There will be more targeted subsidies for patients in Singapore, said Minister of Health Gan Kim Yong during the Ministry of Health (MOH) Committee of Supply debate on Friday (Mar. 5).
With an ageing population and rising incidence of chronic diseases, government expenditure on subsidies increased to S$6.5 billion in FY2020, compared to S$4 billion just five years ago.
Means testing basis changed to per capita household income (PCHI)
First, MOH announced in its press release that it will change the basis of means-testing from a patient’s individual monthly income to PCHI for acute impatient subsidy framework.
PCHI will be computed as the gross household monthly income, divided by the total number of family members living in the household.
In his speech, Gan said that aligning the means-testing basis to PCHI would be more reflective of patients’ means, rather than relying on the personal income of the patient.
For example, an income earner supporting a family of four would get more subsidies than an income-earner with the same income, but with only one dependent.
In other words, if you are a primary breadwinner with relatively high individual income, but many dependents, you would benefit from more subsidies with this change.
Changes in the Community Hospital Subsidy Framework
Gan also said that MOH will enhance subsidies in CHs, with almost all patients experiencing an increase in subsidies.
The maximum subsidy level at the CH will be raised and aligned with that of acute inpatient at 80 per cent of the hospitalisation bill.
The minimum subsidy level at the CH will also be raised to 30 per cent.
The revised community hospital subsidy framework will apply to sub-acute and rehabilitative care at CHs.
Changes in the Specialist Outpatient Clinic subsidies
Lowering subsidies for higher income household income patients
Two new subsidy tiers impacting higher income household families, whose PCHI is above S$3,300, will be introduced.
MOH said that this is meant to allow resources to be distributed to those of greater need, as currently, both median and higher-income households enjoy the same subsidies (at 50 per cent) although they have different means.
The two tiers are: Patients with PCHI between S$3,300 and S$6,500 will have subsidies set at 40 per cent, while those with PCHI more than S$6,500 will have subsidies set at 30 per cent.
For a family of four, these PCHI levels correspond to household incomes of S$13,200 and S$26,000 a month respectively.
Higher-income households will still continue to be eligible for SOC subsidies, and be able to tap on MediSave (up to the applicable withdrawal limits) to help pay for their healthcare bills. MediShield Life will also remain an option for selected costly outpatient treatments.
Allowing private patients from inpatient setting to opt for subsidised follow-up care
In the outpatient setting, Gan also announced that private inpatients would be allowed to opt for subsidised follow-up care at SOCs.
MOH said this will kick in from mid-2022.
Currently, private inpatients at public hospitals (i.e. A or B1 wards) are not eligible for subsidies in SOCs post-discharge.
The move, said MOH, is meant to increase accessibility to subsidised SOC consultations, and address concerns over the affordability of subsequent outpatient costs for patients from private A/B1 wards.
The amount of subsidy available will be based on means testing.
Image courtesy of MOH
According to MOH, 20 per cent of inpatient admissions are expected to benefit from this revision, as this is approximately the percentage admitted today to private wards.
More details about the new subsidy frameworks would be revealed closer to the implementation dates, added MOH.
Top image via Angelo Sumayao/Google Maps