Higher spending on healthcare does not mean a healthier population: Ong Ye Kung

[Windwaver]

https://www.straitstimes.com/singapore/more-spending-on-healthcare-does-not-mean-a-healthier-population-ong-ye-kung

SINGAPORE - The Republic’s healthcare challenge in the coming years is not spending more, but to ensure that Singapore does not go the way of many OECD countries where healthcare costs are “spiralling and escalating out of control”, Health Minister Ong Ye Kung told Parliament on Wednesday.

Better health outcomes can be achieved by continuing with Singapore’s sensible and practical approach of having different layers of safety nets – subsidies, MediShield Life, MediSave and MediFund – and combining it with the Healthier SG strategy to reduce the sickness and disease burden even as the population ages, he added.

Mr Ong was responding to Progress Singapore Party (PSP) Non-Constituency MP Leong Mun Wai’s assertion on Tuesday that the Government has not spent enough to cover Singaporeans’ healthcare costs, and should be spending more to help with medical bills.

Mr Leong had cited data to show that the Government’s share of healthcare expenditure is lower than the average among Organisation for Economic Cooperation and Development (OECD) countries. The majority of the 38 OECD members are regarded as developed countries.

Mr Ong noted that it is widely accepted by health economists that spending more on healthcare does not mean better outcomes. For instance, the United States and Britain spend about 17 per cent and 10 per cent of their gross domestic product on healthcare respectively, compared with Singapore’s 4 per cent.

Despite this, both those countries are facing a high incidence of chronic illnesses and high obesity rates, and expected lifespans there are lower than in Singapore, he said.

Conversely, Singapore has delivered good outcomes given how much it is spending, while keeping healthcare affordable for the middle- and lower-income groups, Mr Ong added. Seven in 10 Singaporeans in subsidised hospital wards do not pay any out-of-pocket expenses, and nine in 10 pay less than $500 in cash.

“So when Mr Leong asked the Government to spend more to lower out-of-pocket expenses further, he really meant to channel resources to unsubsidised patients, that is, those staying in A class wards or private hospitals,” he said. “This is where the big bucks and big expenditure are, and it will push our healthcare expenditure and spending to the levels of OECD countries.”

Mr Leong also failed to mention that such spending ultimately has to be raised from the people through taxes, and made no mention of where PSP will get the funding from, Mr Ong added.

The reality is that government healthcare spending has already been rising, having tripled between 2011 and 2020, and is expected to triple again between 2021 and 2030, said Mr Ong.

Mr Leong had also called for increased spending from the Pioneer Generation (PG) and Merdeka Generation funds, as he felt that spending from those funds has been small relative to their total assets.

This understanding is misplaced as both funds were sized based on the projected lifetime cost of the benefits, said Mr Ong.

He noted that PG members are as young as 74 and “still have quite a bit of runway ahead of them”, though the Government will continue to review the adequacy of both funds.

The Health Minister also responded to Workers’ Party MP Jamus Lim’s suggestion that Singapore’s medical infrastructure is too lean, and that the current hospital bed crunch speaks to a need to relook healthcare capacity.

Mr Ong said every country is facing a similar crunch post-Covid-19, including the OECD countries despite their higher bed-to-population ratio.

The reason for the bed crunch here is that the average length of hospital stay has increased by 15 per cent compared with before the pandemic, he said. This is likely a result of more older people falling ill due to an “immunity debt” as safe management measures were lifted, a problem exacerbated by poorer health from social isolation amid Covid-19.

Singapore is catching up on healthcare capacity as projects delayed by Covid-19 – such as the Tan Tock Seng Hospital Integrated Care Hub and Woodlands integrated health campus – are now being completed, said Mr Ong.

More transitional care facilities will also be set up to offer rehabilitative care for more stable senior patients.

Closing the debate on the motion to support healthcare here beyond the pandemic, Nominated MP Tan Yia Swam responded to Mr Leong’s charge that drug prices were “marked up unreasonably for non-subsidised patients” in order to cross-subsidise others.

Dr Tan, who is a breast surgeon, asked if Mr Leong had evidence that this was happening, and noted that non-subsidised patients are those who opt for an A-class or B1-class ward, or foreigners.

“I, as a doctor, would think that allowing market forces to determine costings is fair, or would Mr Leong also want taxpayers to pay for everyone?” she asked.

Mr Leong said he had heard “feedback from residents (that) they pay different prices when in different classes”, and that while it is understandable for services to be priced differently based on ward class, this should not be the case for drugs.

The NCMP had earlier called on the Government to centralise drug procurement across public and private medical institutions, as doing so would reduce the cost of medicine.

In response, Mr Ong said Singapore deliberately chose to have a variegated market for healthcare, with private-sector doctors having different business models.

For instance, some private doctors charge very low consultation fees but make a margin on the drugs they sell, while others do the reverse, he said.

“Sometimes you want to let market forces operate, but at the same time have some discipline through... what we subsidise and what we don’t, and I think that’s how we rein in unnecessary healthcare costs,” said Mr Ong.

[Windwaver]

https://www.mountelizabeth.com.sg/patient-services/specialists/profile/tan-yia-swam

Dr Tan Yia Swam is a general surgeon at Mount Elizabeth Novena Hospital, Singapore.

