CNA Explains: Singapore’s revised healthcare subsidies – what you need to know

SINGAPORE: More people in Singapore will qualify for public healthcare subsidies; and more financial relief will be offered in community and palliative care settings, after changes that took effect from Tuesday (Oct 1).
The Ministry of Health (MOH) said the aim was to improve affordability for patients and ensure greater continuity of care across acute and community settings.
They have to do with monthly PCHI – that’s per capita household income – which is calculated by dividing total gross household monthly income by total number of family members in a household. 
MOH raised PCHI thresholds for healthcare schemes and grants that are means-tested; across the subsidy tiers. The increases range from S$100 to S$800.
For example, patients with a PCHI of S$2,100 will be eligible for 80 per cent subsidy for C and B2 wards at public hospitals. Previously, their PCHI would have had to be not more than S$1,800.
Those with a PCHI of S$1,500 and below will qualify for a CHAS blue card, which provides the most subsidies out of three tiers. Previously, only those with a PCHI of S$1,200 and below qualified for this. 
The qualifying PCHI for the highest MediShield Life and CareShield Life health insurance premium subsidies was also raised from S$1,200 to S$1,500.
Additionally, MOH raised means-tested subsidy rates for community hospitals and palliative care services (in both hospitals and community) to match those at acute hospitals.
For inpatient care at community hospitals, Singaporeans will receive subsidies of at least 50 per cent, up from 30 per cent in the past.
Starting from Dec 1, MOH will also progressively expand a list of subsidised diagnostic services at community hospitals, to eventually align with those at acute hospitals. These services will include CT and MRI scans.
For palliative care services, all Singaporeans – regardless of their monthly PCHI – will receive subsidies of at least 50 per cent. The qualifying monthly PCHI for the highest subsidy was raised from S$800 to S$2,100.
Previously, there were subsidies of up to 75 per cent for inpatient palliative care and up to 80 per cent for home palliative and day hospice care, but there were some patients who did not receive any subsidies.  
Singapore citizens and permanent residents qualify for means-tested subsidies and grants, though the subsidy cap differs.
For instance, citizens are eligible for up to 80 per cent subsidies for inpatient sub-acute and and rehabilitative care at government-funded community hospitals, as well as palliative care services by government-funded providers.
For permanent residents, it’s up to 50 per cent.
No action is needed on the part of patients, as healthcare service providers and scheme administrators will automatically extend the subsidies and grants to those eligible.
Existing CHAS cardholders who are eligible for a card with higher subsidies will also be automatically issued new ones.
More people – up to 1.1 million Singapore residents, according to MOH – will benefit from increased subsidies.
The increased subsidies for community hospitals also aims to encourage “right-siting” of patients, which refers to providing appropriate medical care wherever cost is the lowest possible. 
In a speech on Monday, Health Minister Ong Ye Kung noted that some patients could be reluctant to move to community care settings because they feel more assured of government financial support in acute hospitals.
The latest changes, along with increased community care capacity and the rollout of Healthier SG and Age Well SG, point to a significant shift in focus from hospitals to community and home settings, said Mr Ong.
Plans for the higher subsidies were actually announced earlier this year, during the Budget by then-Deputy Prime Minister Lawrence Wong. He said then that the changes will cost the government an extra S$300 million a year.
Public health specialist Jeremy Lim said that in the grand scheme of things, this additional spending is not a “large sum” compared to the overall national budget for healthcare. MOH’s revised expenditure for last year came up to nearly S$18 billion.
“What’s important is that the monies help to allay citizens’ concerns about healthcare affordability and increase accessibility,” said Assoc Prof Lim.
“Ideally, citizens then access these services earlier, have better outcomes and have the peace of mind about affordability.” 
And on a wider level, this could improve efficiency and lead to savings from avoiding late diagnosis and complications, he added.