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medical cost: health net that was not there
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redbean



Joined: 07 Mar 2006
Posts: 13855
Location: singapore

PostPosted: Tue Mar 07, 2006 11:28 pm    Post subject: medical cost: health net that was not there Reply with quote

quoting from a report by lee uwen in the today paper, the health feedback group assured sick singaporeans that the ability to pay their medical bills should be the least of their worries. from the procedural aspects, the system will first ensure that no one can be admitted without proof of ability to pay. this will actually take care of those who cannot afford to pay from being admitted. the screening process prior to admission is meticulous and unyielding. no money no admission.

but according to a dr lee kheng hock, the govt's 3m scheme comprising the medisave, medifund and medishield actually was found wanting in many cases when the patients needed the assistance. each case is unique. but because of the stringent criteria, many cases were turned away.

is that not funny? a safety net that was there but not there. actually it is not funny at all. so now the feedback 'group is now pushing for an integrated national healthcare charity fund to be established to act as a "safety net" for them and others in the same boat.' ie those that needed the net that would not work. 'it could be managed by community leaders who will focus solely on raising money. when the pot runs dry, the people will see the need to top it up. it will be like a community based "medifund" that acts as an additional layer of help,' said dr lee.

cannot believe in system perfect singapore that a safety net needs another safety net as it is found to be faulty. how about a third net in case the second safety net fails again? what this portends to is that all the assurance about not to worry is not that comforting after all.

it is like creating all the problems, ie raising all the fees, then create a series of solutions and found the solutions not working. so create more solutions again to patch all the leaking holes. why not go back to the basics and address the problems of high fees. bring down the fees and save all the effort to create all the safety nets with funds that cannot be dispensed out.

does one feel encouraged?
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redbean



Joined: 07 Mar 2006
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Location: singapore

PostPosted: Tue Mar 07, 2006 11:28 pm    Post subject: Reply with quote

Anonymous said...
There are a lot of similarity between the health safety net and the Ez-link solution. It solves the old problem but at the same create new ones. It is never ending...

Do we have a choice?? Yes, we do. Accept it and move on...

January 12, 2006 11:24 AM


redbean said...
i look at this and public transport and school fees. don't suka suka pushed them sky high and create all the skyhigh fee problems. then try to solve them.

and best didn't know why got so many problems or refuse to see all these problems as self created.

January 12, 2006 11:35 AM


Anonymous said...
Creat a problem then solve it by handouts, makes the people giving the handouts look good.

January 12, 2006 12:41 PM


redbean said...
and the recipients feeling very grateful. there are short term and transient political gain especially giving handouts at critical moments.

as a policy, if the finance can be balanced, between lowering cost and lesser handouts as against raising cost and more handouts, the former is more superior and more magnanimous but less evident in its goodness.

the machiavellian touch is very obvious here. give a little at a time to be appreciated many times but whack very hard when needed and pain for once, and soon forgotten.

January 12, 2006 2:32 PM
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redbean



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PostPosted: Wed Mar 08, 2006 10:40 am    Post subject: Reply with quote

expensive health care

i have touched on this topic many times and will continue to bring it up every now and then until the cost of health care becomes reasonable to the average singaporeans. for this is going to be a pain to many singaporeans as age catch up with them but without the money catching up with the high cost of healthcare. and many singaporeans know that this is a serious problem close to their heart.

the government's health care expenditure for the year 2004 is $1.71 billion or about $500 per citizen using a rough population of 3 million. on the other hand, govt subsidy for healthcare is a whopping $1.28 billion for the same year. now that is very high indeed. in fact far too high if one extrapolates on the amount of subsidy to the actual users.

why is the govt unable to bring down health cost? or are we having the same kind of formula or logic used in the computation of hdb flats and subsidies? there is no reason for healthcare to be so expensive when all the people needs is basic healthcare. maybe a different set of figures shall be produced to look at health expenditure according to the classes of wards. how much is being subsidised at the lower end and upper end.

i always call for govt hospitals to provide decent and adequate healthcare and not the luxurious kind. the latter can be provided by the commercial hospitals. and if govt hospitals do provide such services, there must be no subsidy.

but the bottom line is still the factors used in coming out with the cost of healthcare.
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redbean



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PostPosted: Wed Mar 08, 2006 10:41 am    Post subject: Reply with quote

Anonymous said...
it is a known fact that our very very senior stateman used our Public hospital.

