Posts Tagged ‘Medisave’

Bill: Private hospital treatment, public hospital fees

In Public Administration on 31/01/2019 at 12:53 pm

My mum was discharged from atas hospital last Saturday. Nine nights 5-star stay and treatment cost slightly less than $2,500 (excluding Medisave deduction). After Medisave deduction (“our money”), amount I paid via credit card was “peanuts”. (I don’t carry more than $50 cash).

And that’s not all. If there’s a MediShield payout, I will get a refund via my credit card.

All in all, the amount we paid amounted to about 17% of the itemised, detailed bill. And that’s before any MediShield payout.

It was a great deal for her.

What the cybernuts and alt media are missing (Because they all living overseas or have private healthcare plans?) is that for many S’poreans, the public healthcare system (treatment and cost) is good and affordable. There are big, problematic gaps if specialised treatment is needed or if the family is struggling financially. But for the majority of patients, these problems do not arise.

It’s right to highlight and complain about these failings, but that’s different from saying that entire system is not fit for purpose. The condemning by alt media and cybernuts of the entire system based on individual failings only helps the PAP when ordinary people use the system and find out that it works pretty well. They’ll realise that alt media and the cybernuts are propogating fake news. And they’ll vote for the PAP.

Related posts:

Private hospital treatment, public hospital fees

No surplus B2 and C beds in govt hospitals

Will Gleneagles sandwich cost me a fortune?


Integrated Shield Plans? Waste of money? Cont’d

In CPF, Financial competency, Financial planning on 19/08/2014 at 4:30 am
When TRE republished my piece on S’pore overinsuring their healthcare that pointed out, But seven in 10 armed with IPs that target Class A wards in public hospitals chose to stay in lower ward classes when hospitalised. Only one in 10 from the same group chose private hospitals.Echoing a similar trend were those with IPs that target private hospitals – six in 10 chose lower ward classes in public hospitals. The committee noted twice in its report that many Singaporeans want medical treatment beyond that provided in Class B2/C wards but have “over-stretched themselves to buy the most expensive product for higher protection”.,
two responses stood out, one rubbishy (but which I suspect explains why many gold plate and gem encrust their Medishield plans) and the other sensible.
But both imply that because the money’s there in the Medisave a/c so spend it leh (a major point of my piece was that the ltd uses of Medisave “encouraged” gold plating and gem encrusting medical insurance. Btw, an actuary tells me that insurers don’t really make much money from such plans, but admits that it could be because they are inefficient.):

This analysis by Cynical Investor is too simplistic. There are many consideration for buying a medical insurance.

In an emergency, for example if you faint at Tanglin Shopping Centre, the nearest hospital is Gleneagles Hospital which is a private hospital. If you are NOT covered under the highest plan and you go to Gleneagles Hospital, you will need to pay much higher out of pocket. You can of course go to SGH where you can be fully reimburse for the charges but it is further away and you may not have the luxury of time in an emergency.

For non-emergency cases, you can plan which hospital to be admitted but the fact is that the waiting time for admission to B2 or C wards for such cases can be as long as up to 9 months. Can you take the pain for so long and do you want to wait?

Hence most people would opt to buy the most expensive plan when they are young since the full premium can be paid by Medisave. When you are older, you can still downgrade to a lower plan if premium is an issue.

Singaporeans are not as stupid as the report make us up to be. We may be Kiasu but we are definitely not DAFT.


spiny dogfish:

One reason why people buy the most expensive plans is because of the very rapid escalation of hospitalization costs. That and the fact that the insurer has an obligation to renew your plan but is NOT obligated to allow you to upgrade.
When i bought my first shield plan the benefits were enough for a private hospital. When i got hospitalized this year the benefits had not changed as i had naively not upgraded my plan for years. The benefits were only marginally enough for B1 ward. The benefits do not change but the costs keep rising.
And i was told that had my conditon been a chronic one like say cancer or heart disease, it was possible that should i wish to upgrade my plan i would either suffer loading or that very condition would be excluded. BUT i could renew my plan, no problem.

After that you bet i’ll take the highest plan i can afford. In 5 years who knows what this plan will be good for. Just take it as front loading. The real issue is rising medical costs. Dealing with the insurance is treating the symptoms not the disease.

