Financing for Healthcare (Lesson 1: Financing for Singapore (SG's…
Financing for Healthcare
Lesson 1: Financing for Singapore
Low cost basic medical insurance scheme
Help members meet large Clss B2/C hospitalisation bills.
Revamped at the end of
called MediShield Life
Safety net for patients with difficulties paying the subsidised bill charges
Initial capital of S$200 million
Helps individual set aside part of their monthly income
To meet their future personal of immediate family's medical expenses
It provides a monthly cash payout to help pay the out-of-pocket expenses for the care of a severely-disabled person
It offers disability insurance to all 40 year old SGreans with CPF accounts, to risk-pool against the financial risks of suffering a sever disability
SG's Healthcare Financing Philosophy
Believes in ensuring quality & affordable basic medical services for all.
Promotes healthy living & preventive health programmes as well as maintains high standards of living, clean water and hygiene to achieve better health for all
Population ages & families become smaller.
SG's healthcare financing framework:
Increase Govt share of our national healthcare expenditure
Enhance collective responsibility for healthcare
Gradually expand Medisave use
Offer universal healthcare coverage to all citizens.
Individual responsibility & affordable healthcare to all citizens (multiple tiers of protection).
Promoting competition & transparency.
SG's Healthcare System -
Increasing demand for more affordable healthcare
Increasing demand for more healthcare services
Increasing incidence of chronic diseases
Lesson 2: Subsidy & Subvention
Patient Subsidy Types - Codes
Foreign Resident - FR
Non Resident - NR
Permanent Resident - PR
Singaporean - SG
Non Patient - NP
19 chronic conditions under the Chronic Disease Management Programme (CDMP)
Selected dental services, recommended health screening
provide SGreans lower & middle income households have access to primary healthcare by bringing affordable healthcare services closer to patients
MOH engages private GP & private dentists to provide common outpatient medical & dental treatment to the needy at subsidised rates
Restructured hospitals SOC & National dental centres - patients will pay subsidised rates
All pioneers receive CHAS benefits regardless of income or AV of home
Not income dependent, Additional 50% off subsidised services at SOC & polyclincs on top of Means Test Subsidies & Additional 50% off medication listed under the SDL & MAF
Household monthly per person - $1,101 to $1,800
Annual Value - $13,001 to $21,000
Household monthly per person - $1,100 & below
Annual Value - $13,000 & below
Each hospital to determine how to use subvention funds on its own to cover resources like manpower, consumable supplies.
Is the amount of funding given to healthcare providers to provide subsidised services
Evolution of Inpatient Funding
Global Budget Subvention
Are funds allocated based on lump sum, piece rate and casemix funding principles
Are funds allocated based on DRG. Every DRG depending on the complexity of treatment will command a different subvention amount.
Piece Rate Subvention
Are funds awarded based on the total number of patient days and volume of outpatient consult episodes consumed. Funding based on
Lump Sum Subvention
are operating funds given to a healthcare institution based on budgetary forecast
Lesson 4: Insurance and Employment Medical Benefits
Common Types of Health Insurance
Catastrophic Medical Insurance
To cover major illnesses where the associated medical cost is substantial
Covers in-patient & outpatient benefits, certain expensive and prolonged treatments like kidneys dialysis & cancer treatment
The basic H&S (Hospitalisation & surgical) insurance, some insurers refer to it as comprehensive major medical expense insurance
The national scheme called "Medishield Life"
Long term Car Insurance
Pays a fixed monthly amount for long term nursing treatment upon the insured's inability to perform a no. of activities of daily living.
Activities of daily living includes bathing, dressing, feeding, going to the toilet and moving around.
The national scheme : "ElderShield" is long term care insurance scheme.
- To guard against over-consumption
- Daily ward limit, policy year limit, lifetime limit: To address excessive claims
- To avoid first-dollar coverage & help MediShield target only large bills
Is a basic health insurance plan that helps patients cope with large hospital bills and selected costly outpatient treatments.
To cover medical expenses (Excluding the deductible & co-insurance) for stay in Class B2/C wards at public hospitals
Better protection - patients pay less medisave/cash
Protection for all SGC & PR
Protection for life
Cover SGC & PR who are not covered under MediShield Life
Lesson 5: MediFund, Medication Assistance Fund & Medication Assistance Fund (Plus)
Many Helping Hands
MediFund Approval Level
Level 2: Straight Forward Applications (SF)
Level 1: Pre-Qualified cases (AUTO)
Level 3: Non Straight Forward Applications (NSF)
Lesson 6: Financial Counselling
Preventing the undeserving from abusing the subsidies.
Individual Means Testing
Household Means Testing
Community Health Assist Scheme (CHAS) application