Straits Times: Contradiction? No, means testing not urgent back in 2006

BUDGET DEBATE – DAY 6

BY LI XUEYING

HEALTH Minister Khaw Boon Wan and Workers’ Party MP Low Thia Khiang crossed swords yesterday over whether the former was “contradicting” himself by now pushing ahead with means testing for payment towards public hospital stays.

Speaking in Mandarin, the Hougang MP pointed out that just before the May 6, 2006 General Election, Mr Khaw had said that he had not considered the issue. Yet, he was now going ahead with means testing.

The minister declared there was no contradiction, because what he had said in 2006 was that means testing was not urgent on his agenda then.

“I had many other urgent issues to attend to. I wanted to further reform Medisave … and reform MediShield to allow larger payouts.

“So these were the key issues…at the top of my head. I said, at some stage we’ll probably do means testing but it’s certainly not urgent. And I even said I don’t see myself implementing it in the first year,” he said.

“So I have not contradicted what I said during the GE,” said Mr Khaw.

The minister also took on Mr Low’s charge that means testing takes away Singaporeans’ right to decide if they have the means to pay their hospital bills.

Speaking in Mandarin, Mr Low said: “This is a fundamental change. Currently, a patient can gauge his own financial well-being and decide which ward he wants to be in and thus which subsidy to qualify for.

“Under means testing, even if a patient thinks he cannot afford it and so decides to go for the C-class ward, the Government can – after assessing his financial ability – still make him pay higher fees.”

He also questioned the Government’s motive in implementing means testing.

“Means testing allows the Government to legitimately reduce its subsidies to those patients whom it thinks can afford it,” he said.

“This will result in higher bills for some – and perhaps, in future, the majority of – B2- and C-class patients.”

Ultimately, hospitalisation subsidies are the “final line of defence” in Singapore’s social safety net, he argued.

“Once hospitalisation means testing is implemented, Singaporeans’ anxieties about a lack of social security will increase.”

Mr Khaw replied that all Singaporeans – regardless of income level – can still opt for C-class wards.

The only difference is that for richer Singaporeans, “your subsidy need not be as high as someone who is earning a fraction of your income!”

Mr Low then argued that means testing would end up hurting the middle class the most.

“Does the minister not agree that the outcome of means testing will be for the not-so-rich to pay more? The real rich will go to private hospitals,” he noted. “Is the Government unable to afford improving health care, without implementing means testing?”

Mr Khaw conceded that means testing could hurt the middle class. He pointed out however that the Government had “erred on the side of generosity”, by adopting $3,200 as the personal income cut-off.

This way, almost 60 per cent of the population will still qualify for full subsidies in B2- and C-class wards, he noted.

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