Singapore

Age profile of MediShield policyholders

I asked the Minister for Health on 21 October 2013 for the number of MediShield policyholders in each age group. Here was his written reply to my parliamentary question.

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Mr Gerald Giam Yean Song asked the Minister for Health how many MediShield policyholders are currently in age ranges of (i) 0-20 years (ii) 21-30 years (iii) 31-40 years (iv) 41-50 years (v) 51-60 years (vi) 61-65 years (vii) 66-70 years (viii) 71-73 years (ix) 74-75 years (x) 76-80 years (xi) 81-83 years (xii) 84-85 years and (xiii) 86-90 years.

Mr Gan Kim Yong (Minister for Health):

As at June 2013, 3.6 million members, or 93% of the resident population, were covered under MediShield. The breakdown of MediShield policyholders by age group is presented below.

Age Group	MediShield Policyholders
0-20	881,800
21-30	505,100
31-40	598,500
41-50	598,200
51-60	537,800
61-65	189,200
66-70	106,300
71-73	51,500
74-75	29,700
76-80	46,800
81-83	16,500
84-85	6,300
86-90	2,600
Total	3,570,200

The maximum coverage age for MediShield was recently raised from 85 to 90 years in March 2013, in view of the increasing life expectancy of Singaporeans. As a next step, with the proposed move to MediShield Life, we will be studying enhancements to provide universal, lifetime coverage for all Singaporeans, including the most elderly.

MediShield’s capital adequacy ratio

At the 21 October 2013 Parliament sitting, I asked the Minister for Health about the reserves and Capital Adequacy Ratio (CAR) of MediShield, the government-run health insurance scheme. The MediShield Fund has $507 million in net assets (as at December 2012). The purpose of this question was to find out what proportion of this $507 million consisted of reserves and capital set aside to meet MAS regulations for insurers. I also wanted to find out what was the target CAR of MediShield. In his answer, the Minister said that MediShield’s CAR was 165% as at the end of 2012. This means that the scheme has enough capital set aside to fund up to 165% of its claims in 2012. While MAS requires a minimum threshold of 100-120%, MediShield is in fact aiming for a CAR 200%.

This was a follow up to my parliamentary question on 21 November 2011, when the Minister told me that “(b)esides funding current claims, a portion of MediShield premiums is set aside as reserves in line with the Monetary Authority of Singapore (MAS)’s Risk-based Capital framework. Beyond the reserves, MediShield is also required to set aside a certain sum of capital, to meet MAS’s risk requirements and keep the Fund solvent in case of adverse risks.”

In his answer on Monday, the Minister said that MediShield’s CAR was 165% as at the end of 2012. This means that the scheme has enough capital set aside to fund up to 165% of its claims in 2012. While MAS requires a minimum threshold of 100-120%, MediShield is in fact aiming for a CAR 200%.

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Mr Gerald Giam Yean Song asked the Minister for Health regarding the $507 million in net assets of the MediShield Fund at the end of 2012 (a) how much of this represents (i) reserves set aside to fund the expected scheme liabilities (ii) capital set aside to meet MAS’ risk-based capital framework requirements for insurers; (b) what is the quantum of (i) reserves and (ii) capital set aside for each of the years from 2005 to 2012; and (c) what is the minimum Capital Adequacy Ratio (CAR) that MediShield targets to maintain over and above the minimum CAR of 100% required by MAS.

Mr Gan Kim Yong (Minister for Health):

MediShield is a self-sustaining and not-for-profit insurance scheme. This requires setting aside sufficient reserves in the MediShield Fund to meet its liabilities, expected risks and target Capital Adequacy Ratio (CAR).

Between 2005 and 2012, on average, about 65% of the MediShield Fund comprised reserves to fund the expected scheme liabilities. Scheme liabilities include policyholders’ claims as well as premium rebates to help policyholders with old-age premium affordability.

The remaining portion of the Fund, which is what Mr Giam has referred to in his question as “net assets”, is capital from which the MAS-based risk requirements are financed. CAR is computed as the ratio of these “net assets” to the MAS-based risk requirements.