Not to dissapointed these VIP, and to impress them, hospital's adminitrator must acquire the latest and state-of art equipment. Furnishing also must be out of normal. All don't come cheap.

Since our VIPs are paid commercial rate salary, which are abnormally high, they should be persuaded to use Private hospital. Maybe do a mean test on them if they qualify.

February 08, 2006 3:39 PM


redbean said...
there are several policy matters that i don't agree with and in my view are not good for the people and nation. and medical care/cost is one such area that needs a thorough review.

like security and education, you cannot simply turn these functions into profit making businesses. we are talking about running a nation and not a commercial enterprise. not everything should be valued in dollar and cents and not everything shall be managed just for monetary profits.

there are things that are intangibles and have higher values than mere dollars. the people who sacrificed for ns did not get their rewards from the country in terms of dollars. this is a national debt that the country owes to the ns men.

a country that does everything in terms of money would soon lose its soul as a nation. if the govt always think in terms of money, then the people will learn to be as calculative and will respond only in terms of money.

when that happens, we will no longer be a nation.

February 08, 2006 3:49 PM


Matilah_Singapura said...
The reason health care is expensive is because it operates as a govt proetected monopoly.

Suppoing you were a gifted natural healer - try and set up shop and they'll bust you for not being "academically qualified" or "trading without proper permits and licenses".

The sooner we get real free market competition in the health care market, the better deal for all. There are many therapies and procedures which are way, way cheaper and probably safer than some of the "main stream" methods.

The belief that you have to be "a doctor" to heal the sick is bullshit.

February 08, 2006 4:57 PM


redbean said...
the control and licencing have its good and bad points. from the positive side there are more consistency and predictability. but the problem is always the over regulation and control which distorts the true picture and value.

would it be nice if they allow the setting up of a non specialist centre for all the natural and faith healers and the quacks. buyer's beware.

there are certain amount of these being allowed through mediums and spiritual help. but for them to officially sanction it is unlikely.

there goes your free enterprise.

i have been treating many people since i was a child with herbs and i have had many grateful patients but no income. sometimes lucky i got an angpow.

February 08, 2006 5:25 PM


Matilah_Singapura said...
Right. I agree that licencing and regulation is necessay for "professionalism" and to ensure customer trust.

But there is NO REASON that the govt should be the ones to do it.

In the free market there'll be competeting regulation and licencing agencies, all fee based. After a time the market will consolidate, and the best one(s) will lead - i.e. the customers will trust them.

In that way, naturopaths, herbalists, Traditional Medicine practitioners, shamans, boh mohs and the sellers of "magic stones" can compete head to head with Havard medical graduates.

Let the customer decide.

February 08, 2006 9:02 PM


redbean said...
so my suggestion for a non specialist centre may be a solution. or maybe call it more blatantly, a bomoh centre or tangkee centre. or spiritual healing centre.

then with a big signboard saying 'come at your own risk.' the govt shall not be responsible for any harm arising from visits to the centre. caveat emptor!

February 09, 2006 2:32 PM


Matilah_Singapura said...
Caveat emptor anyway lah.

If the surgeon at NUH cocks up, do you think it will be easy to sue him?

hahaha...

February 10, 2006 7:51 PM


redbean said...
caveat emptor is applicable only when there is no negligence or foul motive. no cheating.

like nkf, people gave their money with eyes wide shut. but if there is cheating, nobody can run and nowhere to hide.

