MEDISAVE ACCOUNT

MEDISAVE ACCOUNT:

(Average savings of Singaporeans): 2.

Dr Lim Wee Kiak asked the Minister

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for Health (a) what is the average amount of Medisave a Singaporean has upon reaching the retirement age of 62 years; and (b) following the higher withdrawal limit for Medisave, if there has been a corresponding increase in the utilisation of private paying wards in the restructured hospitals.

Mr Khaw Boon Wan: Mr Speaker, Sir, as at end-2005, Singaporeans aged between 61 and 65, have an average Medisave balance of $11,700. So it is about $12,000. This can cover about 10 normal episodes of Class B2 hospitalisations.

On 1st April, 2006, we raised the inpatient withdrawal limit for Medisave from $300 to $400 per day of hospitalisation. The purpose is to help Singaporeans cope with their hospitalisation cost, particularly for those who choose to stay in the unsubsidised wards.

Prior to this, Medisave covered, on average, 67% and 52% of the Class B1 and Class A/private hospital bills respectively. After the change, the Medisave coverage has increased to 76% and 57% respectively, reducing the patients’ out-of-pocket expenses. The change has also benefited patients in Class B2/C. They can now use Medisave to pay for more than 95% of their bills. So, it is practically the full amount.

Dr Lim asked if the change has led to more patients in restructured hospitals opting for private wards. The evidence based on five months of data does not support such a view. I am glad that patients have remained prudent in their choice of wards in accordance with what they can afford. This will help conserve their Medisave balances for their future needs.

Dr Lim Wee Kiak (Sembawang): Mr Speaker, Sir, I would like to ask the

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Minister for Health whether the current amount in the Medisave is enough, keeping in mind that we are liberalising and allowing Medisave to be used for more chronic illnesses. So for a person having diabetes at 40 years old now, or hypertension as well, the question is whether there will be enough Medisave by the time he actually retires.

Mr Khaw Boon Wan: Indeed, I am very concerned about this particular topic because $11,000 or $12,000 is a five-digit figure, but it is not a big number, bearing in mind that you have many years to go. With medical science, life expectancy is growing every decade by a year or two. So, really, people should look at Medisave carefully and try to conserve, and that is the reason I have to be the very unpopular gatekeeper now and then when Members put up their hands and say, "Please, can I use Medisave for this and for that?", I have to always bring them back to the original purpose of Medisave, which is for costly hospitalisation. So when it is for outpatient treatment, a few dollars, or even if it is tens of dollars, please pay for it out of your pocket and conserve the amount in Medisave for the old age, especially at the time when you will not be working. That is why it took us 20 years after we introduced Medisave to decide to make a major change, which is from inpatient to outpatient, but even then to restrict it to 4 chronic illnesses and we have to restrict it carefully. We have started it for four diseases. Implementation so far has been smooth. It is a little bit of leap of faith. If all patients follow, comply with the instructions of their doctors and manage their chronic illnesses while they are still mild, the hope is that we can avoid very costly complications 20 or 30 years down the road. So, on a life-time basis, hopefully, you save money and not just deplete your funds. That is why for the extension of this scheme to other illnesses, we restrict it to those where

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there are clear-cut disease management protocols and not just for any kind of outpatient treatment. Because if it is purely consumption without any impact on the future health, then I think we should not do so.

Dr Lim Wee Kiak: One last supplementary question. Since the Medisave is mainly used for hospitalisation as well as more serious disease, the question is, for the poor, they cannot really afford the amount of money to use for health screening. Will the Ministry consider in the future or near future to allow Medisave to be used for health screening, especially for the poorer population so that they can detect their disease at an early stage to avoid costly treatment later on?

Mr Khaw Boon Wan: Health screening is a most interesting topic. It covers a wide field. There are a lot of self-interested parties with personal interest at play when they push for certain kinds of screening. For one, some of those esoteric health screenings cost hundreds, if not thousands, of dollars to pick up things which often the patient would die before that thing kills him. That means he dies of something else and not because of that. Because the scanning technology is now so advanced, you can pick up all sorts of things. Nobody is perfect and we have all kinds of problems with us in the body but we may not die of those things, but die of something else. But if you pick it up, and the US begins to coin a term called "pre-disease", you are in fact healthy people, but if you are pre-diseased, you are pre-diabetes, you are pre-whatever, it merely caused you so much anxiety and, of course, along the way some of the hospitals may come in to say, "Do this, do that." And because in the US, they allow advertising of prescription drugs, you are just making the population hypochrondriac. And when they go to the doctor, they ask, "Please

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prescribe this, please prescribe that.", and the money just run out but, at the same time, their health does not improve.

So, for screening, please take it with, shall I say, "a pinch of salt". All I know is some of the most effective health screenings which really make sense, which really prolong life and improve health are rather inexpensive, which is, what is your blood pressure, your cholesterol level, and those basic tests are really very cheap which most people can afford. If you cannot afford it, as MPs, as organised by Dr Lily Neo for many years, we do it on a community level and we can help subsidise them. But for those esoteric $600 or $700 type of screening, if you feel that it will benefit you, please pay for it yourself and do not look to me for subsidy or for Medisave to be used.