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Pursuing affordable healthcare in Singapore – the next step forward

Dr. Nor Anisa Hanan, 11 Jan 2018

Starting from the third quarter of 2017, the Ministry of Health (MOH) Singapore has announced the change from per capita family income to per capita household income in their step to ensure that healthcare is affordable for its citizens.

In the previous per capita family income, only the immediate family members are included but with the new criteria, it also includes the family members that the elderly is living with.

With an ageing population, it was reported that by 2030, the number of people aged 65 and older will double to 900,000, so the care of the elderly should be taken more seriously from now. Under the Community Health Assist Scheme or CHAS, subsidies for nursing homes, home care and also for GP and dental clinics will be expanded to include the middle income.

To qualify for these subsidies, the per capita household income ceilings will be increased from SGD800 to SGD1,500 for CHAS, and from SGD1,400 to SGD2,200 for intermediate and long-term care.

For families who hire a foreign worker to take care of an elderly at their home, a monthly grant will be provided and drug subsidies will be raised especially for those requiring treatment for chronic conditions.

As echoed by Minister of Health, Mr Gan Kim Yong, these changes will not only help the low income significantly – but, also for the middle income.

Affordable milk brands from the start

In the latest move to counter high infant formula milk prices, all three public hospitals – i.e. Singapore General Hospital (SGH), National University Hospital (NUH) and KK Women's and Children's Hospital (KKH) – will carry only two ready-to-feed (RTF) brands that are more affordable, in order to help new parents with their financial concerns after taking their baby home.

This comes after a public outcry last year over the high cost of infant formula, with prices of most brands more than doubling over the past decade, and news that infant formula milk prices in Singapore are among the highest in the world.

The two brands that will be offered starting this July are Nestle's Lactogen and Danone's Dulac. Photo credit: The Straits Times
The two brands that will be offered starting this July are Nestle's Lactogen and Danone's Dulac. Photo credit: The Straits Times

Although it is undeniable that breastmilk is the best and the most cost effective, some infants do require formula.

RTF formulas are commonly adopted by mothers who are unable to breastfeed post-delivery as they might have suffered cardiac conditions, renal failure, or delivered their babies prematurely, said Associate Professor Tan Hak Koon, head and senior consultant at the Singapore General Hospital’s Department of Obstetrics and Gynaecology.

As most parents prefer to stick with the formula their infants had been fed while in the hospital, this makes it easier for them to continue with the cheaper brands after their babies leave the hospital.

Outpatient insurance coverage for bone marrow transplant

Patients with myeloma, also known as blood cancer, may be able to undergo bone marrow transplants as an outpatient if MediShield Life decides to cover the outpatient cost in the future.

The MediShield Life Review Committee will consider whether the insurance cover should be extended to outpatient treatment – possibly providing a cheaper option for blood cancer patients to get bone marrow transplants, said a MOH spokesman.

Currently, many opt to stay in the hospital as the insurance only covers inpatient bone marrow transplants, although admittedly that is the costlier choice.
Currently, many opt to stay in the hospital as the insurance only covers inpatient bone marrow transplants, although admittedly that is the costlier choice.

Director of the National University Cancer Institute Singapore (NCIS), Professor Chng Wee Joo, said that NCIS has been offering outpatient stem cell transplant treatment for myeloma patients since 2011, and the bulk of patients taking this up have been foreigners.

Although heavily subsidised, patients need to pay a high amount out of their own pockets if they were to choose outpatient treatment and the only outpatient treatments covered by MediShield Life are chemotherapy and radiotherapy.

"As outpatient bone marrow transplant has recently become a more established and safe substitute for inpatient cancer treatment, the MediShield Life Council will consider including coverage for such treatment, as part of their regular reviews," said a MOH spokesman. He further added that the change would take some time, as the next review is not expected soon.

With more cancer patients being treated as outpatients and at their homes, the hospital beds can be utilised for the patients who have no choice. This move not only saves the patients from unnecessary exposure to infections, it also saves the patient’s and the caregiver’s time. MIMS

Read more:
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Singapore hospital volunteers growing in numbers – taking on more roles and responsibilities
Singapore MOH investing SGD12 million to improve quality of community care sector

Sources:
http://www.todayonline.com/singapore/kkh-sgh-nuh-use-only-cheaper-infant-milk-formulas-july-1
http://www.straitstimes.com/singapore/cheaper-option-for-bone-marrow-transplants
http://www.straitstimes.com/singapore/health/three-hospitals-here-to-switch-to-cheaper-infant-formulas-from-july-1
http://www.straitstimes.com/singapore/health/three-hospitals-to-offer-cheaper-infant-formula
https://www.channelnewsasia.com/news/singapore/affordable-healthcare-for-all-gan-kim-yong-8455152
https://www.vox.com/policy-and-politics/2017/4/25/15356118/singapore-health-care-system-explained
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