Reduced hospital subsidy for non-citizens

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

Abstract

From October 2007, non-citizens will have to pay more when seeking treatment at public sector hospitals and national specialist centers.

Purpose of health policy or idea

The Government will cut subsidies for hospital treatments for permanent residents (PRs) by 10 percentage points over two years, i.e. a 5 percentage-point cut in October 2007 and another 5 percentage-point cut in October 2008 (see Table 1), while healthcare subsidies will be cancelled completely for other foreigners, including the foreign workers subsidy, from October 2007 on.   

Table 1. Revision of subsidies for permanent residents

Type of ward, class/service	Subsidy level
	Citizen	Permanent resident
		October 2007	October 2008
Class B1	20%	15%	10%
Class B2	65%	60%	55%
Class C	80%	75%	70%
Day Surgery	65%	60%	55%
Specialist Outpatient Clinic (SOC)	50%	45%	40%

An exception, however, will be made for emergency services at hospital emergency departments where fees will not discriminate between nationality or citizenship.

Main points

Main objectives

This is a deliberate move to place the interests of Singapore citizens above non-citizens. A government minister was quoted in the press as candidly saying: "Over the years, Singaporeans have been asking: 'What's the advantage of being a Singapore citizen when PRs are seen to enjoy the same kind of privileges?' So, doesn't that make foreigners opt for the PR option to enjoy the same benefits as Singaporeans - meaning they have the best of both worlds? This move will indicate to Singaporeans that Singapore citizens matter - that's what it's all about."

Political and economic background

Singapore has a population of 4.2 million, of which 1 in 4 is not a citizen. There are two categories of non-citizen residents: Permanent Residents (PRs) and other foreigners, including foreign workers. Currently all residents, regardless of citizenship status, receive the same healthcare subsidies at public sector healthcare institutions ranging from 20 to 80 per cent.

In 2006, Singapore hospitals saw:

• about 10,000 PRs and 10,000 foreign in-patients in Class B2 and C wards, or 9 percent of total subsidised admissions;  
• about 4,000 PRs and 3,000 foreign patients registered for subsidised day surgery, or 7 percent of total subsidised day surgeries; and 
• about 82,000 PR cases and 60,000 foreign cases for subsidised specialist out-patient clinic treatment (SOC), or 7 percent of total subsidised SOC workload. 

The new move to differentially charge non-citizens is expected to free up about S$36 million (ca. €17.5 million) a year, which the government said will be ploughed back for financing citizens' care such as elderly care.

Purpose and process analysis

Current Process Stages

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

Stakeholder positions

Employers of non-citizens will have to bear a heavier burden of health care costs. The Ministry of Manpower is currently in talks with employers and insurers on a compulsory medical insurance cover, the medical insurance premiums for which could range between S$10 and S$20 per worker.

Expected outcome

References

Author/s and/or contributors to this survey

Lim, Meng Kin

Suggested citation for this online article

Lim, Meng Kin. "Reduced hospital subsidy for non-citizens". Health Policy Monitor, April 2007. Available at http://www.hpm.org/survey/sg/a9/1