February 11, 2006 1:23 PM
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redbean



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PostPosted: Wed Mar 08, 2006 5:38 pm    Post subject: Reply with quote

boon wan is amazing not so much in his being a tireless worker. but more in his relentless pursuit to improve the medical services and reducing cost. as a minister, he sets the goals, demanding the civil servants to find the solutions. and that is what a politician should be. tell the administrators what you want that is good for the people. not the other way round.

many politicians ended up as administrators and behave like one. some ended up like a businessman running a business and only think about profits. they either allow the business or the administrators to set the goals for them. and they then went about defending the business and the administrators. that is a big failure as a politician, a political leader who is there to serve the people who voted for him.

the other point about boon wan is his sincerity and setting himself as an example. he demands or calls for the private hospitals to be transparent in their billings. but before doing that, he makes sure that the hospitals under his charge are transparent first. he will look ridiculous if he demands for transparency of private hospitals but keeping his own public hospitals opague.

kudos to boon wan. hey i am praising a minister.
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redbean



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PostPosted: Wed Aug 02, 2006 8:07 am    Post subject: Reply with quote

Good time is here, no need for medical safety net!

It was reported in the media with such jubilation that more people are opting for B1 and A class wards and private hospitals because they can use more of their medisave fund. So there is more money to spend on medicare. And with the economy growing, it is time for celebration, it is time to squander the medisave away.

Throw prudence to the wind. The money in the medisave should be spent away merrily. It is time to encourage more consumption of the good life.
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Matilah_Singapura



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Location: LAND OF SMILES & INSTANT GRATIFICATION, of Delightful Exploitation...and a true Buddhist spirit!

PostPosted: Thu Aug 03, 2006 6:54 pm    Post subject: Reply with quote

I can't wait for the day when the public health care system collapses into a heap of shit.

People who believe "it is the govt's duty to look after me" need to be shipped out to N Korea or Cuba as soon as possible.

Any cuntry that has a majority of irresponsible citizens who refuse to look after themselves and their loved one's deserves the ultimate long-term consequence:

Totalitarianism and eventual destruction.

Remember the Roman Empire, Nazi Germany and Marxist Russia... you get the picture!

Stillnot convinced? Try this one:

When the govt takes over health care all thos Big Pharmaceutical Companies will clamour to BRIBE their way into the Universal Healthcare Market—which is CONTROLLED by govt.

That's how monopolies are created. Once the "lucky ones" win tenders to supply everything from enemas to adult diapers; aspirin to Zyban you've got the possibility of kick-backs, protectionism and all sorts of political nasties going on.

Remember NKF? Good. You get the picture. Laughing
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Joe Public



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PostPosted: Tue Aug 08, 2006 10:55 am    Post subject: Hail Reply with quote

Matilah_Singapura wrote:
Remember NKF? Good.


Heil Hitler! Hell Durai! Laughing
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redbean



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PostPosted: Tue Aug 08, 2006 2:47 pm    Post subject: Reply with quote

Matilah,

The issue here is not about govt helping people. With the ever increasing and unstoppable world class healthcare and world class prices, these people would not know that when they need to pay they might find their medisave not enough.

They either forgot that the money in the medisave is their hard earned money and need to spend it prudently.

Or maybe they knew that it is their money and there is no way of touching it unless they spend it. So the best thing is to spend it when they have the opportunity. Another variation of high spending in medicare through insurance when insurance pays and not their pockets.
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Matilah_Singapura



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Location: LAND OF SMILES & INSTANT GRATIFICATION, of Delightful Exploitation...and a true Buddhist spirit!

PostPosted: Tue Aug 08, 2006 3:08 pm    Post subject: Please goverenment, I have NEEDS... Reply with quote

And the cause fo all that?

The lack of individual vigilance, and the reliance on "someone else to look after me".

Any fool knows that human beings get sick or require medical treatment. Just as any fool knows one needs clothing and food; companionship and love. These are ALL human needs

Do you expect the governent to provide free or subsidised food too?

Maybe some subsidised iPods, or BMWs... how about subsidised hookers? Hmm... I could go with that Laughing

Consider the horrific scenario: where the government provides companionship and love. This is too horrible to contemplate.... Shocked Twisted Evil Shocked

"Needs" can never be a standard of moral value. If it is, one gets into all sorts of contradictions.
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Joe Public



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PostPosted: Tue Aug 08, 2006 5:14 pm    Post subject: Needy needs Reply with quote

Matilah_Singapura wrote:
Do you expect the governent to provide free or subsidised food too?



