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Kin Lian on MediShield




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Former CEO of NTUC Income and presidential candidate Tan Kin Lian talks to The Independent Singapore on what the new medical insurance scheme means.

In what ways are the new proposals better than the present system?

Medishield Life allows every one to be insured, including those who are not healthy and are now excluded under the current scheme. Medishield Life also covers pre-existing illnesses.

These two important features make Medishield Life much better than the current scheme.

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The devil is always in the details. What are the details that we need to study carefully?

The current Medishield scheme covers only the subsidized wards, that is B2 and C. Those who wish to be insured for higher class wards or for treatment in private hospitals have to buy an “integrated plan” from an insurance company. As different companies offer different plans, the differences are quite confusing to the public and there is a risk that the coverage under the integrated plan may be rejected due to non-disclosure or other technical issues.

It is better for Medishield Life to offer options to cover the higher plans, or to specify standard conditions that the private plans should observe. The treatment of claims should be standardised among all the insurance companies offering the integrated plans.

The current level of deductible is too high. Medishield Life should provide an option for the insured person to opt for a lower deductible by paying a higher premium, rather than buy a separate cover from a private insurance company to cover the deductible.

Premiums can turn out to be a sticking point. What kind of premiums would you prefer?

I prefer the premium to be set at a level that is based on the actual claim experience for each age band, rather than to make younger people subsidise the premium to be paid by older people. it is difficult to achieve such a cross-subsidy system, especially when this insurance scheme is compulsory.

As the premiums for the older people are going to be quite expensive, it is better for the government to provide a direct subsidy for the premiums of older people, rather than rely on the younger people to provide the subsidy.

Will this announcement bring about the peace of mind that the government has promised?

The key for a successful national medical insurance scheme is the ability to manage the treatment expenses by providing suitable mechanism in place. If the medical fees are allowed to escalate without control, the insurance will become more and more costly, as is the case in America.

There is the danger that the medical fees and premiums will continue to increase over the years in Singapore, as it seems to be modelled along the American scheme.

We should study the experience in Japan and Canada, where there is negotiation of medical fees at national level between the insurance scheme and the medical providers. This will help to control the escalation of health care cost, to some extent.

Right now, many people are worried that the premiums will continue to escalate in the future. They cannot have  peace of mind, until they are assured that the cost will be kept under control.

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