Her subspecialties lie in minimally invasive breast surgery, ultrasound-guided biopsy or aspiration, breast conservation surgery, skin-sparing/nipple-sparing mastectomy, and sentinel lymph node biopsy.

Having spent more than 15 years in patient care, Dr Tan is experienced in a wide range of breast conditions including lumps, pain, nipple discharge, cancers, and abnormal imaging.

Dr Tan actively serves the medical community by sitting on the Singapore Medical Association Council since 2008, and has recently been appointed the first vice-president of the SMA Council.

She has also published and presented research in articles and journals both locally and internationally.

As recognition for her patient-centric care, Dr Tan has received the KK Service from the Heart Award in 2016 as well as the Gold Award in Singapore Health Quality Service in 2018.

She participates in outreach through educational talks to the public, family practitioners and students. Her passion and commitment to teaching has been recognised with the Dean’s Award for Teaching Excellence.

She believes in personalised treatment recommendations that respect patients’ needs and concerns.

 

[Windwaver]

Higher spending on healthcare cost should be targeted at raising salary package for public healthcare.

Just like how ministers deserve their $$, good doctors and nurses will leave for private practice if they are not paid well enough, passion will only bring you this far.

Higher spending should also go to subsidized groups of people and should shouldn't be spend on private patients especially foreign UHNW.

 

 

[Windwaver]

Now polyclinics are also pretty crowded and will only get worse with an aging population.

[Maxus-MIFA9]

There are still many healthcare cost not covered fully by personal Medisave or Medishield especially those above 60's   

Then our CPF Medisave money keep inside there for what ? 

Talk like no talk, "Ka Ki Kong, Kai Ki Song". 

Edited May 11, 2023 by Picnic06-Biante15

[Inlinefour]

Digging Ear building Polyclinic in the air 🙊🙉🙈 

[DOBIEMKZ]

On 5/11/2023 at 11:06 AM, Picnic06-Biante15 said:

There are still many healthcare cost not covered fully by personal Medisave or Medishield especially those above 60's   

Then our CPF Medisave money keep inside there for what ? 

Talk like no talk, "Ka Ki Kong, Kai Ki Song". 

Actually, I am hoping that our govt allows the use of Medisave money for funeral/wake services.

[13177]

So what OYK has said means what ah? 😅

[kobayashiGT]

On 5/11/2023 at 1:29 PM, 13177 said:

So what OYK has said means what ah? 😅

Is a vicious cycle. I make you sick, you see doctor, i earn money. With the money, i build more healthcare facilities, so i can make you even sicker. 

 

Issit like that? hahahahaha.  

[Windwaver]

On 5/11/2023 at 1:29 PM, 13177 said:

So what OYK has said means what ah? 😅

Means he very proud of the 4% we spend compared to 17% 

No $$ just stick to seeing doctors that keep changing.

[mersaylee]

Get good celery doesn't mean will make good million...ehh...we need healthier choice...😁

[Victor68]

I must say our poly clinics are very good liao. No need for those A class hospitals lah. Got money want to spend more, go private hospitals. 

More importantly, must have enough health care service providers in public clinics. Not enough Singaporean qualify to do medical or we don't want too many? Something government got to seriously reconsider lah.

This healthcare not related to child Brith rate lah. It is the high cost of living for housing. All lifetime saving pumped into one area.

Edited May 12, 2023 by Victor68

[Mustank]

On 5/11/2023 at 12:43 PM, DOBIEMKZ said:

Actually, I am hoping that our govt allows the use of Medisave money for funeral/wake services.

Hahaha when my time draws near, I will tell my sons don’t claim my body. Let Govt deal with it 😬

[Kopites]

On 5/11/2023 at 12:43 PM, DOBIEMKZ said:

Actually, I am hoping that our govt allows the use of Medisave money for funeral/wake services.

Do you want to see another new thread on EV?😞

[Benarsenal]

On 5/12/2023 at 12:09 PM, Victor68 said:

I must say our poly clinics are very good liao. No need for those A class hospitals lah. Got money want to spend more, go private hospitals. 

More importantly, must have enough health care service providers in public clinics. Not enough Singaporean qualify to do medical or we don't want too many? Something government got to seriously reconsider lah.

This healthcare not related to child Brith rate lah. It is the high cost of living for housing. All lifetime saving pumped into one area.

Have you seen our polyclinics? For the longest time the wait there has been ridiculous. If want to see doctor please be prepared to wait at least half a day.

Heard recently become worse, they even turn away patients because simply cannot cope.

[Victor68]

On 5/12/2023 at 1:54 PM, Benarsenal said:

Have you seen our polyclinics? For the longest time the wait there has been ridiculous. If want to see doctor please be prepared to wait at least half a day.

Heard recently become worse, they even turn away patients because simply cannot cope.

So far my appointment time is fairly accurate leh. I go to Bukit batok brand

[Windwaver]

Has anybody asked about the pay scale of our healthcare professionals compared to some other countries ivory tower refuses to compare?

We really need to retain good and hands-on doctors in public healthcare.

[Mrmilktooth]

On 5/11/2023 at 6:02 PM, mersaylee said:

Get good celery doesn't mean will make good million...ehh...we need healthier choice...😁

Investing alot money on our kids education don’t mean they will score top grades neither. I think he probably said something most of us knows…

😂