The member also asked about the CAR that the MediShield Fund targets to maintain. While the minimum CAR is 100%, MAS requires funds to meet a minimum threshold CAR of 120%, below which a “financial resources warning event” is triggered and the regulator may intervene. No prudent insurance fund operates by holding only the absolute minimum requirement, otherwise a small variation in claims would immediately cause a breach. Reserves and capital numbers change from year to year as claims payout changes and the Fund’s assets are marked-to-market. As at end 2012, the CAR of MediShield Fund is about 165%. The MediShield Fund has set a target CAR of 200% to ensure that the Fund is able to meet its liabilities to policyholders even in adverse scenarios. This target is in line with industry best practices.

MediShield liabilities and reserves are reviewed on an annual basis in line with actuarial principles.

Median cash-over-valuation (COV) for resale HDB flats

Mr Gerald Giam Yean Song asked the Minister for National Development if he can provide the figures for the median Cash-Over-Valuation for resale HDB flats by town and flat type in each quarter since 2nd Quarter 2007, with a breakdown of buyers by (i) Singapore citizen (SC) households (i.e. households with at least one SC owner) and (ii) Singapore permanent resident (SPR) households (i.e. households with SPR but no SC owners).

Parliament sitting date: 16 September 2013

Mr Gerald Giam Yean Song asked the Minister for National Development if he can provide the figures for the median Cash-Over-Valuation for resale HDB flats by town and flat type in each quarter since 2nd Quarter 2007, with a breakdown of buyers by (i) Singapore citizen (SC) households (i.e. households with at least one SC owner) and (ii) Singapore permanent resident (SPR) households (i.e. households with SPR but no SC owners).
Mr Khaw Boon Wan : Detailed Cash-Over-Valuation (COV) data, provided there are sufficient transactions during the quarter, with breakdown by town and flat type are published in the HDB InfoWEB and updated quarterly. HDB, however, does not monitor the detailed breakdown as requested by the Member.

We do have some breakdown of COV data by buyer group, as tabulated below:

Source: Singapore Parliament Reports (Hansard)

Tax concessions given to foreign nationals

Mr Gerald Giam Yean Song asked the Deputy Prime Minister and Minister for Finance (a) how many foreign nationals or entities have been exempted from paying the 10% additional buyer’s stamp duty (ABSD) from 8 December 2011 to 11 January 2013, the 15% ABSD since 12 January 2013 or any other stamp duties when buying residential properties in Singapore because of free trade agreements (FTAs); (b) what is the total amount of stamp duties exempted for these individuals or entities; and (c) whether any FTAs currently under negotiation, including the Trans-Pacific Partnership, have similar concessions for foreign nationals or entities.

Parliament sitting date: 16 September 2013

Mr Gerald Giam Yean Song asked the Deputy Prime Minister and Minister for Finance (a) how many foreign nationals or entities have been exempted from paying the 10% additional buyer’s stamp duty (ABSD) from 8 December 2011 to 11 January 2013, the 15% ABSD since 12 January 2013 or any other stamp duties when buying residential properties in Singapore because of free trade agreements (FTAs); (b) what is the total amount of stamp duties exempted for these individuals or entities; and (c) whether any FTAs currently under negotiation, including the Trans-Pacific Partnership, have similar concessions for foreign nationals or entities.

Mr Tharman Shanmugaratnam : Under the “national treatment” obligation of the US-Singapore FTA (USSFTA) and the Singapore-European Free Trade Association FTA (ESFTA), Singapore is obliged to accord Nationals of the United States of America, and the Nationals and Permanent Residents of Switzerland, Norway, Liechtenstein and Iceland, similar tax treatment as Singaporeans in the purchase of residential properties in Singapore 5 .

These are the only two FTAs where “national treatment” has been accorded to foreign individuals in respect of taxes, which include stamp duties. Otherwise, foreign entities do not enjoy Additional Buyer’s Stamp Duty (ABSD) remission.

For the period 8 Dec 2011 to 11 Jan 2013, there were 138 residential property transactions by foreign individuals granted ABSD remission due to the two FTAs. For the period 12 Jan 2013 6 to 31 Jul 2013, there were 114 transactions granted ABSD remission. These transactions are about 1.5% of all property transactions that attracted ABSD during the period.

The amount of ABSD which has been remitted for these 252 transactions was $81.2 million.

