some mps and health industry experts are calling on the government to further liberalise the use of medisave to cover a wider variety of ailments such as:
a. covering more outpatient treatments such as those for chronic ailments
b. costly items, such as scans which are presently
allowed only for cancer patients
and they are also pointing out that medisave usage should be revised yearly to keep up with the rising cost of living.
dr lam pin min, head of the government parliamentary committee (GPC) for health, further suggested that government subsidies be increased for the lower- and middle-income groups as the rise in medical costs outstrips wage increases.
my comments:
our government has long ago recognised the need to expand the use of medisave and since october 01, 2006, medisave has been extended to cover outpatient treatment for specified chronic diseases under the chronic disease management program (CDMP) and the number of chronic diseases currently include:
1. diabetes mellitus
2. hypertension
3. lipid disorders
4. stroke
5. asthma
6. chronic obstructive pulmonary disease
7. schizophrenia
8. major depression
9. dementia (from november 01, 2011)
10. bi-polar disorder (from november 01, 2011)
how does the chronic disease management program work?
For each bill, patients will only need to pay the first $30 of the bill (as the deductible) as well as 15 per cent of the balance of the bill. Medisave can be used to pay for the remaining amount. This is regardless of whether the bill is for a one-off visit or a package.
Deductible:
A deductible of $30 will be set on each outpatient bill. Bills below $30 will continue to be paid in cash;
Co-payment:
A co-payment (in cash) of 15% on each outpatient bill in excess of the deductible will be set; and
Annual withdrawal limit:
Withdrawals will be subject to an annual outpatient withdrawal limit of $300 per Medisave account*. Patients can also use the Medisave of their immediate family member(s) to pay for their treatment, up to a limit of $300 per year per account. A maximum of up to 10 accounts may be used.
*will be raised to a limit of $400 per year per account from next year.
and since july 01, 2011, medisave has also been allowed to be used for health screenings such as:
1. mammogram - applicable to women above 50 years of age and above
2. colonscopy - applicable to persons aged 50 years of age and above
Women aged 50 and above can use their own or their immediate family member’s Medisave for their screening mammograms at approved mammogram centres. Under the Medisave300 scheme, up to $300 per Medisave account a year can be used for screening mammograms from 1 Jul 2011.
Persons aged 50 and above can use their own or their immediate family member’s Medisave for their screening colonoscopies at approved colonoscopy centres. The medisave withdrawal limits for a colonscopy with related hospital charges are $1,250 and $1,550 (with removal of polyps).
although i can see the need to further enhance the use of medisave, there is the dilemma of ensuring balances in the medisave account are there when needed.
adding to this equation is the expected kicking-in of the new formula* for determining the interest rates in the cpf special, medisave and retirement accounts, come january 01, 2013. for example, if the new formula has been implemented, then the interest earned would have been lower because the 12-month average yield of the 10YSGS plus 1%, from 1st September 2010 to 31st August 2011, works out to be just 3.30%.
*Savings in the Special and Medisave Account (SMA) earn 12-month average yield of 10-year Singapore Government Securities (10YSGS) plus 1%
and then there is the other factor of longer life expectancy which cannot be ignored as more people are expected to live past their 80s and 90s.
all-in-all, our government has been continually confronted with the rather perplexing problem of further enhancing the use of medisave which gives rise to the probability of the faster depletion of medisave savings and therefore, may not meet the stated objective of having sufficient medisave funds to last for one's lifetime.
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