But as health-care costs rise, better-off patients will have to pay more By Salma Khalik, Health Correspondent
MORE hospitals, clinics and other medical facilities will be built over the next eight years to cater for a growing and greying population.
It will cost the Government more than $2 billion to build them, a sign that health-care costs can only go up - which begs the question: Who will pay for the higher operating costs?
Along with the Government and employers, it will be patients who have to foot the bill, with the more well-off paying more, said Health Minister Khaw Boon Wan yesterday at the ground-breaking ceremony for a new pathology laboratory at Singapore General Hospital.
In store are two new hospitals in Yishun and in the west, adding over 1,000 beds to the 12,000 in 29 hospitals and specialty centres. Land has also been set aside for two more hospitals in Woodlands and Sengkang.
Polyclinics, nursing homes and community hospitals will be expanded, and there will be a bigger Communicable Disease Centre at Tan Tock Seng Hospital to battle infectious diseases.
Specialist centres, bigger labs, research and teaching facilities and centres to tackle emerging problems such as addictions to gambling are also in Mr Khaw’s plan.
Demand is clear. Singapore’s population has increased by 813,000, or 22 per cent, in the last 10 years.
In the next decade, Mr Khaw expects a similar jump as the population soars towards 5.5 million.
Already, health care professionals are stretched and medical facilities are over-crowded, he added.
Looking at the worldwide trend of spiralling health-care costs, he said Singapore’s spending on health care was 3 per cent of its gross domestic product 10 years ago, and even now, at 4 per cent, it is still ‘the best among developed countries’.
‘Ten years from now, it will surely be higher, but how much higher? Five per cent, 7 per cent or worse?’
Japan, which spends 8 per cent on health care, wants to cap costs at 10 per cent, while in the US, economists project it will rise from 16 per cent to over 20 per cent in future.
Mr Khaw also raised again the thorny issue of means testing - deciding how much subsidy patients enjoy based on their income.
‘Patients who are better off can and should shoulder a higher burden. If they choose subsidised services, they should get a lower subsidy than those who are less well-off.’
That is why means testing is needed, said the minister, who in April had given notice that income checks will start in a limited form in public hospitals within a year. ‘All over the world, medical inflation exceeds general inflation,’ he explained.
As the total cost goes up, so will the patient’s share, just as the Government and employers’ share will.
Madam Halimah Yacob, head of the Government Parliamentary Committee (GPC) for Health, agreed: ‘As Singaporeans, we have to be realistic. We cannot continue to expect a high standard of health care without paying for it.’
To keep a tight rein on costs, Mr Khaw outlined five principles:
· Adopt a healthy lifestyle.
· Make patients co-pay to discourage over-consumption.
· Reward doctors and hospitals in a way that encourages them to find better, safer and cheaper ways to treat patients.
· Give patients enough information so they can choose doctors and hospitals which provide better and cheaper care.
· Accept that when a patient cannot be cured, families and doctors should realise the limits of medical science and learn to let go.
Source : Straits Times - 26 Sep 2007
