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SINGAPORE – To ensure that people who need financial help with their medical bills get a higher share of government subsidies, the current schemes will be renewed in mid-2022.
Acute hospitals, which now base subsidies on an individual’s income, will switch to per capita household income (PCHI) instead, the means test format now used by other public health services.
Explaining the measure during his ministry’s spending debate, Chief Minister of State for Health Koh Poh Koon said that PCHI “also considers the amount of family support available and the number of household members that the individual supports.” .
There will also be a single subsidy range for the two classes of subsidized districts, B2 and C, ranging from 50 to 80 percent.
Today, the subsidy is 50 to 65 percent in B2 and 65 to 80 percent in class C.
The change will mean higher subsidies for lower-income patients who opt for class B2 and lower subsidies for higher-income patients in class C.
Subsidies for outpatient surgery will follow the same format rather than having a single subsidized rate of 65 percent.
The idea is that the higher subsidy encourages patients to opt for outpatient surgery instead of staying in the hospital, when possible.
“This will increase subsidies for 70 percent of outpatient surgery bills and encourage outpatient surgeries rather than hospital admission when appropriate,” said Dr. Koh.
The ministry has decided to allow patients who opt for private class A or B1 rooms to receive subsidized follow-up treatment at specialized outpatient clinics (SOC) if they so desire.
In his 20 years of practice, Dr. Koh said he has come across SOC-funded patients who had preferred a private room because “some preferred air conditioning and others wanted more privacy.”
But patients in these private rooms remain private patients for follow-up treatments.
Said Dr. Koh: “They were concerned about the cost of a long line of SOC consultations after discharge. For this reason, these patients have sometimes had to give up their preference and request a subsidized room instead.”
With the change, they will be entitled to the subsidy based on their PCHI. Now, about 20 percent of patients in public hospitals opt for classes in private rooms.
“With better targeted subsidies on SOCs, we will now allow private patients in the hospital setting to opt for subsidized or private SOC for their post-discharge follow-up.”
However, people with a higher PCHI will receive fewer subsidies in SOCs. The lower subsidy rate will drop from 50 percent to 30 percent for people with PCHI above $ 6,500.
Health Minister Gan Kim Yong said this will channel more subsidies to those most in need.
About 30 percent of patients are expected to pay more in SOCs once the changes take effect in 2022, although for two out of three, the increase should be less than $ 100.
To encourage more people to get the right level of care, the subsidy in community hospitals will more closely mirror the subsidy in an acute care hospital. However, it will not be identical.
Now patients who require longer-term care, such as rehabilitation, may be reluctant to transfer to a community hospital because of the lower subsidy they receive there.
Subsidies to community hospitals now range from 20 to 75 percent for citizens. It will change from 30 to 80 percent.
Dr. Koh said that with MediShield Life’s higher claim limits for community hospitals starting this month, the higher subsidy “should make community hospitals more affordable, especially compared to an extended hospital stay.” .
About 95 percent of patients should benefit from the largest community hospital subsidies.
All of these changes “will ensure a more targeted use of our healthcare resources, stretch our healthcare money and encourage appropriate care,” said Mr. Gan.
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