SUBSIDIES for patients at community hospitals will go up

Patients can also use more of their Medisavefunds to pay for treatments at these hospitals from the middle of this year.

In addition, community hospitals will be geared up to deal with patients recovering from more serious conditions, such as hip fractures and urinary tract infections.
 
Health Minister Khaw Boon Wan hopes these moves will encourage more patients to move from an acute hospital, such as Changi General, to a nearby community hospital like St Andrew’s, when their condition improves.

By doing so, they will help to lower costs as community hospitals are cheaper to run. At the same time, it will free up beds in acute hospitals for other patients.

Mr Khaw said the changes are in response to calls by several Members of Parliament “for rational Medisave withdrawal rules to encourage right-siting of patients in the community”.

As Dr Amy Khor (Hong Kah GRC) pointed out in Parliament yesterday: “Even though the total bill size for a stay at an acute hospital is more, the out of-pocket expenses for the community hospital are generally higher than that for an acute hospital.”

Currently, patients who are relatively better-off receive higher subsidies at an acute hospital, owing to means testing which gives them a lower subsidy in a community hospital.
 
Also, they can use Medisave to pay more of their bills in an acute hospital.

Pointing to the anomaly, Dr Khor called for a review of the Medisave amount for use at community hospitals, and increased Medisave use for day rehabilitation centres.

“This would lead to greater optimisation of the different health-care facilities,” she said.

Responding, Mr Khaw announced the higher subsidy, saying it will be calculated based on a daily cost of $400, instead of the current $271 a day.

Also, the maximum withdrawal from Medisave will be raised from $150 to $250 a day, and $3,500 to $5,000 a year.

Based on these new limits, three out of four patients would be able to settle their community hospital bills in full using their Medisave, said the Health Ministry in a statement.

St Luke’s Hospital told The Straits Times the change should help one-third of its C-class patients, who will be able “to fully cover their stay ... and lessen the monetary burden on family members”.

Another change: People can withdraw up to $25 a day from Medisave for day rehabilitation services. It is now $20.

The increase is to help patients pay for the higher cost of better care, with skilled therapists. The ministry is working with health-care providers to offer good rehabilitative care near patients’ homes.

Mr Khaw is also looking at how to improve ElderShield, the long-term disability insurance that pays $400 a month for up to six years, when someone cannot do without physical help.

Dr Lily Neo (Jalan Besar GRC) had questioned the adequacy of ElderShield “in serving its intended purpose in terms of its accessibility, quantum and tenure of payout”.

Mr Khaw said the payout is enough for the low-income group. But he would like to see it doubled to $800 a month.

Instead of increasing the premiums, he is toying with the idea of starting premium payments earlier – from age 35 or even 30, instead of the current 40.

Mr Khaw also expanded on an earlier announcement to help lower middle income patients pay for expensive cancer drugs via Medifund – a government aid now offered only to the very poor.

The fund will get $10 million for this purpose and the money can be used for six drugs: three for cancer, one for asthma, one for osteoporosis and the last for anaemia caused by kidney failure.

The amount is on top of the $8.5 million committed earlier to help pay for the medicine of Aids/HIV patients.

More money would be poured into this Medication Assistance Fund, should it prove useful, said Mr Khaw.

Non-Constituency MP Sylvia Lim suggested removing the $30 patients must pay before using Medisave to pay for outpatient treatment of chronic ailments.

“There is anger among some elderly sick that even in their poor health, they have been denied use of their own savings for health care,” she said.

The minister felt it would be an unwise move and added: “I have the unpleasant task of being the gatekeeper to Medisave.
 
I know Medisave is your money, but if it runs out prematurely, you will be in trouble. I am trying to prevent such an outcome.”