(1) Forcing everyone to buy insurance :
Think about this for a minute - what does it mean to force everyone to buy medical insurance? Insurance companies are in the business to make money. There is no free lunch. This article here (http://wherebearsroamfree.blogspot.sg/2013/08/lee-hsiao-loongs-mad-plan-...) has a good explanation on how, like casinos, the real beneficiary will be insurance companies. Premiums for everyone will (or as PM Lee puts it, "MUST") go up, if nobody can be excluded.
But the issue I want to discuss here is this - what if, I cannot afford the insurance? The Govt says that they will subsidise if I cannot afford. But the Govt's definition of "affordability" is different from most Singaporeans. If you stay in a 4-room flat, you can afford. Or a 5-room flat, or a landed property (bought decades ago). Or if you've children who're working. Or brothers/sisters.
In other words, until you've downgraded to a studio apt, AND empty out completely your CPF funds AND empty out completely your children/brother/sister/father/mother's funds, you "can afford" to pay insurance. To me, this is like a bigger version of the Parents Maintenance Act - where you're forced to pay for something by the Govt.
Think about this further -- already >60% of Singaporeans do not have enough in their minimum sum to retire. If most of us live to 90+, we will be facing 20-30 years with no income. Already what's there is inadequate for retirement. Now, we're forced to buy insurance.
Will Singaporeans be forced to downgrade to studio apts? Will we be forced to sell our flats, because the Govt says we can "afford" insurance?
(2) Example of Obamacare in the USA :
This New MediShield is really like Obamacare in the USA. Everyone is required to buy insurance too. There is a penalty - if you don't pay, you'll be fined. So we will inevitably be looking at something like that here in Singapore. Unless you buy from NTUC or GE or AIA, you will be fined.
The difference is that unlike the USA, Singapore is super-efficient when it comes to fining. Will my bank accout be garnished? Or CPF account? Or will my children's bank or CPF accounts be garnished, if I'm unable to pay for the insurance? I cannot afford it, but the Govt thinks otherwise.
The other big difference is this - Obamacare applies primarily during the working phase of an adult's life. When he/she reaches his 60's, Medicare kicks in, which is a Universal Health program with the Govt as the Single Payer. This is a huge difference because it offers the Govt as the final safety net, especially in the crucial years when the person is not employable anymore.
New MediShield is Obamacare with no safety net. Somehow, you're supposed to find the funds to keep paying insurance premium, year after year, even at your 90's!!! And as Barrie's article explains, even then, your coverage has "holes".
(3) Do you trust PAP to design the system?
To me, New MediShield is a big mistake. I do not trust the PAP govt to define "affordability". 20 years ago, 10-15 years housing loan is considered affordable, today 25-30 years loan is. Do you trust them to formulate a system that will give you peace of mind when it comes to healthcare?
And this New MediShield is to be handled by Gan Kim Yong. Prior to this, he was the Manpower minister. Under his watch, did he really look after the welfare of workers? How did he not realise that Singaporean PMETs are losing their jobs unfairly to foreigners? How did he not realise that entire departments in some companies are stuffed by foreigners from some countries? How did he not realise that the real wage of low income earners have been declining during his tenure? In other words, he has a track record of handling things badly -- how would you feel if PM Lee appointed Mah Bow Tan to implement this New MediShield?
What then do I suggest?
I think the better way forward is to design a safety net outside of the existing system. The USA has Medicare. We need something like that, of our own. You definitely cannot build it around MediShield -- its just plain suicide.
This safety net has to be operated by the Govt, not insurance companies. Simple reason - insurance companies are just middlemen out to make money. Why even have this intermediary?
And this safety net has to be funded primarily by the Govt. Then you have true deficit spending. No, not the current MediShield where as PM Lee puts it, the system "must break even". Once you even go there, you've completely gone off-course.
And I suggest that a team of people look into this, not Gan Kim Yong. Someone like former GIC chief Yeoh Kam Leong or Lim Chong Yah. Someone with established progressive credentials.
Otherwise, once we head down this New IncomeShield path, premiums will definitely go up for everyone. The quality of the coverage will go down, because to keep premiums "affordable" (while taking on an increased risk-pool of pre-existing conditions), more exclusions or out-of-pocket payments are implemented. And bear in mind - whatever are the initial rates, those are just "teaser" rates. A few years ago, many Singaporeans got shocked when MediShield premiums were increased significantly. Those are the real rates. And its only going to get worse from here.
Meanwhile, we will have ever increasing situations where those who are unable to pay for the premiums have their bank or CPF account garnished, or their children's or in the worst case, forcibly downgraded to move to a 30-year lease Seniors' flat. Of course, the Govt will never disclose such statistics, camouflaging them with "overall residents" numbers (citizens+PR) when it suits them.
What kind of a quality of life is it for Singaporeans when we do not even have the basic liberty to decide how we want to spend our final days, without burdening our children or sell our homes?
TRS Contributor