insurance

Insurance coverage for persons with disabilities or special needs

My speech in Parliament during the Committee of Supply debate (Prime Minister’s Office).

Persons with disabilities or special needs often receive inadequate insurance coverage to protect themselves. Even if they manage to get insured, the scope of coverage and insured amount is often limited. MAS is proposing to issue guidelines to insurers that they should not indiscriminately reject an application solely based on declared personal information such as a disability.

Mr Chairman,

Instead, insurers are expected to carry out an objective assessment of every application based on reliable information or data relevant to the risks being insured. However, even under the new proposed guidelines, insurers are not prohibited from declining applications, setting higher premiums or applying conditions in view of the risks presented by an applicant with a disability.

Can the Minister explain when these guidelines will be issued, and how they will be materially different or more beneficial to persons with disabilities or special needs?

Cost of cancer treatment

The upcoming changes to the insurance coverage of cancer drugs not on the Ministry of Health (MOH)’s Cancer Drug List may affect patients with rare cancers, who may find themselves saddled with far higher bills for unsubsidised drugs.

On 4 July 2022, I asked the Minister for Health two Parliamentary questions on this issue:

Mr Gerald Giam Yean Song asked the Minister for Health (a) whether the Ministry has assessed to what extent the new limitations on insurance coverage and Medisave use for cancer drug treatments will impact doctors’ treatment decisions for their patients based on their clinical judgement; and (b) how it will affect patient care for those suffering from less common cancers.

Mr Gerald Giam Yean Song asked the Minister for Health whether his Ministry plans to establish and fund a National Cancer Care Appeals Board consisting of doctors from different specialties to discuss appeals from doctors on behalf of individual patients with complex cancers for whom standard therapies may be inappropriate or ineffective, review real world evidence and make timely decisions on whether to allow insurance coverage and Medisave use for off-label drugs or drugs not on the Cancer Drug List.

Senior Parliamentary Secretary (Health) Rahayu Mazam responded to my questions on 5 July 2022. After her answer, I asked her several supplementary questions:

I’m not sure if my question on the introduction of a National Cancer Care Appeals Board was answered. I understand from the Agency for Care Effectiveness (ACE) website which SPS just referred to that it takes 10-11 months from the time pharmaceutical companies submit their pre-submission form to ACE, to the time the Drug Advisory Committee (DAC) meets. However, for individual cancer patients for whom time is of the essence, anything more than one week may be too long to wait for a decision on a drug subsidy approval. Can we therefore have a National Cancer Care Appeals Board which can make rigorous yet speedy decisions to subsidise drugs for individual patients, to allow these patients to get the life-saving drugs they need? The DAC can then take the necessary time to review the drug for inclusion on the Cancer Drug List to benefit patients at the national level.

Secondly, has MOH modelled out how many patients per year will be adversely affected by these changes to the insurance policies, how much in cost savings are expected, and what is the price in human lives that MOH is prepared to accept in order to achieve these cost savings?

The SPS’ replies will be published in the Parliament Hansard and reported in the media.

Govt considers covering congenital illnesses under MediShield

MediShield should be run on social principles, to ensure that no child, no adult, no elderly person is left behind because of their inability to pay.

I am glad to read that, in response to the calls from several Singaporeans, including Tan Kin Lian and myself, the government is now considering covering under MediShield, the national health insurance scheme, children with congenital illnesses.

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MediShield should cover congenital illnesses

If CPF Board can cherry pick who to insure and who to reject, then what makes it different from any profit-oriented private insurance company?

Two letters to the Straits Times forum in the past week shed light on a little known fact that our national health insurance scheme, MediShield, does not provide the universal coverage that many Singaporeans would have expected it to.

On September 2nd, a parent wrote in to express dismay that his newborn daughter was refused MediShield coverage because she was born with a suspected cyst in her lungs, a condition diagnosed during pregnancy. He said the CPF Board, which manages MediShield, denied her coverage, citing “the higher insurance risk posed by her pre-existing health condition”.

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