Since 2006, MOH has allowed Medisave to be used for outpatient treatment for chronic diseases such as hypertension, up to a limit of $300 per year.
However, it would seem that this has been under-utilised. According to the Ministry’s reply to my parliamentary questions last month, only 15% of chronic disease outpatients paid bills with Medisave in FY 08. Of those who did utilize Medisave for payment, only 30% of claims reached the annual limit on withdrawals of $300.
I recently met an elderly gentleman with hypertension who has Medisave balances but is unable to use them to pay outpatient bills. This is because of the current policy that the outpatient must pay the first $30 of any bill. He showed me that many of his polyclinic bills were below $30.
According to MOH data, the median size of polyclinic bills for chronic diseases is $36 with 3 months’ medication. With the $30 deductible, plus an additional 15% of the balance to be paid in cash, Medisave would not be usable or useful for many such bills.
There are elderly sick who have little cash and savings. Yet, they are not allowed to draw their own Medisave money for medical treatment, but are asked to get family support. This increases the elderly person’s dependence on family members.
The elderly gentleman I mentioned told me he would sometimes default on his follow-ups due to finances. This could precipitate a worse, in-patient condition which would deplete his Medisave even more rapidly.
The government may be concerned about Medisave accounts being depleted. But safeguards already exist via the annual $300 cap, the requirement to co-pay 15% and the admin fee of $3.50.
The government should consider removing the deductible. There is anger among some elderly sick that even in their poor health condition, they have been denied to use of their own savings for healthcare.
(Note: this speech was delivered in Parliament on 9 Mar 2010.)
