8/21/2013

Bringing Medishield Life down to earth

The madness of this Medishield Life has gone into everyone without any firm ideas being crystallised. At most the Medishield Life Scheme is just a red hot balloon floated in the air, an idea that has been thrown out in a rally but with no meat or bones in it. It has however, got many people thinking, excited, some scared to death and many people in delusion. Some even feel that their old age health problems are solved and there is no need to worry anymore. And there are those who are going to profit from it handsomely and smilingly quietly to themselves for the good fortune.

It is time to bring this hot balloon down to earth to make it real. Gan Kim Yong has said that there is nothing firm about this sketchy scheme and many hours of hard work will ensue to turn this into a reality, a practical solution to meet the expectations of all interested parties. The initial exuberance that such a scheme would cover all the medical needs of the oldies need to be toned down and the high expectations need to be doused with a pail of cold water. The cost of covering everything and every need of the oldies will make it near impossible to cover from the insurance point of view unless cost is not an issue. The premium is going to cost a bomb. It cannot be small and affordable for sure.

For practical and cost reasons, such an insurance coverage must be carefully defined. To be feasible from the insurer’s point of view and a reasonable premium to be paid, the insured must know that there is a price for everything. The people may want to demand that the Govt takes ownership of such a scheme and practise some filial piety towards the senior citizens of the country.

I hesitate to want to offer any free solutions for various reasons, ie not having a full appreciation of the complexity of such an issue, not having the resources and time to think deeply into the issue, and not wanting to insult the millionaire talents to think on their behalf, nor to offer stupid solutions as a layman. But there is no harm to make a few general suggestions that are obvious to many and not be accused of trying to be clever.

I would like to suggest that the Govt provide a first level of protection to all senior citizens either from 65 or 70 years onward comprising C class ward stay in govt hospitals and general geriatric care. Basically this scheme will pay for ward charges and basic medical care that are not prohibitive in cost. The scheme shall not cover any major and costly operations. The object of such a scheme is to provide some peace of mind to the poor oldies that they would be reasonably well taken care of in a hospital if admitted. The scheme shall not cover for expensive operations and treatments. This could be defined by the professionals. This scheme shall be provided free to the senior citizens and the scheme can be compulsory without frightening the people with unlimited premiums to pay.

A comprehensive coverage for all senior citizens cannot be extravagant and unlimited in nature.

On top of this basic coverage, the people could then be given a few enhanced medishield schemes that they are willing to pay for. These have to be voluntary and allowing the people to chose one within their means and expectation. Here the rich and those with the ability to pay can ask for the sky and demand for the best. This is like feasting in a restaurant, the economy class or high end restaurants with different price tags to suit the different aspirations and expectations. The Govt can offer the basic healthcare needs while the luxury part should be individualised and pay through the individual’s own pocket. The poor must not be made to pay for the rich and their high expectations. This is elementary.

Having two such schemes operating in parallel would not bust the Govt’s coffer or deplete the savings of the people in the Medisave. A comprehensive no limit coverage is definitely impractical and insane from the cost point of view. It will bankrupt every insured and also the insurers. To make such a scheme compulsory is unthinkable unless the Govt is footing the bill. To pass the bill to the insured is irresponsible.

8/20/2013

Are we in the same boat?

My boat is a luxury cruise liner that can sail the high seas. And all the cabins are fitted up like a 5 star hotel room. And buffet is served round the clock for free. And if I am sick of the buffet spread, I can swagger into one of the fine dining restaurants to have the best of eastern or western cuisines. And if I am bored there are many entertainment outlets to amuse me to keep me happy or laughing the day and night away. And there will be plenty of waiters and waitresses running around to serve me with the snap of a finger. That is the boat I am travelling. Money is never an issue and in my boat, actually a huge ship, I can afford to pay for everything without a care. I just sign and sign away whatever that I want or amuses me.
 

Are you in the same boat? How many of you think you are in the same boat? How many of you are in a rickety sampan or a refurbished tongkang fitted with a 60 horsepower engine? How many of you are lucky enough to be in a small yacht or a two bedroom pleasure craft? How many of your boats can travel the high seas and visit all the best resorts in the world and be feasted every meal, without a worry or a care of where the next dollar is coming from?
 

