If you have been following the news closely, the issue of Means Testing has dominated the local front page for several days.  

The Context

Means Testing is a scheme introduced by the Ministry of Health (MOH), its purpose being to appropriately allocate limited healthcare resources in Singapore. Means testing will be based on salaries declared in tax or CPF returns [for salaried workers] and housing type [for the retirees, children and unemployed]. 

Why the need for Means Testing?

 

Patients going to the hospitals routinely ask for the senior consultants in the mistaken belief that their chances of recovery is guaranteed; however, they fail to recognise that the minor ailments that they are suffering from can be treated just as effectively by the other [albeit less, junior] doctors.  This has resulted in long queue-lines for all patients and MOH is looking towards improving this aspect of patient care.

Economists normally have 2 solutions for this phenomenon – either raise the price until supply equals demand, or let the queue mechanism sort itself out. Those who can afford to pay but cannot afford to wait will naturally leave the queue.

However, to apply this principle, ceteris paribus, to healthcare might result in some unpleasantness. Means Testing is the proposed solution: by allowing people who can afford to take up the better-class wards, we’ll be able to free up the remaining wards. This would also mean that we will be able treat more people, thus freeing up queue-lines. At least, this is the ideal case scenario.

Public views

The main concern from the public is whether healthcare costs incurred will increase under such a scheme. The reason is obvious – people are now expected to be warded according to their income or housing type. The concern is that people suffering from chronic diseases will be incurring large hospital bills, too much for them to handle. Retirees have also voiced their fears in that they may not be able to afford the bills since they no longer receive any remuneration and yet, hospital bills will be pegged to their housing type. 

Clarifications

In response to public concerns, Health Minister, Mr. Khaw Boon Wan, says that in the short term, the ‘majority of Singaporeans should continue to receive the same level of subsidies as they do today and will not be affected’. To keep the scheme fair, Minister Khaw feels that Means testing must fulfill these five criteria:

1.       Patients have autonomy over choice of ward.

2.       All C and B2 class patients will receive subsidies that are pegged to their income – that is, the higher –income patients will receive less subsidies.

3.       Assessment of the patient’s ability to pay must be kept simple and convenient [automated].

4.       Means testing should be flexible in implementation; patients will always be given special considerations in light of their circumstances.

5.       No patient will be denied treatment because he cannot afford it. 

The Means Testing seems like a fair and pragmatic solution to the already thinly spread healthcare resources. But what are your views? Comment at the Pharmacy Forum .

 

 

Other comments

Check out this link for more views on the matter:  http://www.todayonline.com/articles/230962.asp

---