Means
test
Mass impact: Out-patients
They number 3m, 16 times more than in-patients and will
feel brunt immediately, says blacktag.
Jan 11, 2008
In
or out?
Blacktag is wondering why people have focused their attention
on inpatient ward admission charges in the public discussion
on means testing - see here for an example.
A quick
Internet search reveals that Singhealth, one of two major
public hospital clusters in Singapore, has an annual 3 million
outpatient visits, and only 181,451 inpatient admissions.
The
outpatient setting is probably where the true impact of
means testing will be felt immediately.
A considerable
number of people game the current system by obtaining polyclinic
referrals to tertiary care (currently, this is the only
way to obtain subsidised care at public hospitals in Singapore).
In response
to one ST Forum writer's query, there are certainly many
people who earn S$10,000 per month who receive subsidised
outpatient care.
Some
use the public healthcare system for cheap blood tests for
monitoring of a chronic condition, whilst continuing their
follow-up with private specialists.
To illustrate,
the same blood tests can cost a subsidised patient $21,
but a private patient $150. Ditto for CT scans, which can
cost $120 as a subsidized patient, close to $500 as a full-paying
patient (and incidentally nearly $1,000 in Mount E or Gleneagles).
Outpatient
care for a subsidized patient is quite similar to that of
a paying patient, so there is much less incentive to upgrade,
unlike the inpatient setting.
The
current lack of the Medisave cushion for many chronic diseases
will mean that the cost will be felt even more keenly by
outpatients, rather than the inpatient minority.
Regardless,
blacktag has considerable sympathy for a Republican approach
to healthcare, and he salutes Mr. Khaw Boon Wan for trying
to execute what may be truly the next major evolution in
healthcare financing since 3M.
http://blacktag.blogspot.com/2008/01/in-or-out.html
