MEDISAVE (Withdrawal limits)

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MEDISAVE:

(Withdrawal limits): 13.

Dr Tan Sze Wee asked the Minister for Health (a) whether, with advances in medical science resulting in shorter hospital stays and more day surgeries, the higher Medisave daily withdrawal limits will translate into patients paying a smaller proportion of hospital charges out of their own pockets; (b) whether the Ministry will consider having a higher limit for the first few days of hospital stay; and (c) whether the Ministry will consider reviewing the limits for surgical procedures, which are based on the Table of Surgical Procedures (TOSP) which has largely been unchanged since its launch more than 10 years ago.

The Minister for Health (Mr Khaw Boon Wan): Mr Speaker, Sir, from 1st April, patients will be able to withdraw from their Medisave accounts to pay for their hospitalisation at a higher daily withdrawal limit of $400. This is a substantial increase from the current rate of $300.

Dr Tan asked if the higher Medisave withdrawal limit would mean patients paying less of their hospital bills out of their pockets. The answer is yes. Indeed, that is the objective of the exercise.

Current Medisave withdrawal rules were set with Class B2/C patients in mind and this should remain the primary objective of Medisave.

However, incrementally, for the middle-income group who have larger Medisave balances and would normally use Class A/B1 wards or private hospitals, we should allow them to use more of their

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Medisave balances to pay for their hospital bills.

This can be done in various ways. We can raise the daily limit by $X and increase the surgical table claim limits at the same time. Or we can allow a larger $X daily limit but keeping the surgical table claim limits unchanged.

Yet another alternative is to have multiple daily claim limits, allowing higher claims for the first few days of hospitalisation, as suggested by Dr Tan.

I decided to go for a simple solution by simply raising the daily withdrawal limit substantially from $300 to $400.

The impact will be significant. On average, a Class B1 hospitalisation bill would be covered up to 76%, ie, more than three-quarters by Medisave, therefore, reducing co-payment in cash to 24%, while a Class A bill would be covered up to 62%, thus reducing the cash co-payment to 38%. Patients will save hundreds of dollars in their out-of-pocket expenses.

For Class B2 and C patients, the change will enable practically all of them to have their hospital bills fully covered by Medisave, without their having to dip into their pockets.

My next task is to see how Medisave can be used for costly outpatient care, especially for those with chronic illnesses.

But even as we liberalise the use of Medisave, I must remind our patients to remain prudent in their choice of hospitalisation class and use of medical services. Medisave is for a rainy day when one is old and no longer employed. So better not deplete it prematurely.

Dr Tan Sze Wee (Nominated Member): Mr Speaker, I thank the Minister for the clarification to my question. I would like

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to pose a supplementary question. In view of the fact that Medisave will be raised in terms of daily withdrawal limits as well as the utilisation and outpatient selected use, will the Minister consider raising the ceiling on the balances on Medisave as well. This is because the Medisave balance that is in each person's Medisave account will probably be higher for those who could contribute more, and because of the fact that the utilisation amount is going to rise over time.

Mr Khaw Boon Wan: I think the Member is referring to the Medisave contribution ceiling (MCC). Once you hit this ceiling, and if you continue to contribute, the excess will then go to the Special Account. I remember Mdm Halimah, on several occasions, had also argued for the lifting of this ceiling. It is something that we can take a look. But if the worker continues to work and therefore builds up his contributions, once we change the flow rate, and allow greater withdrawals for higher classes, then his balance will come down, below the ceiling. When they work, they will continue to build up their balance again. So it is quite a dynamic situation. But certainly it is an idea which we will take into consideration.