Selling CareShield Life like ‘buay ko yok’?

Piggy bank in the hands of the doctor.Piggy bank in the hands of the doctor.

Why announce now to collect so much more money from the people for “long-term care”, when we have already announced the increase in GST to fund the expected increased spending on healthcare? 

I refer to the article “Severely disabled people can withdraw up to $200 a month from Medisave from 2020” (Straits Times, Jul 3).

It states that “People who are severely disabled will be allowed to dip into their Medisave accounts and withdraw cash from 2020 – provided they or their spouse have at least $5,000 in their accounts.

This is the first time members will be allowed to withdraw cash from Medisave since it was set up in 1984 as part of Central Provident Fund contributions to help defray hospital bills.

The bigger the sum in their accounts, the more the members will be able to withdraw.

Those with $5,000 in their Medisave accounts – a floor that covers three in four people aged 65 years and older – will be able to take out $50 a month.

On the other hand, those with $20,000 or more in their Medisave accounts will be allowed to withdraw $200 a month. This covers about half the people aged 65 or older, who are more likely to suffer from severe disabilities.

Separately, a fund is being set up to provide more help to needy disabled people.”

As to “Explaining the rationale to allow cash withdrawals from Medisave, Health Minister Gan Kim Yong said: “When a Singaporean is facing severe disability and, at the same time, facing financial difficulties, I feel that we can afford to be more flexible” – is this a joke or what? Allowing people who are severely disabled (unable to perform 3 out of 6 daily activities of living (ADLs)) to withdraw their own money – and only from as little as $50 a month – is “facing financial difficulties, I feel that we can afford to be more flexible”?

Will this, arguably be one of the biggest jokes for national healthcare schemes in the history of the world?

With regard to “He said this change will not result in higher Medisave contributions. Those deemed severely disabled will be able to dip into their accounts from the age of 30.

Potentially half the population would be able to draw on this in their lifetime” – since only “three in four people aged 65 years and older” have “$5,000 in their Medisave accounts” – only “about half the people aged 65 or older” have “$20,000 or more in their Medisave accounts” – wouldn’t the higher premiums for longer premium payment periods under CareShield Life deplete Singaporeans’ Medisave accounts even more and faster, into the future?

With regard to “A new safety net called ElderFund will provide needy disabled people up to $250 a month from 2020” – will the higher premiums result in a continuance of the current public healthcare system, whereby from a cashflow perspective – the Government may still not be spending any money on healthcare as the inflows exceed the outflows annually?

As to “Another two million people, aged 41 years and older when CareShield Life is launched in 2020, will be encouraged to join the scheme from 2021 even though it is optional for them.

These Singaporeans will be offered a $500 to $2,500 incentive to offset their premiums over 10 years.

If they join the scheme within two years, those with chronic ailments and mild or moderate disabilities will be allowed into the fold despite their health conditions. There will be stricter underwriting for those who join later.

People in two-thirds of households can get 20 per cent to 30 per cent premium subsidies. Those who cannot pay their premiums after some years can get additional support.

People aged 42 to 51 years in 2021 who are on ElderShield400 will be automatically enrolled in CareShield Life. They may opt out within two years with no penalty.

Those on the scheme who seek to upgrade to CareShield Life will need to pay higher premiums for 10 years or up to the age of 67, whichever is longer.

Those who are on the older ElderShield300 or who do not have ElderShield coverage may also join CareShield Life if they pay an additional “catch-up premium” over 10 years to bring them to the level of those on ElderShield400″ – why do we make it so complicated and confusing with

… “$500 to $2,500 incentive to offset their premiums over 10 years”

… “can get 20 per cent to 30 per cent premium subsidies – Those who cannot pay their premiums after some years can get additional support”

… “42 to 51 years in 2021 will be automatically enrolled –  may opt out within two years with no penalty”

… “upgrade – pay higher premiums for 10 years or up to the age of 67, whichever is longer”

… “catch-up premium”?

Why not just simplify things by charging everyone lower premiums, instead of all these “incentive premiums”, “additional support”, “premium subsidies”, “catch-up premium”, etc?

Is this not in a sense, akin to “buay ko yok” (selling medicine on the streets)?

Are there any countries in the world that “sell” their national long-term care scheme to their citizens in this way?

Also, since “People aged 42 to 51 years in 2021 who are on ElderShield400 will be automatically enrolled in CareShield Life” – what is going to happen to the estimated $3.6 billion of accumulated ElderShield surpluses?

Finally, here’s what arguably makes the least sense – is the most illogical – since we have already announced the GST increase to 9 per cent, from 2021 to 2025, to fund increased public healthcare spending – why is there a need now to also announce all the above measures to collect more money from the people, from 2020?

By the way – isn’t 2020 the expected date of the next general election?

Leong Sze Hian

 

 

 

 

 

About the Author

Leong
Leong Sze Hian has served as president of 4 professional bodies, honorary consul of 2 countries, an alumnus of Harvard University, authored 4 books, quoted over 1500 times in the media , has been a radio talkshow host, a newspaper daily columnist, Wharton Fellow, SEACeM Fellow, columnist for theonlinecitizen and Malaysiakini, executive producer of Ilo Ilo (40 international awards), invited to speak more than 200 times in over 30 countries, CIFA advisory board member, founding advisor to the Financial Planning Associations of Indonesia and Brunei. He has 3 Masters, 2 Bachelors degrees and 13 professional  qualifications.