Means Testing Starts On Jan 1 2009

PATIENTS warded in B2 and C class wards in public hospitals from today will be means-tested to determine the level of subsidy they will get. They will be asked upon admission to give their signed consent to grant hospitals permission to check their income.

Details of how much they earn, however, will not be disclosed to counter staff, who will know only the subsidy band into which patients fall.

A Health Ministry spokesman said hospital admission systems will be linked to the Central Provident Fund Board and to the Inland Revenue Authority of Singapore so the subsidy level can be calculated and bill estimates presented to patients.

Patients may refuse to have their incomes checked. But this will mean they will automatically get the smallest subsidy - 50 per cent for treatment in a B2 ward and 65 per cent in a C-class ward.

Up till yesterday, B2 and C-class patients got their respective flat subsidy rates. From today, patients in these two ward classes will fall into one of 16 subsidy levels.

Those earning $38,400 or less a year will continue getting the full 80 per cent subsidy in C class and 65 per cent in B2 class. People with annual incomes of $62,412 or more will get the minimum subsidy of 65 per cent in C class and 50 per cent in B2 class.

People with no income, such as retirees or housewives, will have their subsidy rate pegged to the value of their homes. If their homes are valued at $11,000 or more, they will get the minimum subsidy. About a fifth of all homes fall into this category.

All unemployed residents of HDB flats - excluding those in executive condominiums - will be entitled to full subsidy.

Following a policy started two years ago to put citizens above non-citizens in health benefits, permanent residents will receive 10 percentage points less subsidy than citizens with the same income.

A permanent resident in a C-class ward, for example, will get a subsidy ranging from 55 per cent to 70 per cent.

Although today is the start date for means testing, patients who will be admitted for treatment later this month but who have already done their pre-admission registration will continue to be subsidised at the old rate regardless of their incomes or house type.

The same applies to patients already in hospital by yesterday.

Member of Parliament Josephine Teo, who is on the Government Parliamentary Committee for Health, said that when the introduction of means testing was debated, 'no one could have foreseen the dramatic change in economic conditions'.

She suggested that 'the assessment of means must look to the future even though we use past income as a gauge'.

Fellow GPC member Lam Pin Min, however, argued that the means testing system is 'dynamic' - it will accommodate a patient who has taken a pay cut by bumping up his subsidy accordingly.

But he urged the Government to show compassion, especially when assessing older patients' eligibility for subsidies.

Health Minister Khaw Boon Wan yesterday promised to do so. He told The Straits Times: 'We have and will always be sympathetic to those in financial difficulties. That is why we have significantly ramped up Medifund disbursements this year and the next.

'If the patient's employment condition has changed from the historical record in CPF, we will certainly take that into account.'

But some retirees are not taking chances. A former teacher who lives in a terrace house said he plans to start declaring an income of a few hundred dollars a month for giving tuition.

This way, he can continue getting the full subsidy if he is hospitalised, even though he lives in a relatively expensive house.