] Tan Chuan-Jin: I would like to thank the Member for the supplementary question. Let me reiterate the principles governing this approach. In the first place, why we have these mandatory requirements for employers to cover for foreign workers is precisely because we expect the employers to pick up the tab and not for Singaporean taxpayers to foot the bills for the foreign workers. So, it is covered by insurance.

Singaporean employees are covered under the comprehensive schemes provided. Under section 89 of the Employment Act, the employers are also required to bear the cost of medical examination for employees who have been in service for three months or more for the purpose of determining if the employees are entitled to paid sick leave. The medical examination has to be performed by the medical practitioner appointed by the employer or a medical officer appointed by the Government or approved medical institution. Over and above that, as mentioned earlier, we have the MediShield, Medifund and Medisave schemes where we try to provide coverage for Singaporeans. At the same time, insurance is also provided, depending on individuals, as they take up insurance policies in the market. Subsidies are also provided for Singaporeans for hospitalisation.

The approach is different and it is important not to look at it from the perspective of whether it is fair or unfair. The whole point is that, for foreign workers on employment in Singapore, they have to be paid for by their employers so that the taxpayers do not pay for the bills.

Going forward, as has been highlighted in the various discussions, and especially during the Budget debate, healthcare costs and healthcare provisions for Singaporeans form an important area that we continue to work on. And as highlighted, going forward, healthcare spending is something that we are watching carefully and we will make sure that comprehensive coverage is provided. As reiterated earlier – and let me make this quite clear – no Singaporean who does need medical treatment will be denied medical treatment because he or she cannot afford to cover the cost.

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3.00 pm

Mr Speaker: Order. End of Question Time. Ministerial Statement. Deputy Prime Minister and Minister for Home Affairs.

[ Pursuant to Standing Order No 22(3), Written Answers to Question Nos 16-18, 29-30, 32, 39-41, 43-47, 49-50, 53, 57-60, 62, 65-68, 71, 73, 78, 80-83 and 85-87 on the Order Paper are reproduced in the Appendix (Pg 318-342). Question Nos 19-28, 31, 33-38, 42, 48, 51-52, 54-56, 61, 63-64, 69-70, 72, 74-77, 79 and 84 have been postponed to the next available sitting of Parliament. ]