Are we in the same boat? I will like to believe that we are in the same boat. Or even to dream, imagine or hallucinate, that we are in the same boat, living and enjoying life.

Health care – Please don’t help us

It has never failed. When the Govt said it is going to help you, be frighten, be very frighten. The Govt is going to help the people with a life time health care scheme. That is the good news. The bad news, you are going to pay for it dearly. It cannot be for free right? And there is no escape this time. It is going to be compulsory! Imagine the frustration over the years when Medishield cannot be made compulsory? Now with this ‘the Govt will help you Medishield Life’ it is now compulsory. And the premiums to pay for health care for life, I can’t imagine how much it is going to cost. The minister has said that it will be ‘affordable’, another very frightening word. We all know what affordable means to the average Sinkies and what affordable means to the rich and powerful. And the assurance that those who cannot afford to pay will be subsidized is not too much of an assurance either. How poor would one has to be before one is qualified for subsidies?
 

What are the statistics for Singaporeans to live to 70, 80, 90 and above 100? What kind of sicknesses were they hit and how big were the bills? At the moment the number for the oldies seeking major ops or expensive ageing related sicknesses could be relatively low. Many would rather die than to live on and on like the undead or vampires. The statistics would not be a true reflection of the reality as many could not afford to see the expensive treatments in the hospitals. But once there is such a medical coverage for life, many oldies will be demanding to want to be treated with no consideration to the prohibitive cost. It is free in a way with insurance coverage. Why not? How would this snow ball into an insatiable demand for more medical services?
 

When is the Govt going to accept that when one gets old, one must die? When is the Govt going to accept that many oldies cannot afford to grow old or did not want to grow old and live a life like walking corpses? There must be a clear definition of the kind of coverage under Medishield Life for the insurers to pay for, a ceiling on what is payable. It cannot be an open book and a blank cheque with the insurers footing every bill. If so, the cost would simply be passed down to the insured at great cost.
 

I hope the Govt would seriously reconsider this clever idea so that the people would have a choice to pay or not to pay. If it is so good, please make it optional and for all the rich to opt for it and for those who have reasons to want to live forever to pay for it themselves. Do not pass the financial burden to the innocent and the young and the majority that do not want it nor would appreciate it. Do not prevent people from dying. Dying naturally is a privilege, a blessing, and a right of being a human. Many would love to end their pathetic lives on earth soonest, the earlier the better. It is not a luxury to live a long life when one does not even have enough to eat. Prolonging life unnaturally is only a luxury for the rich.
 

Please think carefully. Please think of what the ignoramus are asking for. It may be true that some are asking for life long medical coverage. I bet this is a minority who did not know what they are asking for. We need wisdom in this issue of life and death. It is not simply about living and about the ability to pay, through a compulsory medical insurance scheme. It is geriatric care that is needed more.
 

This Medishield Life Scheme could be a very cruel scheme to many who did not ask for it. For those who cannot afford to live a life with simple human comfort, prolonging their lives is like making them a prisoner in a sick and dilapidated ageing body. Please, don’t help the people to extend their misery and pain on earth, and to empty their savings for it. They need their savings for the simple three meals. Don’t take that away. They don’t have millions in their bank accounts to feel happy and to want to continue living. They don’t need a heart bypass or chemotherapy or a pace maker or whatever machine to replace their failing organs.
 

Remember, when one passes 70 expect to die and prepare to die. That is the normal and natural thing to do. Do not prepare and expect to live another 100 years. It is a blessing to die naturally while one is still reasonably healthy than when one is bedridden and need someone to scrub your back. You simply stink and rot while still alive. And without the money you are dependent on other people’s charity and kindness to clean you and feed you. It is not filial piety to hang on to a life and to keep a dysfunctional body alive. Paying to keep a body alive but not working is an unkind act. There is a time to let go.
 

PS. When the Medishield Life scheme is extended to 92, it means you will have to continue to pay till 92. If it is extended forever, you pay forever. Tio boh?

8/19/2013

Hsien Loong - We are all in this together

How many of you believe that you are all in this altogether?
 

