Good Evening Ministers, I am Shahirah. I was just wondering, because healthcare costs
seem to be making up quite a big part of the Budget (and I am acually directing it to Dr Amy Khor
in particular), what are some of the ways that people like me, or even older than me - not just those
in the Pioneer Generation - what can we do to better manage healthcare costs and what
are some of the incentives for them. Thank you.
and affordable, so cannot say it's not affordable any more (to excess healthcare services and so on).
The concern now is that will we over-consume,
will it lead to spiralling healthcare costs. How to contain this cost.
And then, of course, will it lead to higher demand at the hospitals, SOCs and so on.
So maybe just let me briefly touch on this since there's always this question, and it's
also related to PT's question about costs and whether eventually we will increase taxes anot.
Basically, from our perspective, if you increase
subsidies and then there's universal insurance coverage for everyone, of course there is
this concern that there may be more demand for these services and lead to over-consumption.
So in fact, we tackle this through a multi-pronged approach - it's a holistic approach, that
means we look at different angles. Firstly, of course, you look at technology
as well as the model of care to try and manage costs.
But one of the key things that we need to do, and which we always preserve in our healthcare
financing framework is that there has to be co-payment.
So even for SOCs, if you go to SOCs or polyclinics, there will be some co-payment.
Even in insurance, actually there is a co-insurance, co-payment portion.
We need to keep this co-payment in order to ensure that there is personal or self responsibility,
so that you make your choices - your lifestyle choices, healthcare choices, treatments and
so on - and then exercise some financial prudence because there is a co-payment portion.
What we do now is to make sure that this co-payment is affordable, but there must be some personal
responsibility and even from the healthcare provider's perspective.
The other thing, of course, is we need to see how we can transform model of care and
perception (mindset), encourage people to go to GPs - primary care sector, polyclinics,
GPs - and only on the advice of GPs and the family physicians, if they need to go to
see a specialist at the specialist outpatient clinic or go to hospitals then they go because
those are costlier. So if you don't over-consume, that will help
to contain costs. If you go to GPs and family physicians, again,
that is less costly, that will help to manage costs.
That is really part of our transformation of the model of care.
That's why you find that we have actually implemented CHAS because we want to encourage
people to go, and of course there will be enhanced subsidies for CHAS now for the Pioneer
Generation Package. So it's not just about enhanced subsidies
at SOCs, but also at polyclinics and then through CHAS.
Every Pioneer Generation member will get the CHAS card so that they get subsidised care
at the GPs, and of course they can go to the polyclinics.
And then right sighting, as in if you need to go to the hospital, we need to discharge
you when appropriate to the right setting - whether it's community hospitals, nursing
homes, home care, community care. So we are enhancing that because, again, that
is lower costs - hospitalisation and all that is really very costly.
It's not just about occupying a bed. It is also actually about costs.
So these are various ways that we do, and of course, at the public healthcare institutions,
we make sure that there is very strong clinical protocol for the healthcare provider - make
sure that they give you cost effective treatment, drugs and practices.
Again, to make sure that you are financially prudent - exercise financial prudence, and
that also will help to contain costs. Otherwise, if you over-consume, you go for
unnecessary treatment or you go for treatment that is not cost-effective, again, that will
lead to higher costs. So these are things that we do.
But having said that, over the long-term, because population age, there is more demand
for healthcare as well as the fact that when you get higher quality care - medical advancement,
technological advancement - I think inevitably costs will rise but we need to contain it
as much as possible. And I hope that will allay some of your worries.
Of course, after we implement all these, we need to keep a close watch also on costs.
Follow-up question on managing healthcare costs, and this time I think the question
is very apt and is a very good question. How do I manage my own healthcare expenses.
I think earlier on, I did elaborate quite briefly on the different ways that from our
perspective, how we manage and how we try to contain healthcare costs.
What about the individual perspective, and that leads me to - I think actually, ultimately, first
of course not over-consuming because you do need to pay for your own healthcare costs anyway.
So you basically need to come to your own decision,
make wise decisions about the kind of treatment you want to take,
whether you want to go A-class ward, private hospital - that kind of thing, you need to make your
own decisions. It must be appropriate decisions.
And of course, treatment based on your doctor's advice.
So you don't go for unnecessary screening, unnecessary tests and so on and so forth.
That is from the over-consumption point of view, from your perspective.
But I think ultimately, really, the best way to contain healthcare expenses - costs to you -
is to adopt a healthy lifestyle (healthy living).
If you don't smoke, exercise regularly, the chance of you needing medical treatment is
less or you can delay or defer the onset of chronic diseases for instance, and of course
preventing it from getting even more serious. That will definitely save you significant
healthcare costs, and that's one of the reasons why MOH and HPB, we are going to promote aggressively
healthy living as well as preventive healthcare and we are coming up with a masterplan for this.