CPF: PAP govt recycles hot air, smoke again/ All part of the wayang to diastract us?

In CPF, Political governance on 30/07/2014 at 4:35 am

Deputy Prime Minister Tharman Shanmugaratnam said earlier this week that the government would explore the option of private pension plans for the CPF for those who are able to take higher risk. But he also warned that private pensions “will not be a walk in the park”, as higher risk did not always translate into higher returns. (BT 24 July)

Here we go again. Time for civil servants and fund manager marketers to reopen their files from the early noughties.

As BT reported, Industry anticipation of the prospect of private pension plans for the CPF was intense in 2004. Such plans were mooted as a means to enhance returns and lower costs for CPF members.

Private pension plans were envisioned as balanced or mixed-asset portfolios which would be farmed out to the private sector to be managed on an institutional basis. The ideal scenario was that there would be no sales charge, and annual fees would be reduced to a fraction of the prevailing fees … In 2004, estimates of the fund size needed for an expense ratio of 50-75 basis points ranged from S$200-300 million to as much as S$1 billion*.

In 2007, the government said the CPF’s “risk-free” structure would be retained because the majority of members did not have large balances and because private pension funds would be “too risky for older members”.

That was the decision then.

Now in 2014, Tharman is raising the issue again? Now the rich can have private pensions, he says? Hello, why didn’t that happen in 2007? It was dismissed out of hand apparently on the ground that the rules had to be the same for everyone in the scheme.

Is the govt trying to distract us from the real issues of the day that can cause it problems as it spends our money on ourselves in trying to buy our votes: Minimum Sum calculations, how CPF Life funds are invested and is it that safe, and Medisave, Medishield flaws that show up the govt’s incompetency or meanness. One of these days, I’ll blog on what actuaries say about Medishield’s proposed buffer reserves: they agree with WP’s GG rather Gan and Puthu. Remember the higher the reserves, the larger the premiums paid.

Roy Ngerng’s “revelations”** and PM’s law suit distract S’poreans from these impt issues. Sadly, new media ais ana abets unwittingly the govt’s wayang. And now there is more smoke from Tharman.

Whatever leh, govt’s attitude on private pensions, and “tweaking” the CPF system reminds me of Charles Dicken’s description of the Circumlocution Office in Little Dorrit.

It describes the govt procrastinating over everything. It also can be seen as a reproach to the government that whatever it does the results are just empty words. And our govt dares call cyberspace “noise” given its track record on private pension plans?

The Circumlocution Office was (as everybody knows without being told) the most important Department under Government. No public business of any kind could possibly be done at any time without the acquiescence of the Circumlocution Office. Its finger was in the largest public pie, and in the smallest public tart. It was equally impossible to do the plainest right and to undo the plainest wrong without the express authority of the Circumlocution Office. If another Gunpowder Plot had been discovered half an hour before the lighting of the match, nobody would have been justified in saving the parliament until there had been half a score of boards, half a bushel of minutes, several sacks of official memoranda, and a family-vault full of ungrammatical correspondence, on the part of the Circumlocution Office.

This glorious establishment had been early in the field, when the one sublime principle involving the difficult art of governing a country, was first distinctly revealed to statesmen. It had been foremost to study that bright revelation and to carry its shining influence through the whole of the official proceedings. Whatever was required to be done, the Circumlocution Office was beforehand with all the public departments in the art of perceiving — HOW NOT TO DO IT.

Through this delicate perception, through the tact with which it invariably seized it, and through the genius with which it always acted on it, the Circumlocution Office had risen to overtop all the public departments; and the public condition had risen to be — what it was.

It is true that How not to do it was the great study and object of all public departments and professional politicians all round the Circumlocution Office. It is true that every new premier and every new government, coming in because they had upheld a certain thing as necessary to be done, were no sooner come in than they applied their utmost faculties to discovering How not to do it. It is true that from the moment when a general election was over, every returned man who had been raving on hustings because it hadn’t been done, and who had been asking the friends of the honourable gentleman in the opposite interest on pain of impeachment to tell him why it hadn’t been done, and who had been asserting that it must be done, and who had been pledging himself that it should be done, began to devise, How it was not to be done. It is true that the debates of both Houses of Parliament the whole session through, uniformly tended to the protracted deliberation, How not to do it. It is true that the royal speech at the opening of such session virtually said, My lords and gentlemen, you have a considerable stroke of work to do, and you will please to retire to your respective chambers, and discuss, How not to do it. It is true that the royal speech, at the close of such session, virtually said, My lords and gentlemen, you have through several laborious months been considering with great loyalty and patriotism, How not to do it, and you have found out; and with the blessing of Providence upon the harvest (natural, not political), I now dismiss you. All this is true, but the Circumlocution Office went beyond it.

