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MPs wrap two-day debate on MediShield Life

Is the national universal healthcare insurance scheme affordable for all citizens and can it be sustained? These were some of the issues raised in Parliament over the past two days. 

SINGAPORE: Concerns about MediShield Life subsidies, the sustainability of the scheme and greater regulation of Integrated Shield Plans were some of the issues raised by 24 Members of Parliament who took part in the debate on the national universal healthcare insurance scheme over the past two days.

Affordability of premiums

Some MPs described MediShield Life as a forward-looking policy. But concerns about the affordability of premiums remained. While permanent subsidies will be given to lower- and middle-income groups, those staying in residences with an Annual Value of above S$21,000 will not receive any.

Some MPs felt tagging subsidies to properties would exclude vulnerable groups. Associate Proffessor Fatimah Lateef, who is MP for Marine Parade GRC, pointed out that these may include retirees who purchased their homes many years ago at affordable prices, or who inherited these properties. “They may not be very cash-rich. Even if they are eligible for the Pioneer Generation Package now, come 2019, their premiums will be relatively high without the subsidies," she said.

One suggestion by MP Denise Phua was to have a universal flat subsidy for all Singaporeans, with additional means-testing for those with lower incomes.

Is the scheme sustainable?

The sustainability of MediShield Life was also on the minds of some MPs. Holland-Bukit Timah MP Christopher de Souza questioned if Singapore's rapidly ageing population would affect MediShield Life premiums in the long term. "Essentially, this looks good and feels good now, but how will it be funded to ensure it is a financially sustainable endeavour that will remain in existence 30 or 40 years down the road?" he asked. 

More  flexibility for pensioners? 

Workers' Party MP Png Eng Huat asked if pensioners who already have medical benefits for life could be given the choice of whether to join MediShield Life.

"To mandate pensioners to join the scheme may have the opposite effect if they end up on the short side of the benefits," he said. "The Government has already made the provision to guarantee pensioners medical benefits for life. This guarantee should stand for pensioners who wish to remain status quo."

Integrated Shield Plan

MPs also weighed in on Integrated Shield Plans. Some felt the Government should have a greater role in the proposed standard Integrated Shield Plan for class B1 wards.

Potong Pasir MP Sitoh Yih Pin suggested that private insurers concentrate solely on class A wards and private hospitals. "If the service product is standardised, and unique to restructured hospitals and the insurance product is standardised, in theory at least, there is little economic sense for there to be many provider," he said.

"In fact, a single insurance provider will enjoy economies of scale, and better risk pooling. Hence, I would like to call on the Government to consider taking over the administration of IPs for B1 services just as it does for the B2 and C services. If it does so, it can also institute certain elements that private insurers are very hesitant to practice, such as front-loading of premiums and coverage of pre-existing diseases."

Dr Lily Neo asked the Health Ministry to also consider capping premiums of B1 Integrated Shield Plans within certain parameters and regulating the premium increases. "With this B1 plan in place, it would set the benchmark for other integrated shield plans and thus it will be easier for policy holders to compare and make choices before commitment," the Tanjong Pagar MP said.

Other issues raised included greater public education on MediShield Life and encouraging collective responsibility across the community and healthcare institutions.

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