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ELEVEN years ago, the Ministry of Health (MOH) embarked on a portable subsidy scheme to help the old and poor see a doctor near their homes when they were sick. For this group, the cost of visiting a general practitioner was beyond their means, so even with a high fever and runny nose, they would take the bus to the nearest polyclinic. The idea was “to provide convenient and affordable health care for needy elderly and disabled Singaporeans”, explained an MOH spokesman.
When the Primary Care Partnership Scheme (PCPS) started in 2000, it was only for the treatment of acute problems such as flu or diarrhoea. For long-term chronic care, patients had to go to a polyclinic for subsidised care. This changed in 2009 when a few chronic conditions were added. By the end of this year, the scheme will cover 10 chronic conditions and dental care. To qualify, people have to be means-tested. They have to be at least 65 years old and from families whose per capita monthly household income is $800 or less. This is the total income of the family divided by the number of people in it. There are 405 GP clinics on the scheme and more than 30,000 people now carry the PCPS card. With the card, the GP’s bill is about what they would have paid had they gone to a polyclinic.
From next year, the scheme will be extended to people aged 40 and older – down from the current starting age of 65. The spokesman said chronic ailments, such as diabetes and high blood pressure, generally show up from age 40. Four in five people with chronic ailments are above that age. When a person has a chronic ailment, it is likely that he has to take medication for the rest of his life. If he has more than one problem, the cost mounts.
Today, a third of patients at polyclinics are there to seek treatment for their chronic problems since the cost of medicine and consultation is far cheaper than at a private GP clinic. But polyclinics are open only during office hours. By letting them see a GP, most of whom keep their clinics open at night, but still paying polyclinic rates, the MOH hopes more people would have their conditions well-controlled. The scheme will also be extended to people from the lower middle-income group – or those from families with a per capita income of $1,500 a month.
Health Minister Gan Kim Yong had explained that he hoped to “rebalance” the workload and give GPs more work. When the changes come into effect from next year, about 710,000 people would qualify for this portable subsidy. With the expanded catchment, the MOH expects to spend $28 million a year.
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