MediShield fund $5.9b, claims to premiums ratio 43%?


Are we setting aside too much reserves for MediShield Life?

According to the Ministry of Health‘s (MOH) web site – “As at end 2016, the total assets of the Fund stood at $ 5.9 billion. Over the past 5 years, on average, about two-thirds of the Fund comprised reserves to fund the expected scheme liabilities.”

Does this mean that the claims paid as a proportion of the assets of the fund were about $1.967 billion (0ne-third), with about $3.93 billion (two-thirds) as reserves?

From the table below – the actual claims paid was $2.734 billion with $3.417 required reserves.

The claims paid to premiums collected ratio was 43.2% ($2.734 divided by $6.332 billion).

Is this the lowest claims to premiums ratio of all the national health insurance schemes in the world?

If we include the interest earned by the fund – what is the loss ratio?

As to “The following table shows the Fund’s incurred loss ratio over the period 2012 to 2016. The incurred loss ratio over the period is 99%. This is derived from the Fund receiving $4,871 million in premiums while paying out or setting aside $4,815 million to support policyholders’ claims and scheme liabilities” – since it is a mandatory scheme which even Singaporeans and PRs living abroad have to pay premiums, and the premiums increase with age as well as the premiums and premium subsidies can be decided almost at the will of the Government – is there really a need to have so much reserves “to support policyholders’ claims and scheme liabilities”?

Is this the ‘most reserves’ national health insurance scheme in the world?

Table: MediShield Life Fund Incurred Loss Ratio (in $millions)  

Year Premiums Collected
Total Monies Required for Fund Operations
[B] + [C]
Incurred Loss
([B] + [C] / [A])
Claims Paid
Change in Required Reserves
2013 $770m $335m $366m 91%
2014 $723m $381m $331m 98%
2015 $1,099m $437m $569m* 92%
2016 $1,858m $745m $1,182m 104%
2017 $1,882m^ $836m $969m 96%
2013-2017 $6,332m $6,151m 97%

Source: CPF Annual Reports

^ In 2017, the Government provided $821mil (44%) in premium subsidies and other forms of support to help keep premiums affordable for Singapore Residents.

Leong Sze Hian

About the Author

Leong Sze Hian has served as the 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), Hotel Mumbai (associate producer), invited to speak more than 200 times in about 40 countries, CIFA advisory board member, founding advisor to the Financial Planning Associations of 2 countries. He has 3 Masters, 2 Bachelors degrees and 13 professional  qualifications.