Because the Circumlocution Office went on mechanically, every day, keeping this wonderful, all-sufficient wheel of statesmanship, How not to do it, in motion. Because the Circumlocution Office was down upon any ill-advised public servant who was going to do it, or who appeared to be by any surprising accident in remote danger of doing it, with a minute, and a memorandum, and a letter of instructions that extinguished him. It was this spirit of national efficiency in the Circumlocution Office that had gradually led to its having something to do with everything. Mechanicians, natural philosophers, soldiers, sailors, petitioners, memorialists, people with grievances, people who wanted to prevent grievances, people who wanted to redress grievances, jobbing people, jobbed people, people who couldn’t get rewarded for merit, and people who couldn’t get punished for demerit, were all indiscriminately tucked up under the foolscap paper of the Circumlocution Office.

Numbers of people were lost in the Circumlocution Office. Unfortunates with wrongs, or with projects for the general welfare (and they had better have had wrongs at first, than have taken that bitter English recipe for certainly getting them), who in slow lapse of time and agony had passed safely through other public departments; who, according to rule, had been bullied in this, over-reached by that, and evaded by the other; got referred at last to the Circumlocution Office, and never reappeared in the light of day. Boards sat upon them, secretaries minuted upon them, commissioners gabbled about them, clerks registered, entered, checked, and ticked them off, and they melted away. In short, all the business of the country went through the Circumlocution Office, except the business that never came out of it; and its name was Legion.

Sometimes, angry spirits attacked the Circumlocution Office. Sometimes, parliamentary questions were asked about it, and even parliamentary motions made or threatened about it by demagogues so low and ignorant as to hold that the real recipe of government was, How to do it. Then would the noble lord, or right honourable gentleman, in whose department it was to defend the Circumlocution Office, put an orange in his pocket, and make a regular field-day of the occasion. Then would he come down to that house with a slap upon the table, and meet the honourable gentleman foot to foot. Then would he be there to tell that honourable gentleman that the Circumlocution Office not only was blameless in this matter, but was commendable in this matter, was extollable to the skies in this matter. Then would he be there to tell that honourable gentleman that, although the Circumlocution Office was invariably right and wholly right, it never was so right as in this matter. Then would he be there to tell that honourable gentleman that it would have been more to his honour, more to his credit, more to his good taste, more to his good sense, more to half the dictionary of commonplaces, if he had left the Circumlocution Office alone, and never approached this matter. Then would he keep one eye upon a coach or crammer from the Circumlocution Office sitting below the bar, and smash the honourable gentleman with the Circumlocution Office account of this matter. And although one of two things always happened; namely, either that the Circumlocution Office had nothing to say and said it, or that it had something to say of which the noble lord, or right honourable gentleman, blundered one half and forgot the other; the Circumlocution Office was always voted immaculate by an accommodating majority.

Such a nursery of statesmen had the Department become in virtue of a long career of this nature, that several solemn lords had attained the reputation of being quite unearthly prodigies of business, solely from having practised, How not to do it, as the head of the Circumlocution Office. As to the minor priests and acolytes of that temple, the result of all this was that they stood divided into two classes, and, down to the junior messenger, either believed in the Circumlocution Office as a heaven-born institution that had an absolute right to do whatever it liked; or took refuge in total infidelity, and considered it a flagrant nuisance.


*Background facts about CPF

Data compiled by Morningstar shows that there are funds which handily beat the CPF rates. Aberdeen’s Pacific Equity Fund, for example, generated annualised returns of 4.6 per cent over three years; 13.8 per cent over five years; and 13.5 per cent over 10 years. The maximum loss and volatility over the periods were in double digits, however.

