MEDISHIELD SCHEME

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MEDISHIELD SCHEME:

10\. Dr Amy Khor Lean Suan asked the Minister for Health (a) how many Singaporeans have opted out of the MediShield scheme to date; (b) of these, how many are women; (c) what is the profile of these women in terms of their age, marital and employment status; (d) whether the Ministry will consider allowing those who have opted out of MediShield one last opportunity to opt in; and (e) if so, what conditions are likely to be imposed for the opt in.

Mr Khaw Boon Wan: Dr Amy Khor asked me for some MediShield opt-out data. I have earlier clarified with her that she is actually interested in the number of Singaporeans who have completely opted out of catastrophic medical insurance, and not just MediShield. Besides MediShield, Singaporeans can choose from among 15 private catastrophic medical insurance plans.

We encourage Singaporeans to subscribe to catastrophic medical insurance. Failure to do so may render one in financial difficulty in the event of a major illness resulting in a huge hospital bill. That is why we operate MediShield on an opt-out basis. Its auto-cover feature kicks

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in as soon as an individual starts working and contributing to the CPF, unless he or she opts out. Singaporeans appreciate the need for catastrophic medical insurance. Nine in ten working Singaporeans are insured under MediShield or its equivalent private insurance products.

At present, about 400,000 adult Singaporeans are not covered by any Medisave-approved catastrophic medical insurance. Of these, nearly 60% or 227,000 are women. Among these women, about 40% are above 60 years old. CPF does not have readily available information on their marital or employment status. Presumably, some opted out of MediShield after they stopped working. But the majority remain insured as they and their spouses see the benefits of continuing coverage.

Singaporeans who have opted out have the opportunity to join MediShield anytime. However, to be fair to those who have stayed loyal to MediShield, CPF would have to subject these applicants to medical underwriting and, hence, medical examinations. Therefore, we strongly advise those who are uninsured to opt in while they are healthy, to avoid future regrets.

Dr Lily Neo: May I ask the Minister whether he would consider a component to encourage people to keep fit and healthy by having incentive premiums for MediShield, eg, annual discounted premiums for those who can maintain their weight or BMI and normal blood lipids and sugar?

Mr Khaw Boon Wan: In principle, I like those features, because I am a great champion on healthy lifestyle. And if we can shape and influence behaviour that way, we should. The practical problem, of course, is how do we verify. Some of those data may be genetic. For example,

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I am genetically predisposed to high cholesterol. To say that just because of high cholesterol, you have a higher premium to pay, many Singaporeans may not find that acceptable. But if you say, "All right, if you do regular exercises, then I will give you a discount", how do you verify? Everybody would put up their hands and say, "I do regular exercise." But when you ask, "What exactly do you do?", you find that self-declaration is very difficult to verify. But I have been encouraging our private insurers to think deeply into this, because they have much more global experiences. Some of them are apparently thinking about incorporating some of these features and I am anxiously looking forward to their products.

Dr Amy Khor Lean Suan: I would like to ask the Minister, given that 60% of the 400,000 women who have opted out or are not in MediShield or any other form of catastrophic insurance, whether MOH, say, through the Health Promotion Board, would undertake any programme to encourage the whole lot, but particularly the women, since due to longer life expectancy, to actually come into the MediShield programme.

Mr Khaw Boon Wan: The short answer is, yes, because the more people are insured under any of these catastrophic plans, it is better, both for the individual as well as the society. The question is how to reach out, and we will do our best. It is always this half-empty half-full sort of phenomenon. We can certainly do better, and I intend to do more aggressively on this front. We are now trying to see where I can locate suitable points to remind.

The younger people, it is easy because, upon registration of marriages, that gives me a useful milestone to remind the couples. But for the elderly, I probably have to work with the People's Association and the various community efforts to try to reach out to them.