Sunday, August 28, 2011
SINGAPORE GOVT TO IMPROVE HEALTHCARE FOR THE PEOPLE
A video excerpt from Singapore PM Lee Hsien Loong's National Day Rally speech on 9 August.
The following is a transcript of the above speech. The graphics are sourced from the Ministry of Health's website. They sum up the main points made by the PM regarding healthcare for Singaporeans.
"The next five years - there is going to be rapid change. Our aging population is going to throw up new challenges and there will be other groups which will have specific needs which we have got to tackle. We will keep on improving our social safety net, enhancing it, keep the present approach but improve the schemes and I would like to talk about two things which we will be doing tonight.
One is to do with medical care and particularly with outpatient treatment, especially for older people. Many Singaporeans worry about medical expenses, especially if you are older or you have an elderly member in your family. The 3M framework, Medisave and so on, works well for inpatient care but for outpatient treatment, I think we can do better. One group of these elderly is those who need long term care. They may be bed-ridden or they may have Alzheimer’s and I talked in the Chinese speech just now of some of the things we are doing to help this group. We will give more support, expand services, make the services more affordable.
Another group is patients who have chronic ailments, maybe high cholesterol, maybe high blood pressure, maybe diabetes and amongst the people who are in their 70s maybe half will have one chronic ailment or another. When you have something like this, you will know that you need regular checkups and you need long term medication. It is not that you take the pill 10 days and the problem is cured. You have these pills, take it for the rest of your life, every three or six months see the doctor, the doctor will examine you, adjust the dosage, six months later see again.
Try and keep well for as long as you can. But the pills can be expensive, particularly over a long period of time and the low income patients tell me they may skip an appointment because they fear they cannot afford the pills. Or they may say “the doctor says I eat this every day but I take it every other day instead to save money”, which is not the way it is supposed to be done because if you do that, your condition will worsen and more trouble will come later on, serious complications.
I think that we should make outpatient care more affordable and accessible for this group: the elderly and the not so elderly. We have a scheme to help elderly chronic patients like this. It is called the Primary Care Partnership Scheme (PCPS), which helps the low income elderly and disabled. What it means is: you have a card, you are registered, you can see your GP instead of going to the polyclinic but you get a subsidy like you are going to the polyclinic. It is more convenient, you have more choices and you probably get faster service.
We will change this scheme which is now quite restrictive and where you have to be 65 years old before you are considered for this scheme. We will change it so that you can start at the age of 40. Because when you have high blood pressure or cholesterol or diabetes, by the age of 40 it is beginning to show up particularly if you have not looked after yourself. When you have conditions like this, the earlier you start treating, the better I think the results will be and you have to cooperate and we will improve the scheme to help you to be able to have consistent treatment over a long period of time.
We will also revise the income criteria to include more households so that a broader range of households can come in under the scheme and can get consistent good long term care. We will also make the medication more affordable to lower income households. We will expand the drug list so that it covers more drugs and we will increase subsidies for the more expensive drugs with safeguards so that those with chronic ailments or cancer where chemotherapy can be very expensive, well you will get more help.
I think these are major moves. We will implement them carefully and as we gain experience with them, we can consider how to fine-tune and how we can take further steps forward. We have to be very careful because you do not want to end up like the Americans where the government health schemes have eaten up a huge amount of the budget and financially and fiscally it is a big problem for them. But we can do better, we will do better and MOH is working on it and they will announce the details later on. So this is one area where we can improve our social safety nets."