Means testing for hospitalisation subsidy (2)

• Abstract
• Purpose of health policy or idea
• Characteristics of this policy
• Political and economic background
• Purpose and process analysis
• Expected outcome
• References

Abstract

The Ministry of Health is thinking of using means-testing to determine qualification for subsidised hospital care.

Purpose of health policy or idea

It has been one year after the topic was raised, generating much discussion. Although lower-income patients generally welcome the idea, middle-income patients are unhappy or wary. Some are concerned that if means-testing were to be based on income, issues of privacy may arise should hospitals be allowed to access income databases to determine eligibility. Furthermore, the challenge of finding an administratively simple way to implement means-testing has proved daunting.

Realizing that the topic is a controversial one, the Health Minister Khaw Boon Wan has promised to do it gradually as it is not a pressing issue and in any case, few people are actually abusing the present subsidised ward system.

Degree of Innovation	traditional		innovative
Degree of Controversy	consensual		highly controversial
Structural or Systemic Impact	marginal		fundamental
Public Visibility	very low		very high
Transferability	strongly system-dependent		system-neutral

Political and economic background

Purpose and process analysis

Current Process Stages

	Idea	Pilot	Policy Paper	Legislation	Implementation	Evaluation	Change
Implemented in this survey?

Expected outcome

One idea that the MOH is considering, is instead of shutting well-off patients out of all subsidised wards, a sliding scale of subsidies may be introduced, so that those with higher-incomes can still go to subsidised wards, but get a lower subsidy. For example, most Class C patients may get the usual 80 per cent subsidy, but a better-off patient choosing a Class C ward will get a lower subsidy. Such an incremental approach might cushion the impact of means-testing on well-off patients.

But for now, there is no rush to implement it. The issue is on the back burner.

References

Reform formerly reported in

Means testing for hospitalisation subsidy Process Stages: Idea

Author/s and/or contributors to this survey

Lim Meng Kin

Suggested citation for this online article

Lim Meng Kin. "Means testing for hospitalisation subsidy (2)". Health Policy Monitor, May 2005. Available at http://www.hpm.org/survey/sg/a5/1