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A cataract surgery last month has left the former CEO of NTUC Income confused about Medishield. And he is not even talking about Medishield Life, which will start next year.

Tan Kin Lian says he went for the surgery, which cost him $3,200 for the operation and an additional $800 for the pre-and post-operation expenses.

“The $4,000 is not covered by Medishield,” says the losing candidate in the presidential elections in 2011.

According to Tan, he can claim up to $1,250 from his Medishield account for his surgery.

But Tan says his deductible is set at $1,500 (minimum sum you have to pay a year when you make a claim). In his case, his subsidised amount of $1,250 is less than the deductible sum, so he could not claim the amount.

Also, Tan is a private patient. So, he could not claim the rest of his bills either.

The deductible clause for Medishield Life is similar to Medishield’s.

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Tan says the deductible clause in MediShield Life is so unnecessary.

“Do not believe in the idea that the deductible is necessary to discourage people from going to hospital when it is not necessary. People do not go to hospital for fun. They go there only when it is necessary. Even if they want to be admitted “for fun”, the doctor will know how to chase them away!” he says.

He says even though he is an insurance expert, he is at a loss about how the scheme works. The hospital staff – “who has counselled patients for many years” – had no answer for him either.

“I expect that even a subsidised patient will have to bear more than $1,000 out of pocket for this surgery, even though he is covered under Medishield or Medishield Life.

“It is so complicated that most patients do not know what is covered and what is not. They have no control over the amount they have to pay. They are entirely at the mercy of the hospital,” says Tan.

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He also says that MediShield Life would cover less than 5 per cent of health care spending in Singapore. He says retired patients will bear the highest cost, as they do not have any employer to pay the bills and their healthcare bills are typically the highest.

Minister for Health Gan Kim Yong noted in Parliament that the government would raise healthcare spending from 33 per cent to 40 per cent.

However, Tan points out that the new scheme still does not take into account cost of medicines and consultations.

“A retiree told me that he spends $250 a month on medicines. Why can’t the government provide them at cheaper prices, at least through bulk purchase, or sourcing for suitable, cheaper medicines?”

But PAP MP Zainal Sapar said in Parliament that MediShield Life is meant to cover only the essentials. Anything beyond, one can purchase private insurance.

Tan proposes to emulate the medical schemes in Japan, Taiwan, Australia, Canada or Hong Kong.

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Patients will pay an annual premium for an insurance scheme that covers 90 per cent of their total medical bills.

He notes that this would cost the government more, but can be offset through the government surplus or a “modest reduction in the hefty defence budget.”

“In America, the cost of medical care for retirees is paid entirely by the federal government. I am not asking to follow this system, as it is extremely costly, but it goes to show the other extreme. And this is being practised in a capitalist economy, which Singapore is modelled after.”

Tan will be presenting his speech, “Medishield Life- still full of holes” in the #ReturnOurCPF protest at Hong Lim Park tomorrow.