Singapore — There has been response in the form of a letter to the press on the proposed increase in MediShield Life premiums explained in Parliament by Senior Minister of State for Health Koh Poh Koon on Monday (Nov 2).

Dr Koh had said that the ageing population of Singapore, added to medical advancements and increased operating costs, contribute greatly to higher healthcare costs.

The Ministry of Health announced in September plans to increase premiums by up to one-third.

The letter writer, Mr Lim Teck Koon, disagreed with the premise that ageing is the key driver of the higher cost of healthcare because the argument is “tenuous” for the reason that “ageing and the use of healthcare resources are mediated by many lifestyle and chronic diseases”.

The writer added that some of the diseases, such as obesity and diabetes, could occur even before a person begins ageing.

Mr Lim added: “Ageing people who are obese or have diabetes consume much more healthcare resources as a result of these conditions, compared with their counterparts without these problems.”

He gave the example of those who have had their lower limbs amputated due to diabetes, stating that there are 1,500 such patients every year.

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Mr Lim said: “The average age for those who undergo major amputations is 66. The amputation and its associated high cost are driven by diabetes, not age.”

He added that explaining the hike with ageing alone masks the fact that the country is among the countries with the highest proportions of diabetics.

And as for obesity, the number of Singaporeans who are overweight and obese rose from 26.2 per cent to 36.2 per cent from 1992 to 2017.

People who are overweight or obese “are at major risk of cardiovascular diseases, diabetes, musculoskeletal conditions and some cancers (including breast, ovarian, prostate, liver and colon)”, according to the World Health Organisation.

His point is that “obesity is not an inevitable part of ageing”, and that Japan only has 23.8 per cent of overweight and obese people, the lowest percentage among Organisation for Economic Cooperation and Development countries.

“Ageing people who are obese or have diabetes consume much more healthcare resources as a result of these conditions, compared with their counterparts without these problems.

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“One wonders, had we been more pre-emptive, interventional and effective with our public health measures, would we be in a better position now?” Mr Lim added.

He also advocated for a more pro-active stance in getting to “the root of the problem”, as many of the current endeavours are educational and voluntary, with no proven effectiveness yet.

He also brought up the Government’s “very tentative” attitude toward obesity, “as if avoiding being labelled ‘fat shaming’ is more important than slowing the trajectory of a major health crisis”.

“When the runway is too short, an expedient thing to do is to raise the MediShield Life premiums, which is essentially just a financial solution for a medical problem,” he added. /TISG

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Koh Poh Koon defends medishield life premium increases