COS 2012: Increasing MediShield coverage and benefits

MediShield is a government-administered insurance scheme that is meant to help cover the costs of major hospital bills. Unfortunately, some of those who need MediShield coverage the most, like babies with congenital problems and the very old, are often denied coverage.

Parliament

Committee of Supply Debate, 7 March 2012 (Ministry of Health)

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Mr Chairman,

MediShield is a government-administered insurance scheme that is meant to help cover the costs of major hospital bills. Unfortunately, some of those who need MediShield coverage the most, like babies with congenital problems and the very old, are often denied coverage.

MediShield currently covers 92% of Singaporeans . Those who are not covered include some of the elderly, homemakers, and others who have voluntarily opted out of MediShield. Some are not able to obtain MediShield coverage due to pre-existing conditions.

I would like to ask what the Ministry is doing to achieve a higher level of coverage for all Singaporeans? What is the Ministry’s targeted level of coverage of MediShield?

Currently new-borns with congenital conditions are either denied MediShield coverage completely, or have their conditions excluded from coverage. This does nothing to relieve the financial hardship that parents of these children may face.

In order to ensure that these children are adequately covered under MediShield, will the Ministry consider providing pregnant women an option to buy a MediShield rider to cover for any congenital problems or prematurity-related complications? This should naturally be done before any problems are diagnosed. It would be a one-off payment for the rider, and it could be actuarially adjusted upwards for older women, as they are at a higher risk of having babies with congenital problems or prematurity-related complications.

This will provide the insurance coverage if the baby is later diagnosed with a problem, yet it would ensure a large enough risk pool to cover the potential pay outs. Overall, this change should not require any increases in premiums.

As proposed during my Budget debate speech, will the the Ministry consider doing away with the age cap of 90 years old for MediShield altogether? There are only about 11,000 Singaporeans aged above 90 , we should be doing all we can to help this small group of seniors who have made it this far, instead of denying them the insurance coverage when they need it the most. Beyond age 90, many of them may have outlived their own children or siblings, and have no direct relatives to support them.

I note that some enhancements to MediShield coverage may require premium increases. However, based on the Minister’s reply to my Parliamentary Question, between 2006 and 2010, MediShield collected an average of $131 million more in premiums each year than it paid out in claims .

While I appreciate the need to set aside a portion of the premiums as reserves, can the Ministry re-look at whether the premiums collected can be used to cover at least part of the increased coverage, instead of passing the additional cost entirely to policy holders?

Currently, MediShield premiums vary widely according to members age, from $30 per year for those aged below 30, to $1,123 for those in their 80s. This imposes a heavy burden on older members, many of whom may be retired or have exhausted their Medisave. If premiums need to be increased to cover the additional claims, can they be increased for working adults instead the elderly?

Author: Gerald Giam

Gerald Giam is the Member of Parliament for Aljunied GRC. He is a member of the Workers' Party of Singapore. The opinions expressed on this page are his alone.

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