We hear a lot about what goes on behind closed doors in this debate. Perhaps we need to talk more about what goes on inside closed minds too.
Laughing Laughing Laughing
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redbean



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PostPosted: Tue Oct 30, 2007 8:06 am    Post subject: Reply with quote

Boon Wan told, go ahead with mean testing

The issue of means testing has been in the back burner after Boon Wan has second thought over its implications. I think he was wavering as the idea is anything but mean. Now he has been told to go ahead with means testing.

And of course, means testing, like raising GST, is to help the lower income group to pay for their medical fees. This is an unique formula that only works in this island. And if I did not hear wrongly, it is also to make medical fees more affordable to middle income earners in case they can't afford it anymore.

Lucky Singaporeans.
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redbean



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PostPosted: Wed Oct 31, 2007 8:04 am    Post subject: Reply with quote

Giving is stairway to hell

I was reading Sheralyn Tay's report in Today on what Charles Hampden-Turner said at the conference on National Volunteerism and philanthropy and Corporate Social Responsibility. In his speech he said everything that we need to know about the false assumptions and farce of charity and means testing.

He does not recommend blind generosity, the singlemindedness to give and think that that is the road to paradise, a good and generous act. One side just give and the other side just receive, instead of rewarding success, we reward failure.

And related to means testing is that the recipients will try to outdo each other to be the '100% certified slob' to qualify for handouts or subsidies. These people may even give up job opportunities or other means to help themselves as those means would make them less eligible to qualify. Thus there will be 'a race to the bottom.' And that was exactly what the public were slapped with during those charity shows when pathetic cases were paraded to show how bad their conditions were.

Does anyone bother about the pride and diginity of these poor souls? Or poor souls need no pride?
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PostPosted: Thu Nov 01, 2007 8:08 am    Post subject: Reply with quote

My take on the mean criteria

With means testing becoming a reality, let's guess what the criteria will be to qualify people for medical subsidies. Starting at C wards. First condition will be living in rental flats. Personal income not more than $800 pm and household income not more than $1,500. Also there must be no savings and the Medisave account must have less than $3000.

For B2 wards, subsidies will be eligible to those living in 3 rm HDB flats or equivalent. Personal income should not be more than $1500 pm and household income not more than $3000. And Medisave should not be less than $10000.

For B1 subsidies, only for those living in 4 rm HDB flats. Personal income less than $2000 and household income less than $4000. Medisave account should be less than $15000.

I think these could be the possible conditions for means testing. Anyone in better conditions than these should be warded in B1 or A wards and pay accordingly. The poorer people will thus benefit from lesser people competiting for the subsidies while more people will have to pay the full rate, providing more subsidies for the poorer people. Brilliant right?

What say you people?
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PostPosted: Sun Nov 04, 2007 12:42 pm    Post subject: Reply with quote

$30k Medisave wiped out in 3 months

17 year old Siti Aishah suffered from ovarian cancer. It took 3 months of treatment to wipe out the $30k which her father, driver Mohammad Abdullah, took to save in 40 years. Her total hospital bill, despite govt subsidies, came to $41k in just one month.

And her ordeal is just beginning. She will need medical care, medicine, treatment and hospitalisation probably for her whole life. Another half a million or more!

According to KKH's chief medical social worker Sylvia Mun, only 'a 3 day ward stay for something as minor as asthma can be a financial disaster' to low income families. Middle income families are not spared either. Serious or chronic illnesses would wipe them out as well.

At the rate we are going, Singaporeans will be in deep financial debt because of hospitalisation. What is a little $30k in the Medisave going to do when one is settled with hefty hospital bills? And with mean testing, only the truly down and out will qualify for govt subsidies while the so called more able, probably anyone earning $2k pm and above will have to pay a big chunk of their hospital bills.

There is no escape. As long as hospital and medical cost are running away, the fate of Singaporeans are sealed. The Health Minister has been working and working hard. What is the result?

What we really need is a philantrophic organisation and a few selfless people in the medical profession to start an alternative hospital to serve the people at the lowest cost possible. Something like Sheng Siong versus NTUC Fairprice. Prove to the the govt that cost can be brought down and there are people who will not be crazy about making millions and millions at the expense of the people and the sick.
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