What are the combined surpluses for MediShield Life and ElderShield?

I refer to the article “Why zero co-payments are a bad idea in health insurance” (Straits Times, Feb 1).

It states that “Health insurance requires a fine balance: too little overburdens patients; too much encourages overspending. Good insurance design retains co-payments and focuses on value-based care.”

$2.4b MediShield fund’s assets?

In this connection, according to the report on the “MediShield Fund“ – “As at end-2013, the Fund assets stood at $2.4 billion.

Over the past five years, on average, about two-thirds of the MediShield Fund comprised reserves to fund the expected scheme liabilities.

The remainder is capital which meets the same standards required of other insurers under the Monetary Authority of Singapore (MAS)’s risk-based capital framework”.

What about the accrued % since inception?

In Table 1 – the insurance premiums of $372,132, 385,563. 404,732, 421,297 and $770,039 million, from 2009 to 2013, adds up to a total of $2,353,763 billion shown in the same table.

So, does the “Fund assets of $2.4 billion” include the interest that should normally accrue on the annual surpluses of premiums less claims, every year since the MediShield scheme started?

Surpluses before 2009?

Also, does the “Fund assets of $2.4 billion” include surpluses prior to 2009?

We have calculated from the table, that the claims to premiums ratio is 59 per cent (claims $1,395,382 billion divided by premiums $2,353,763 billion).

Most profitable scheme in the world?

Does this make MediShield the most profitable national health insurance scheme in the world?

Need 80% more?

Why would a national health insurance scheme that will insure 100 per cent of the population (including those not residing in Singapore) which has been made compulsory for every resident, need to have a capital adequacy ratio that is 80 per cent more than the expected minimum for private insurers?

Make actuarial report public?

Can the actuarial report for MediShield Life be made public?

The Government should spend more on healthcare to help Singaporeans.

By the way, are there any countries in the world, whereby the mandatory national health insurance scheme is apparently, making money?

$2.6b in premiums, $100m in claims

According to the article “Gan Kim Yong: $2.6 billion collected in premiums for ElderShield insurance and around $100 million paid out in claims since 2002” (theonlinecitizen, Feb 18, 2017)

– “from 2002 to end-2015, about $2.6 billion have been collected in premiums for ElderShield insurance and around $100 million have been paid out in claims, adding that about $130 million in premium rebates have been given to policyholders so far, the first tranche in 2007 and another in 2012.”

What is the accumulated interest (investment returns) on the excess premiums over the last 15 years? Will it increase the total excess premiums accumulated to over $3 billion?

So, does it mean that the combined surpluses of MediShield Life and ElderShield may be about $6 billion?

As to “Healthcare expenditures are steadily growing worldwide. Between 2004 and 2014, the World Bank reckons that the average share of health expenditures of high-income countries has increased from 10.9 to 12.3 per cent of gross domestic product (GDP). Singapore is no exception as its share of health expenditures has increased from 3.3 to 4.6 per cent between 2011 and 2015” – Singapore’s public healthcare  spending as a percentage of GDP, at just about 2.5 per cent ($9.8 divided by $400 billion), is probably the lowest in the world.

Leong Sze Hian