SINGAPOREANS WITH NO HEALTH INSURANCE COVERAGE

SINGAPOREANS WITH NO HEALTH INSURANCE COVERAGE: 14.

Assoc. Prof. Paulin Tay Straughan asked the Minister for Health (a) what is the proportion of Singaporeans who have no health insurance coverage and what is done to ease their vulnerability; and (b) with regard to the Integrated Shield plans (i) what is the proportion not covered by this additional insurance, including those who are excluded because of pre-existing health conditions; and (ii) whether this practice of private agencies willing to insure only the healthy will cause a

Column: 971

serious gap in our national healthcare system.

The Minister for Health (Mr Khaw Boon Wan): MediShield and the Integrated Shield Plans provide health insurance for Singaporeans to help take care of major illnesses which may lead to large hospital bills. MediShield is designed for patients who choose the subsidised wards, Class B2 and Class C. It now covers 84% of our total population and 93% of all working Singaporeans.

Integrated Shield Plans are provided by private insurers and they are designed for those who prefer Class A wards and the private hospitals. They cover about half of our population.

Singaporeans should subscribe to MediShield at least, and from young. The premiums are affordable and can be paid out of Medisave. The uninsured comprise two main groups: the young below 20 years and non-working spouses. For the young, we have introduced an opt-out scheme for all newborn babies since December 2007. Practically all newborn babies are now covered from birth, 98%. We are working with schools to get the students into MediShield. For example, at the time of Primary One registration, we introduce a similar opt-out scheme. And, again, the parents are very sensible, less than 4% have opted out. So it is 96% coverage. For the adults, we are working with NTUC to get their members to sign up for their spouses. This is work in progress. Overall, we aim to reduce the uninsured percentage to a single digit. And I am quite confident we can do it because the new measures introduced since December 2007 had been effective. For the whole of last year, when we had a full year implementation of these new measures, MediShield membership increased by 200,000 members.

Health insurers do not cover pre-existing conditions as they would have

Column: 972

the unintended effect of some buying insurance only when they are sick. This would be unfair to the existing policy holders.

Instead, the correct response is for Singaporeans to get insured from young, preferably soon after birth, before any health condition develops.

For commercial reasons, private insurers would prefer to only insure the young and healthy, attracting them away from MediShield, and leaving the high-risk members to MediShield. This phenomenon is known as "cherry picking" in the industry. That is why we had to restructure the health insurance industry in 2005, requiring all private Shield insurance plans to be integrated with MediShield. This way, we protect the MediShield risk pool and enable basic health insurance to remain affordable for the lower-income Singaporeans who use the Class B2 and C wards.

3.00pm

Mr Speaker: Order. End of Question Time.

[ Pursuant to Standing Order No. 22(3), Written Answers to Question Nos. 14, 21-22, 24, 26-28, 30, 34-37, 39-41 and 44-45 on the Order Paper are reproduced in the Appendix*. Question Nos. 15-20, 23, 25, 29, 31-33, 38, 42-43 and 46 have been postponed to the sitting of Parliament on 19th August 2009 .]

*Cols. 1059-1088.