Social activist Constance Singam is one of the 450,000 senior citizens who will come under a new programme to support their health needs. .Here she talks about what it means for people like her, the politics behind it and how it fits in with the government’s world view of welfarism.
First, what do you make of the package announced by PM?
There are no surprises. Medisave top-ups and support to pay MediShield Life premiums will minimise finacial burdens on the family. We will have to wait for the Budget announcement to get more specific details of the financial support . The government could specify an amount that we can tap into for our medical insurance premiums and co-payments in the Medishield Plan. I do welcome the subsidies for treatment at polyclinics, specialist outpatient clinics and those run by GPs.
I hope when the details of the package are announced in Parliament we will see a more holistic approach to ageing which goes beyond the pathology of ageing to include a discussion on the social and physical environment. Easing the challenges that our ageing population faces would make life more liveable and even enjoyable for our senior citizens.
To what extent will it give peace of mind to our senior citizens?
I think it is impossible for the government, for any government, to promise peace of mind. A system that promises to give peace of mind goes beyond medical care. It should include disease prevention, access to social activities, assistance with daily living, assistance with medication, monitoring for illness, or more intensive assistance. How fast can these services be made available to the pioneers?
It is important, for the well-being and peace of mind of our ageing population that capacity building and strengthening and supporting informal care systems be carried out. These include training programmes that extend beyond general practitioners to include health and social service workers who will specialise in the care for the aged. This would facilitate a process of effective care and communication and promote respect for the older citizens.
Why do you think this package is being announced and why now?
Although the issue of an ageing population and all the problems asociated with it have been discussed for the past 20 years, our government has been slow to respond. But the last election has delivered a message to the government. Voters want the government to offer solutions to the real problems they face – rising cost of living, cost of health care, the growing gap between the rich and the poor, the increase in the level of poverty etc.
An academic article I read recently suggests that by the year 2030, about 25 per cent of the voting population will be made up of older citizens. That is a very powerful block of voters.
How do you see this package in the context of the government’s view of welfarism?
I think they are just afraid to use the term welfarism, especially since their focus is the economy and not the people as individuals with needs, values and aspirations of their own.. In Singapore the term welfare has negative connotations. It suggests – and this has to do with the PAP rhetoric- an attitude of giving in to people’s weakness and promoting a state of dependency which must at all cost be discouraged.
Their view is based on fear more than anything else. It is a view based on an ideology of mistrust which Jeremy Lim writes about in his book Myth or Magic: the Singapore Healthcare System.
As the pioneers age and face many difficulties – financial, social – they are going to be equally mistrustful of a government that they have given their full support during all those early years. How do you win back support once you have lost it?
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