![](https://i.imgur.com/CLvY2jA.png")
08-01-2022, 09:30 AM
We had sort of band aid a few years ago to patch the medishield to become medishield life. If this was not done many people hospitalised would end ip with big bills because the original medishield was inadequate.
Besudes this the govt raises medisave sum to cope with rising costs that people have to pay when medishield life insurance fail to cover. The moderately affluent S'poreans cover themselves with integrated plans to patch the gaps should they get sick but the premiums are rising and is not affordable for poorer Singaporeans.
The collective policy actions to contain the govt's cost and gradually increase the healthcare burden shouldered by citizens is on an unsustainable trajectory. Medical cost inflation is at double digits while wage increase of a large segment of the population is in the low single digits.
A few years ago Koh Boon Wan mooted the idea of allowing medisave to be used in selected Malaysian hospitals so it can last longer for many situations that medishield fail to cover. Although the report says Malaysian hospitals cost half, people on the ground knows it cost less than a quarter. Because of covid19, I have not be able to go to Johor for my dental. I have not been able to get treatment at polyclinic that is timely ( they tell me available dates are 6 months out). I believe I have been paying more than 300% in excess of what I normally pay.
![[Image: pQ2WYsj.jpg]](https://i.imgur.com/pQ2WYsj.jpg)
The big elephant in the room is why is medical cost so high in Singapore and why is it rising so fast. Thus has to be studied in greater detail for us to go ahead sustainably.
I believe it is due to many factors the govt has failed to control. I have often said good governance in Singapore is actually an illusion once you begin a closer examination - as investors just look at all the shit that happened on SGX when Tharman was in charge of the MAS.
Back to the issue of medical costs potential factors:
1. Rising bureaucracy at health care facilities. Many positions that do not directly treat patients have been created. These could be sue to regulation or bloat.
2. Salaries of doctors and specialists have been rising very fast as private sector hospitals lure them for medical tourism. We have millionaires and billionaires who come to Singapore for treatment willing to pay top dollar. You have to use your average wage to compete with what billionaire's are willing to pay when they get sick. Healthcare is a scare resource being rationed to ordinary citizens but also sold gohighest bidder. This will break. I don't expect highly paid politicians to ever so something about highly paid doctors.
3. Excessively selective and restrictive entry to medical school leading to insufficient doctors. We reject people with good grades from medical school then hire to patch the shortfall from India and Phillipines. I am not sure if that leads to high costs but it is another thing that does not make any sense here and nothing has been done about it.
4. Does the govt attempt to recover land costs used to build hospitals?
5. Do we have collective negotiations with big pharmaceutical companies to drive cost down. Recent years big pharma maximise their profits by selective pricing by looking at average GDP of a country. Unfortunately due to high income gap Singapore has high average GDP and a disproportionate number with low income wage earners.
If we don't rein in the medical cost spiral whatever we implement just kick the can down the road and break at some point in time.
The medical cost issue requires proactive management and significant action. I will mot resolve itself.
Besudes this the govt raises medisave sum to cope with rising costs that people have to pay when medishield life insurance fail to cover. The moderately affluent S'poreans cover themselves with integrated plans to patch the gaps should they get sick but the premiums are rising and is not affordable for poorer Singaporeans.
The collective policy actions to contain the govt's cost and gradually increase the healthcare burden shouldered by citizens is on an unsustainable trajectory. Medical cost inflation is at double digits while wage increase of a large segment of the population is in the low single digits.
A few years ago Koh Boon Wan mooted the idea of allowing medisave to be used in selected Malaysian hospitals so it can last longer for many situations that medishield fail to cover. Although the report says Malaysian hospitals cost half, people on the ground knows it cost less than a quarter. Because of covid19, I have not be able to go to Johor for my dental. I have not been able to get treatment at polyclinic that is timely ( they tell me available dates are 6 months out). I believe I have been paying more than 300% in excess of what I normally pay.
The big elephant in the room is why is medical cost so high in Singapore and why is it rising so fast. Thus has to be studied in greater detail for us to go ahead sustainably.
I believe it is due to many factors the govt has failed to control. I have often said good governance in Singapore is actually an illusion once you begin a closer examination - as investors just look at all the shit that happened on SGX when Tharman was in charge of the MAS.
Back to the issue of medical costs potential factors:
1. Rising bureaucracy at health care facilities. Many positions that do not directly treat patients have been created. These could be sue to regulation or bloat.
2. Salaries of doctors and specialists have been rising very fast as private sector hospitals lure them for medical tourism. We have millionaires and billionaires who come to Singapore for treatment willing to pay top dollar. You have to use your average wage to compete with what billionaire's are willing to pay when they get sick. Healthcare is a scare resource being rationed to ordinary citizens but also sold gohighest bidder. This will break. I don't expect highly paid politicians to ever so something about highly paid doctors.
3. Excessively selective and restrictive entry to medical school leading to insufficient doctors. We reject people with good grades from medical school then hire to patch the shortfall from India and Phillipines. I am not sure if that leads to high costs but it is another thing that does not make any sense here and nothing has been done about it.
4. Does the govt attempt to recover land costs used to build hospitals?
5. Do we have collective negotiations with big pharmaceutical companies to drive cost down. Recent years big pharma maximise their profits by selective pricing by looking at average GDP of a country. Unfortunately due to high income gap Singapore has high average GDP and a disproportionate number with low income wage earners.
If we don't rein in the medical cost spiral whatever we implement just kick the can down the road and break at some point in time.
The medical cost issue requires proactive management and significant action. I will mot resolve itself.
I, being poor, have only my dreams; I have spread my dreams under your feet; Tread softly because you tread on my dreams.
![[+]](https://sgtalk.net/images/bootbb/collapse_collapsed.png)
