SINGAPORE: Even as some hospitals look to increase the number of medical social
workers in the next few years, some have raised suggestions on how healthcare
subsidies are being delivered and formulated.
Healthcare experts said that,
although increasing the number of medical social workers - who are now
stretched by large caseloads - will help in making sure patients are adequately
informed of their financial assistance options, they urged the authorities to
improve the subsidy system for patients by pegging subsidies to inflation
rates, or to create a "one-stop shop" to streamline the complex
financial schemes and make it simpler for patients.
Their suggestions came after
Deputy Prime Minister Tharman Shanmugaratnam indicated during a National Day
constituency dinner last month that the government will improve the way that
subsidies are being delivered, as it was not well understood by some, which he
admitted was probably the government's fault for not communicating it clearly
enough.
In improving the way information
on subsidies is being delivered to patients, Dr Jeremy Lim of the Saw Swee Hock
School of Public Health said that schemes needed to be simplified, and
effective financial counselling is "critical", which can only be done
by well-trained hospital staff.
"The government can support
by simplifying the schemes and hospital management can assist by streamlining
the evaluation and approvals for any exceptional subsidies," he said.
Currently, according to hospitals
TODAY spoke to, patients are advised on their estimated bill sizes upon
admission, based on their choice of ward class, expected length of stay and
types of surgical procedures or treatments. Needy ones can seek advice from
medical social workers.
Professor Phua Kai Hong of the
Lee Kuan Yew School of Public Policy, who cited "a big information
gap", said there should be a "one-stop centralised body" that
takes care of all medical financial schemes and transactions, making it easier
for patients. "Right now, it is very decentralised and there is a lack of
knowledge; the onus is pushed back to the patient to find out more. The medical
social workers are also very busy and stretched," he said.
There are currently about 400
medical social workers in Singapore and the hospitals, as well as the Ministry
of Health, said that it is an ongoing process to level up the skills of medical
social workers via training.
Subsidies can also be formulated
differently to bring down bills for patients, said the medical experts. Prof
Phua called for subsidies to be pegged to inflation, while Dr Lim said
co-payment of bills could be capped to a maximum determined by the patient's
income.
"Subsidies are typically on
a percentage basis which, to economists, would be regressive as the poor pay
proportionately more of their income. Also, there is no cap on how much
patients pay and hence patients do face continued anxiety over unexpected
complications or extremely large bills," Dr Lim said.
TODAY
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