First, how much are you earning and how much is a minister earning?
Second, what kind of homes are you living in?
Thirdly, how many houses do you own?
Fourth, how many houses do you own outside of Singapore?
Fifth, how much do you have in your savings?
Sixth, what kind of jobs are you employed?
Seventh, where do you eat, hawker centre, food court or restaurant?
Eighth, where do you send your children to school?
Ninth, do you have to worry for your next meal?
Tenth, do you have to worry about your hospital bill?
 

Are we in this altogether? Other than worrying about providing for your family, do you have to worry about your children’s future?
Hsien Loong’s National Day Rally – Not enough

Heard Hsien Loong’s Rally speech and what came across were some cosmetic changes that were less than expected after the hype by Heng Swee Kiat. There were great expectations for sure but now the great disappointments. With the strong ground shift and the negative sentiments, many were thinking that this would be a good opportunity for Hsien Loong to make some dramatic changes as preparation to the GE in 2016 or a possible surprise snap election. If these were all that the govt was willing to change to redeem itself and its falling popularity, it was obvious that many would see it as plain inadequate.

First the changes on high cost of healthcare. There will be some savings for the senior citizens at the polyclinics and those using CHAS. The changes to the Medishield scheme to Medishield Life is not as good as it first appeared. This new scheme will cover all the seniors that lived past 90 and at first glance sounded very attractive. But with this sweeping coverage that most seniors would not need, many would have died, many would not need a heart by pass or major ops, the failure to fine tune the needs of the very senior citizens would mean a huge paper cost to be shared by the rest. Everyone is going to pay for it.

Is this the best shot the govt could come up with and the need to raise the premiums for Medisave? What else is new? What was sorely missing is the silence on bringing down healthcare cost. Hsien Loong touched more on how to help the seniors pay and the need to increase the premiums for Medishield. What is so good about it when the cost is passed down to everyone?

In the case of housing, those earning up to $4k monthly household income would benefit from more subsidies and a lower net purchase price for 2 to 4rm HDB flats. The prices of these flats would still be maintained at the existing levels but the net sales price would be brought down to the levels of the 2005/6. The ignoramuses were clapping in glee like it was a big savings. They could only see how high were the current prices and thought it was a big discount and were very grateful. They forgot that the prices have been inflated so high and the supposedly lower prices were still very much higher than the prices in early 2000. There is nothing surprising that these people could be so easily deceived into thinking that it was a good deal. They could only see as far as the tip of their noses.

There was nothing mentioned about removing the upper income ceilings and many high income earners would still be disqualified from buying direct from HDB. How does this fit in to Hsien Loong’s statement that every Singaporean family would be able to afford a HDB flat? How many Singaporeans would still not be able to buy from HDB? I have received comments from a young couple that they were still excluded from HDB, and there were many highly qualified young Singaporeans that would prefer to remain overseas than to return to be robbed of a million to buy private properties because of the income ceiling.

This stupid policy means that many highly qualified Singaporeans would not return and their skills would be lost, a policy that literally kept highly skilled Singaporeans away from home. Is this policy meant to be this way so that the Govt can find the excuse to bring in more Third World fake talents to replace the sons and daughters of Singapore that they have driven away?
There were the usual big plans into the future, bigger Changi Airport and two huge puzzles of land in Paya Lebar and Tanjong Pagar for more concrete buildings to house more people. Do not be happy too early if these two big complexes are meant to house the 7m or 10m population. The existing infrastructure with the upgrades would still be inadequate, particularly the roads and public transportation. There will be rooms and housing for 7m or 8m, but could there be room for them to move around? It would be good if the new spaces created were meant for the same population size, allowing more breathing space for all, better facilities and bigger leg room. Fear not, it will be for more people, for more compact living.

The changes in some of the policies were to rein in the excesses of flawed policies but not enough to bring things back to an easier way of life. And the future developments would mean the squeeze and crams and jams would be worse. The cost of living will be up and up with more people cramming up in this island when the sky is the limit for building more Towers of Babel.


Would these changes be enough to win back more confidence and more votes in 2016? I doubt so.