Negotiations on other FTAs like the Trans-Pacific Partnership are still ongoing. MTI will continue to seek a balanced package in our FTA negotiations to ensure that the FTAs provide meaningful benefits for Singapore, while taking into account the costs.

Source: Singapore Parliament Reports (Hansard)

Compulsory vaccination for children

Parliament sitting date: 16 September 2013

Mr Gerald Giam Yean Song asked the Minister for Health (a) what is the rationale for some vaccinations, including the pneumococcal disease vaccination, under the National Childhood and Adolescent Immunisation Schedule which are required for Primary 1 registration being chargeable for Singaporeans at polyclinics; and (b) whether the Ministry will consider making all vaccinations under the Immunisation Schedule free for Singaporeans.
Mr Gan Kim Yong : To help parents defray the cost of childhood vaccinations, the use of Medisave was extended to cover the cost of all vaccinations in the National Childhood Immunisation Schedule (NCIS), up to $400 per account per year from June 2013. The Government has also provided a Medisave Grant of $3,000 for all newborn Singaporeans which can be used to pay for these vaccinations.

In addition, vaccinations under the NCIS that confer strong herd immunity against the respective diseases for the whole population are offered free for citizens at the polyclinics. In doing so, we hope to encourage higher up-take of these vaccinations and achieve adequate coverage for the population.

Parents are required to produce records of their child’s immunisation certificates at Primary One registration, for BCG, diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella and hepatitis B, all of which are free for citizens at the polyclinics.

MOH will continue to regularly review the financing framework of the NCIS to ensure its relevance and affordability to Singaporeans.

Source: Singapore Parliament Reports (Hansard)

Waiting list for HDB subsidised rental flats

Mr Gerald Giam Yean Song asked the Minister for National Development (a) what is the current number of applicants on the waiting list for HDB subsidised rental flats; and (b) when will this waiting list be cleared.

Parliament sitting date: 16 September 2013

Mr Gerald Giam Yean Song asked the Minister for National Development (a) what is the current number of applicants on the waiting list for HDB subsidised rental flats; and (b) when will this waiting list be cleared.

Mr Khaw Boon Wan : There are 1,900 registered applicants on the waiting list for public rental flats. On average, the applicants will be allocated a flat within 7.5 months. However, the actual waiting time for each applicant differs, depending on the zone selected, the choice of flat type, as well as the EIP quota for the block and the neighbourhood.

Source: Singapore Parliament Reports (Hansard)

Projected increase in MediShield payouts under MediShield Life

I asked this question during the 16 September 2013 sitting of Parliament. I wanted to find out how much more in claims MediShield is expected to bear under the proposed MediShield Life scheme, which is going to cover all Singaporeans, including those above the age of 90 and those with pre-existing health conditions. I was expecting the Government to have already done its actuarial calculations to arrive at an answer. However, the Minister was not ready to reveal the numbers yet (or perhaps the full calculations had not been done yet).Singaporeans will need to wait until at least next March (i.e., the Committee of Supply debate) to find out the details of the MediShield Life scheme.

One thing is clear: Claims are going to go up. The question therefore will be: How much more will premiums rise, and will the Government be prepared to step in the reduce the premium burden on Singaporeans?

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Mr Gerald Giam Yean Song asked the Minister for Health what is the projected annual increase in MediShield payouts if (i) all Singaporeans and Permanent Residents are enrolled (ii) all pre-existing, congenital and neonatal conditions are covered and (iii) the maximum coverage age is removed.

Mr Gan Kim Yong (Minister for Health): Mdm Speaker, as part of the overall healthcare financing review to ensure that healthcare remains affordable for all Singaporeans, MOH is studying the introduction of better coverage for large bills and moving to life-long MediShield coverage for all Singaporeans.

As the move to MediShield Life is a major policy shift, we will have a public consultation exercise later this year to seek Singaporeans’ views on the proposed MediShield Life. The details and costs of the MediShield Life, including the likely impact on the payouts from MediShield Life if all pre-existing conditions and all residents are covered for life, are currently under study. More details will be shared during the public consultation exercise.

