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SINGAPORE: From the middle of next year, patients will be able to get up to 80 percent in subsidies regardless of whether they enter class B2 or C rooms of public hospitals, the Ministry of Health announced on Friday (March 5). (MINSA). ).
Currently, 50 to 65 percent of the hospitalization bill for ward B2 is subsidized, while this proportion is 65 to 80 percent for bills for ward C.
Making the announcement in Parliament during his ministry’s Supply Committee debate, the Minister of State for Health, Dr. Koh Poh Koon, said that the inpatient acute subsidy framework will also apply to daytime surgeries. Currently, these surgeries are subsidized at 65 percent.
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“This will increase subsidies for 70 percent of outpatient surgery bills and encourage outpatient surgeries rather than hospital admission when appropriate,” he said.
The move away from the “legacy system” comes in line with a change in the resource testing base for patients admitted to acute care hospitals.
Currently, the basis of the means check for these patients is their monthly income. Beginning in mid-2022, resource tests will be conducted based on per capita household income (PCHI).
The Ministry of Health said that this “better reflects the means of the patient, since it takes into account the general financial resources of the household compared to the number of household members who support themselves with that income.”
“With the adoption of PCHI, we now have a better basis for resource assessment in the acute inpatient setting and no longer need to rely on our legacy system of using room choice as a means of differentiating subsidy levels.” , a said the spokesman for the Ministry of Health.
Dr. Koh said that in his clinical practice and during Meet-the-People sessions, he has seen how the sole earners can earn a high individual income, but take full responsibility for the needs of their household.
“For these people, the costs of health care can become a significant strain, and I have great sympathy for them,” he said.
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He added that the physical differences between rooms B2 and C “are no longer so obvious” due to improvements in infrastructure to raise patient safety and infection control standards.
However, although the subsidy level will be unified for classrooms B2 and C, the charges for patients in rooms C will continue to be lower than the B2 charges.
“Your out-of-pocket costs would still be higher in B2 because the original bill, the unsubsidized bill, would be higher in B2,” the Health Ministry said.
Most patients receiving subsidies will not see a change in their out-of-pocket payments, the ministry said.
About a third of patient bills, mainly from households with a lower PCHI, will see an average decrease in such payments of around S $ 150, the Health Ministry said. On the other hand, 15 percent of patient bills, mainly from households with a higher PCHI, will see an average increase of around S $ 200.
INCREASE IN SANITARY EXPENDITURE
The subsidy changes come as Singapore’s health spending is expected to increase as its population ages, the incidence of chronic diseases increases, and the accessibility and quality of care improves.
In the last financial year, government spending on patient subsidies is projected to reach S $ 6.5 billion compared to S $ 4 billion five years ago, the Health Ministry said.
While the Government will continue to set aside a larger health care budget over time to support the needs of the population, “we must ensure that our resources are distributed in a way that better targets those who need more support,” said the Ministry of Health. The grants should also encourage patients to seek care in the most appropriate healthcare settings, he added.
“These changes to the subsidy framework fine-tune our system to achieve these goals,” the Health Ministry said.
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CHANGES TO SUBSIDIES IN COMMUNITY HOSPITALS
The Ministry of Health also announced changes to subsidies for patients in community hospitals and specialized outpatient clinics.
The maximum level of subsidy in community hospitals will be raised from 75% to 80%, in a measure to facilitate the “proper placement” of patients. This will align with that of acute hospital care. The minimum subsidy level in community hospitals will also be raised from 20 to 30 percent. In general, almost all patients will see an increase in subsidies, the Health Ministry said.
The average size of daily bills is lower in community hospitals, and therefore subsidy levels are lower as well, the Ministry of Health explained.
Community hospitals are playing an increasingly important role in Singapore, the Health Ministry said. These hospitals provide key services such as rehabilitation and subacute care for patients with complicated medical conditions, but who do not require the more intensive care that is provided in hospitals.
Most subacute and rehab patients are expected to benefit from higher subsidies. After taking MediShield Life claims into account, about 60 percent of community hospital patient episodes will cost less in copayments. The average decrease in co-payment will be about S $ 120, the Health Ministry said.
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CHANGES IN ALLOWANCES IN SPECIALIZED CLINICS FOR AMBULATORY PATIENTS
In specialty outpatient clinics, lower-income families receive subsidies for 60 to 70 percent of their bills, while all other patients receive 50 percent in subsidies.
Two new levels of subsidy will be introduced. Patients whose PCHI exceeds S $ 3,300 and up to S $ 6,500 will receive a 40 percent subsidy. Those with PCHI over S $ 6,500 will receive a 30 percent subsidy.
“These changes will allow resources to be distributed to those who need them most,” said the Ministry of Health.
About 30 percent of all subsidized patients from specialized outpatient clinics, mainly from homes with higher PCHI, will see an increase in their bills, the Ministry of Health said. Of those, 70 percent will see less than S $ 100 increase in total copay in one year.
In another change, patients who choose to be admitted to wards A or B1 of public hospitals will be eligible to receive subsidies at specialized outpatient clinics in case they require follow-up visits at these clinics. About 20 percent of inpatient admissions today are in private wards of this type, the Health Ministry said.
“Some of these patients who require a long list of follow-ups in specialist outpatient clinics after discharge have concerns about affordability,” the Health Ministry said. Your eligibility will be based on the resource verification framework.
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Taken together, the changes do not result in a reduction in government spending on patient subsidies, the Health Ministry said.
“These latest comprehensive grant changes will allow us to ensure that our grants are progressive, so that those with the greatest need, especially low- to middle-income households, receive the support they need, while encouraging patients to seek care in settings appropriate for your medical needs. It will also contribute to a more streamlined health system, ”said the Ministry of Health.
Starting in June this year, the Flexi-MediSave limit will be raised from S $ 200 to S $ 300 per year to better support elderly patients, the Ministry of Health added.
The Flexi-MediSave scheme allows patients 60 years and older to withdraw from their own or their spouse’s MediSave account to pay for outpatient expenses at polyclinics, public specialty outpatient clinics, and CHAS GP clinics. The scheme can also be used in conjunction with other MediSave outpatient schemes.