As at March 2014, there was S$259.5 billion in total members’ balances in the CPF. The Ordinary Account (OA) accounted for S$100.7 billion and another S$62.8 billion sat in the Special Account (SA).

In terms of participation in the CPF Investment Scheme, S$20.7 billion of OA funds were invested, and S$5.7 billion of SA funds.

**Uncle Leong (Roy’s sifu) has been telling S’poreans for years what Roy has discovered. The only thing that Roy did different was to accuse the govt of “stealing” our CPF, something that he has repented of:

I recognise that the Article means and is understood to mean that Mr Lee Hsien Loong, the Prime Minister of Singapore and Chairman of GIC, is guilty of criminal misappropriation of the monies paid by Singaporeans to the Central Provident Fund.

3.I admit and acknowledge that this allegation is false and completely without foundation.

4.I unreservedly apologise to Mr Lee Hsien Loong for the distress and embarrassment caused to him by this allegation.




Daft Sinkies? Dishonest insc agents? Or Medisave sucks?

In CPF, Financial competency, Financial planning on 08/07/2014 at 4:29 am

I was shocked to read in BT on Saturday that the MediShield Life Review Committee highlighted something that should never have been allowed to happen by a truly nanny govt or a govt that cares for its people:

 [O]ne issue has stuck out like a sore thumb: the overbuying of Integrated Shield Plans (IPs).

In the clearest indication that something is amiss, the committee’s report released last Friday stated that about three in five Singaporeans covered under MediShield purchased IPs.

But seven in 10 armed with IPs that target Class A wards in public hospitals chose to stay in lower ward classes when hospitalised. Only one in 10 from the same group chose private hospitals.

Echoing a similar trend were those with IPs that target private hospitals – six in 10 chose lower ward classes in public hospitals. The committee noted twice in its report that many Singaporeans want medical treatment beyond that provided in Class B2/C wards but have “over-stretched themselves to buy the most expensive product for higher protection”. (Emphasis mine)

So S’poreans fork out premiums to stay in the best (OK most expensive) wards, but then don’t use them ’cause no money? Presumably the insurers are laughing when they see their bank statements.They pay out less than what they are prepared to pay for.

Shumething is clearly wrong.

BT as part of the constructive, nation-building media tries to avoid blaming S’poreans. insurers and their agents, or Medisave.

Having said that, it qualified that this typically happens during the working years, when premiums can be paid entirely or mostly through Medisave, the national medical savings scheme used to foot hospital bills, among other things.

A quick comparison of the IPs offered by the five insurers – AIA, Prudential, Aviva, NTUC Income and Great Eastern – showed that premiums for the first 40 years of an individual’s life were priced suitably low to gain market share.

For example, existing private IPs for Class B1 in public hospitals range between $78 and $207 annually, according to the comparison provided by the Ministry of Health’s website. The amount payable doubles to about $297 to $410 when the consumer is between the age of 41 and 50. It rises to between $425 and $921 for those aged 51 to 65, and for those who are 66 to 90, the yearly costs go up to between $888 and $4,245.

It calls for more education rather than pointing out that Medisave nudges S’poreans towards over-insuring despite describing the process of nudging (for the daft: the last three preceding paras).

While information is relatively accessible and most people understand that they have to pay more as they get older, only a small number of people truly realise the exponential spike in IP premiums from age 60 onwards, not to mention the accumulated lifetime costs.

All these point towards a poor comprehension of the workings of IPs – a point that the committee also made sure to reiterate throughout its report. This is why there is a pressing need for the government to educate the wider public of its entire healthcare financing system, as well as the things to look out for in choosing an IP if required, so that the individual can make an informed decision.

But it ignores the T Rex in the ward, Medisave: this typically happens during the working years, when premiums can be paid entirely or mostly through Medisave, the national medical savings scheme used to foot hospital bills,

The answer to the title of this rant?

All three with Medisave the catalyst. It worsens the stupidity (or financial incompetency) of many S’poreans and the dishonesty of agents, by nudging via skewed incentives money in Medisave cannot be touched except for illnesses and medical insc premiums, so might as well buy the more expensive coverage)). It’s our money in MediSave, but we can only spend it in the right ways, one of which leads to bigger profits for insurers..

Update: Follow-up