Mr Gerald Giam Yean Song (Non-Constituency Member): Madam, I have three supplementary questions. First, my concern is that the increased coverage will also come with higher premiums. While I support the increased coverage, my concern is that these higher premiums will be a financial burden on some members, especially the elderly and the low income. So, my questions are: Is the Government planning to subsidise MediShield Life premiums as part of its overall plan to increase the healthcare budget, because currently MediShield is completely self-funding and receives no Government subsidies? Secondly, can the Government provide more details about the Pioneer Generation Package that was announced during the National Day Rally? Would it be means tested and what is the cut-off age? Lastly, when will the full details of MediShield Life be announced?

Mr Gan Kim Yong : Mdm Speaker, first let me explain that today, the Government already indirectly subsidises MediShield because the Government provides top-ups into Medisave, and Medisave is being used to pay for the premium for MediShield. So, indirectly there is Government subsidy for MediSheild, particularly for the lower income. Going forward, with MediShield Life, as the Member has rightly pointed out, with enhanced benefits, the pay-outs will increase and that is the objective of enhancing the benefits, and therefore the premium has to go up as well.

The Government is very conscious about the impact of higher premiums and therefore we have already made the commitment that we will make sure that the lower income as well as the older Singaporeans who may not have sufficient savings will be looked after. We will make sure that the premiums, with Government subsidies, will be affordable for them. That is the first question.

The Member also asked about the Pioneer Generation Package. The details are being worked out now. In due course, we will reveal more details on who will qualify for Pioneer Generation Package, and what is provided for in the Pioneer Generation Package. I urge the Member to be patient and we will reveal that in time.

Last question is about the details of MediShield Life. We will have a public consultation. We are still working on MediShield Life and what form it will take. But the key parameter is that we want to make sure that all Singaporeans will be included and they will also be included throughout their lives. Therefore, we will remove the age limit on MediShield Life.

As for the other features, for example, how we can enhance the payouts, how we can help to reduce the co-payment especially for the larger bills, these are the details that the Ministry is working on now. During the public consultation, we will share more details. And we hope to be able to give even more details, and the broad shape of the scheme by the next Committee of Supply (COS) debate.

Source: Singapore Parliament Reports (Hansard)

Malaysian-Registered Motor Vehicles Entering Singapore

Parliamentary Question to the Transport Minister on 12 August 2013.

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Mr Gerald Giam Yean Song asked the Minister for Transport (a) in each of the last six months, how many Malaysian-registered motor vehicles entered Singapore, with a breakdown by (i) nationality of the vehicle registrant (ii) vehicle type and (iii) duration of stay in Singapore; and (b) what are the allowable reasons for Singaporeans residing in Malaysia to enter Singapore with Malaysian-registered vehicles.

Mr Lui Tuck Yew : In the last six months, foreign-registered vehicles made about 9 million trips into Singapore, or about 1.5 million trips per month. About 67% are made by motorcycles, 24% by cars and the remainder by goods vehicles, buses and taxis. More than 90% of these trips are of duration two days or less, with about 80% of one day duration only. We do not have statistics on the nationality of the vehicle owners.

Under the Road Traffic Act, Singapore Citizens and Permanent Residents are not allowed to drive or use foreign-registered vehicles in Singapore, unless they meet certain conditions. They must prove that they work and reside in West Malaysia, and have paid the relevant Singapore registration fees and taxes for these vehicles as if they were registered in Singapore. Furthermore, they are allowed to drive their Malaysian-registered vehicles into Singapore only for up to 28 weekdays a year, in addition to weekends and Singapore public holidays. Similar to foreigners driving foreign-registered vehicles into Singapore, they must pay the applicable Vehicle Entry Permit fee, which is $20 per day for cars, when they enter Singapore, and the vehicles must not stay in Singapore for more than 14 days per visit.

LTA takes strong enforcement action against individuals who drive or use a foreign-registered vehicle illegally. The maximum penalty is a fine of up to $5,000 or imprisonment of up to six months.

Companies Participating in the Travel Smart Scheme

Gerald Giam Yean Song asked the Minister for Transport (a) how his Ministry plans to increase the number of companies participating in the Travel Smart scheme from the current 12; (b) what is the Ministry’s target number of participating companies; and (c) what tangible incentives does the Government plan to give companies to implement flexi-work options so as to spread out peak hour commuter load on public buses and the MRT.

