Mr Speaker,
The MediShield Life Scheme (Amendment) Bill 2024 introduces several changes to the MediShield Life framework to adjust premium structures, enhance administrative powers and improve the affordability of healthcare coverage. I would like to seek clarification on several areas that may impact Singaporeans financially and administratively.
Ministerial Powers for Regulation and Subsidy Criteria
Clause 11 amends Section 34 of the Act, which grants the Minister broad powers to make regulations, including determining premium rates for different classes of insured persons. MediShield Life premium subsidies now consider both Per Capita Household Income (PCHI) and the Annual Value (AV) of one’s residence. The AV tiers provide the highest subsidy to lower income insured persons living in properties with AVs up to $21,000 and a reduced subsidy for AVs between $21,000 and $25,000, while AVs above $25,000 receive no subsidy, unless they are from the Pioneer or Merdeka Generation.
This criterion could present a financial challenge for some low or no-income households, particularly retirees living in private property and are born in 1960 or later. These individuals may face rising medical bills yet do not qualify for premium subsidies due to the property they live in. Many of these elderly Singaporeans are unlikely to downsize their homes, especially if they are currently suffering from serious illnesses. The physical and emotional disruption of relocating during a vulnerable period is impractical and could worsen their health conditions.
For retirees and other low-income households, I urge the government to consider removing AV as a means-testing criterion. Minimally those with AVs above $25,000 should still be allowed to apply for premium subsidies, and a holistic and transparent assessment should be made based on their individual circumstances. This approach would allow the scheme to target subsidies more effectively towards those who genuinely lack cash flow for their healthcare needs.
Premium Adjustments and Transparency
Clause 5 grants the Minister flexibility to set premium rates through prescribed means, possibly via online publications. Although this change could streamline the process, I have some concerns about stability and predictability of premium rates. Policyholders, especially those with lower incomes, rely on consistent healthcare costs to plan their finances. Frequent premium adjustments could challenge their ability to budget effectively.
Will the government establish a regular schedule for premium adjustments, and if not, how much advance notice will policyholders receive to prepare for changes? This will provide policyholders with more transparency and predictability regarding their healthcare expenses.
Approval of Claimable Medical Services
Clause 4 grants the Minister discretion to approve medical institutions and the treatments they offer as eligible for MediShield Life claims. Although this change may help manage costs, it could also limit access to necessary care if certain treatments or institutions do not receive approval. Unapproved services might force policyholders to pay out-of-pocket, discouraging them from seeking essential treatment.
Could the Minister clarify if the criteria for approving medical services and a complete list of approved services and institutions will be published regularly? This will help policyholders to make informed healthcare choices and avoid unexpected costs.
Additionally, does this amendment allow the Minister to designate Traditional Chinese Medicine (TCM) and other traditional medical practices as approved medical treatments in the future? Many Singaporeans rely on TCM and other traditional practices for managing chronic conditions and maintaining overall health.
Enhanced Penalties for False Information
Clause 6 broadens the scope of offences related to false or misleading information in health declarations, means declarations or claims. This amendment aims to deter fraud, but it may disproportionately impact elderly or less tech-savvy policyholders who may make honest mistakes in their submissions.
What are the provisions for rectifying minor or first-time errors, especially for vulnerable groups? Establishing a grace period or correction mechanism would prevent harsh penalties for honest mistakes, particularly for seniors unfamiliar with digital processes.
Use of Means Information for Recovery Actions
Clause 9 allows the government to use means information to assess eligibility and support recovery actions for outstanding premiums. Although this approach may ensure targeted resource allocation, it could place additional pressure on low-income policyholders. Aggressive recovery actions, if based primarily on financial data, could create financial stress for households already struggling to meet healthcare costs.
Will the government provide safeguards like automatic premium loans or deferred payment options to protect financially vulnerable policyholders and help them maintain coverage without incurring penalties?
Will policyholders lose coverage if they still fail to pay their premiums?
Service of Documents and Demand Notices
Clause 10 introduces electronic methods for serving official documents, including email, which may improve efficiency. However, policyholders who are less comfortable with digital platforms might miss important updates, potentially leading to unintended coverage lapses or penalties.
Does the government offer additional communication methods, such as phone calls or in-person notifications, to ensure all policyholders receive and understand crucial information?
Conclusion
Mr Speaker, this Bill seeks to enhance the MediShield Life framework, but these changes must not place unnecessary burdens on those who rely on the scheme most. For low-income households, I urge MOH to review the use of AV as a criterion for means testing, so that retirees and those with limited cash flow can receive subsidies based on their actual financial need.
Sir, I support the Bill but I look forward to the MOS’ responses to my questions.