When I was in my twenties and thirties, I devoted time training and competing, particularly in middle distance running. I was inspired by the athletes I watched in international competitions, pushing themselves beyond the limits of physical and mental boundaries, determined to fly their national flags high. I am often left in awe in the wake of sporting excellence. From Olympic gymnast Nadia Comaneci scoring perfect 10s in 1976 in Montreal, to earlier heroes like Emil Zatopek, who won the 5,000m, 10,000m and marathon, in the same Olympic Games in Helsinki in 1952; to our very own champions C Kunalan and Chee Swee Lee, to our Malaysia Cup winners playing the beautiful game. For me, sporting excellence was, and still is a pure form of sincerity and commitment to the nation, and putting it lyrically, is ‘poetry in motion’.
By comparison, my own endeavours were modest. The pinnacle of my achievement was winning the Ladies Section of the NUS Mini-Triathlon in my final year of undergraduate studies, and later, some cross-country runs in organisations I worked for. Nevertheless, modest as my endeavours were, I paid a physical price. I aggravated a hip problem and sustained cartilage tears, which plagued my quality of life as I entered my forties and fifties. I stopped running, switched to modified and lower impact activities like swimming, and focused on recovery and strength building in order to age well.
I share this experience to illustrate what is but a fraction of what our national athletes do to their bodies, over and over again, at higher intensities, and on a much larger scale. The intensity and consistency one needs to put in to represent Singapore in global competitions, facing off with the best in the region and the world, is beyond imagination. Top athletes such as golfing legend Tiger Woods and basketball sensation Yao Ming had their sporting careers prematurely end or cut short by injury. The mental pressure is another key aspect, which we are still learning more about, thanks to the likes of Japanese tennis star Naomi Osaka.
Injuries that Persist or Emerge Later
As for sports-related physical injuries, they can persist for a long time, both in recreational and competitive athletes. A recent Straits Times article found that youth have been suffering from sports-related injuries in the post-pandemic period at a higher rate, and that injuries sustained in youth are likely to recur in some form later in life[1]. Frequent or severe sports injuries may also put youth at risk of longer-term wear and tear related degenerative conditions such as osteoarthritis.
Orthopaedic surgeon Dr Tan Ken Jin shared his observations in a 2020 article entitled: “10 Sports Injuries with Lifelong Consequences”[2]. The 10 lifelong sports injuries he pinpointed were: sprains, hamstring strains, stress fractures, ACL knee injuries, patella (kneecap) dislocation, meniscus tears, tennis elbow, shoulder dislocation, sciatica (lower back pain) and fracture. These injuries could have resulted from improper training practices or wearing improper sporting gear, or basic elements like not having proper warm ups or stretching. Even with all these done properly, getting injured is commonplace in competitive sports, particularly high impact sports such as basketball, soccer, badminton, tennis, volleyball and gymnastics. And the injuries do not just go away when one stops competing. One lives with them.
More is also known today about latent injuries that emerge long after one’s sporting days are over. There is an increasing concern especially in contact and collision sports about chronic traumatic en-cepha-lopathy or CTE, a type of dementia caused by repeated head injuries that affect the brain’s function over time. In a 2022 study, researchers found that players of contact sports such as American football, rugby, and soccer were 68 times more likely to develop CTE than those who did not[3]. In fact, a group of former English and Welsh rugby players have initiated a class action lawsuit against their respective rugby governing bodies, asserting that they failed to protect players sufficiently in the sport, with many players ending up with dementia or CTE later in life[4].
This knowledge has led to concerns among sporting bodies across the world, and some have implemented changes to the rules of training and sports to reduce the risk to athletes.
Current State of Play re Medical Coverage
How well covered are our national athletes against such long-term or latent injuries? When I asked a Parliamentary Question in January on insurance coverage for national athletes, the basic answer from MCCY is that the coverage is there while the athlete is still representing Singapore[5].
Based on what we know now about sports injuries which are latent or have lifelong consequences, covering athletes only while they represent Singapore is clearly inadequate. There is a joke about the Football Association of Singapore in this context – that FAS stands for “Forget After Service”. To be fair to the FAS, we have noted their recent efforts to provide career support to former players, which is a step in the right direction. Even so, the injuries and their long-term impact on function and quality of life remain. A friend of mine who used to be a national hockey player reflected on his life and the injuries he sustained, and concluded that it was simply not worth it.
The contributions of our national athletes are beyond just reimbursements and compensations. While they commit to sporting excellence, their careers and other life decisions may be put on hold, their education may get delayed, and they may lose work or business opportunities in the prime of their lives. It will also not be possible to trace back the amount of personal and family resources ploughed into training and getting to the levels they have achieved.
What the Country Can Do
Nevertheless, there is one low-hanging fruit that I think we can and must do: Provide all national athletes with medical subsidies for the duration of their lifetimes. Such a gesture is appropriate as it acknowledges the physical toll that highly competitive sports takes on one’s wellbeing, and that it is only right that society contributes more to those who have served to bring glory to the nation at the world stage.
Since national athletes are covered while serving, these subsidies should kick in after they have retired from representing Singapore. As to who should qualify for such coverage, this should be further discussed; one possibility is to include Singaporeans who have represented the nation in any internationally recognized sport for at least a year. As to how to peg the amount of subsidies, this should be worked out, but what is important is that the subsidies lessen the out of pocket healthcare expenses of former national athletes compared to other citizens. Even a further subsidy of just 10 to 20% more would be a powerful signal that society has not forgotten them and respects their sacrifice and service.
To this end, I call for the setting up of a multi-disciplinary task force. This task force will work on a scheme to give additional subsidies to former national athletes for their treatment costs for sports-related conditions, so long as the treatment is sought in our public healthcare institutions. To manage the costs to the national budget, the scheme should be scoped in terms of who would qualify and what the quantum of subsidies should be. As to the composition of the task force, I would suggest the inclusion of medical and sports science scholars and professionals, who would advise on the types of injuries and conditions that are associated with competitive sport. It should also include government officials from the relevant agencies, such as Sport SG and the Ministries of Health and Finance.
As a side note, it has been suggested to me that in speaking on this topic on our retired athletes, I should declare an interest, as my partner is a former and retired sports star. I can assure the House and the public that I have no pecuniary interest in this, as he pays his own medical bills.
Conclusion
In my speech, I have focused on how we should Do Right for our National Athletes in terms of supporting their healthcare needs over their lifetimes. As a citizen of Singapore, I do not wish to see our sporting heroes worry about their medical bills. I believe we should look seriously into providing lifetime medical subsidies to our national athletes.
Let me end by quoting the American running legend Carl Lewis. He once said: “I want to be remembered as a person who felt there was no limitation to what the human body and mind can do, and be the inspiration to lead people to do things they never hoped to do”. Sports does that, uplifting all of us in good times and bad. For the pride and joy that our national athletes have brought us, we can do this bit more for them.