I asked the Transport Minister on 12 August 2013 about the Travel Smart Scheme, in which companies commit to implementing flexi-work options such as staggering working hours or tele-commuting.

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Mr Gerald Giam Yean Song asked the Minister for Transport (a) how his Ministry plans to increase the number of companies participating in the Travel Smart scheme from the current 12; (b) what is the Ministry’s target number of participating companies; and (c) what tangible incentives does the Government plan to give companies to implement flexi-work options so as to spread out peak hour commuter load on public buses and the MRT.

Mr Lui Tuck Yew : The Travel Smart project is a pilot study to help understand the impact of various organisational practices and interventions in shaping the travel patterns of employees. The 12 participating organisations, with a total of 25,000 employees, will develop and implement Travel Smart Action Plans, which include initiatives like flexi-work measures, and installation of shower and locker facilities and cycling facilities, amongst others. Each of the 12 organisations can claim up to $20,000 from LTA’s Travel Smart Reimbursement Grant to subsidise their costs. We will also be looking into customising travel incentive programmes together with the Travel Smart organisations to further encourage their employees to shift their travel times outside of the morning peak period.

Preliminary feedback has been encouraging. We will review the results in early 2014 before deciding how best to expand the programme.

Aside from Travel Smart, the Ministry of Manpower and the Singapore Workforce Development Agency had launched a one-stop programme called “WorkPro” on 1 April this year to build progressive workplaces for their employees. WorkPro includes a Work-Life Grant that provides funding support of up to $160,000 to help employers implement and sustain the use of flexi-work arrangements such as flexi-time to improve work-life harmony.

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Source: Singapore Parliament Reports (Hansard)

Indonesia’s Agreement to Share Concession Maps to Tackle Haze

Gerald Giam Yean Song asked the Minister for the Environment and Water Resources (a) to what extent will Indonesia’s agreement to share digitised concession maps of its forests on only a case-by-case and government-to-government basis help with the identification of errant companies engaging in slash-and-burn practices; (b) what are the situations in which Indonesia has agreed, or not agreed, to share their concession maps; and (c) whether any date has been set for the launch of the ASEAN Sub-Regional Haze Monitoring System (HMS) platform.

My Parliamentary Question following up on the haze issue, asked during the 12 August 2013 sitting.

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Mr Gerald Giam Yean Song asked the Minister for the Environment and Water Resources (a) to what extent will Indonesia’s agreement to share digitised concession maps of its forests on only a case-by-case and government-to-government basis help with the identification of errant companies engaging in slash-and-burn practices; (b) what are the situations in which Indonesia has agreed, or not agreed, to share their concession maps; and (c) whether any date has been set for the launch of the ASEAN Sub-Regional Haze Monitoring System (HMS) platform.

Dr Vivian Balakrishnan : Haze is caused by the burning of forests because this is the cheapest way to clear land. The Ministers of the Sub-Regional Ministerial Steering Committee (MSC) on Transboundary Haze Pollution agreed to explore sharing concession maps and the use of satellite and mapping technologies to monitor hotspots and identify errant companies. Singapore was at the forefront of this effort by developing the technology platform to enable this – the ASEAN Sub-Regional Haze Monitoring System (HMS). The overlay of Indonesia’s concession maps on the hotspot data will help to pinpoint which plantation companies are responsible for illegal slash-and-burn practices.

Unfortunately, the agreement that was reached among the Ministers at the 15th MSC meeting held on 17 July 2013 fell short of Singapore’s recommendation: a fully functioning system populated with comprehensive accurate concession maps overlaid with hotspot locations accessible to the general public. Unfortunately, Indonesia claimed there were legal impediments to greater transparency. Consequently, we could only get a consensus to adopt the joint haze monitoring system with data shared at the Government-to-Government level, subject to the ASEAN Leaders’ approval at the ASEAN Leaders’ Summit in October 2013.

Nevertheless, even if the maps can only be shared on a Government-to-Government basis, the HMS should enable governments to identify errant companies and take appropriate enforcement action against them. We therefore hope that ASEAN will launch the HMS with the relevant country concession maps promptly in October 2013. We also hope Indonesia will ratify the ASEAN Agreement on Transboundary Haze Pollution as soon as possible.

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Source: Singapore Parliament Reports (Hansard)