SINGAPORE, Oct 4 — The estimated set-up costs of an upcoming national programme to improve Singaporeans’ health is more than S$1 billion (RM3.25 billion) over the next three to four years, Health Minister Ong Ye Kung told Parliament on Tuesday (Oct 4).
The funding will go towards new information technology (IT) systems, ground support capabilities and one-time support for general practitioners (GPs) to provide them with the necessary IT enhancements, Mr Ong added.
An additional S$400 million yearly will also go towards recurrent costs for the Healthier SG programme.
These costs include support measures for residents such as higher subsidies for drugs targeting common chronic diseases at GP clinics and the annual service fee for GPs, Mr Ong said.
And while the Government will do its best to relieve the administrative burden on GPs, it is inevitable that they will have to handle more paperwork as a result, said Mr Ong, who also provided a breakdown of what and how GPs will be paid for under the nation’s biggest healthcare reform in years.
“We estimate that in the coming few years, Healthier SG service fees and revenue from subsidised services can grow as more residents enrol and become a significant component of a GP’s annual revenue — maybe a quarter, or maybe a third.
“So hand on heart, MOH (the Ministry of Health) I think has always been a very fair and prompt as a service buyer, and I assure GPs that we will continue to be so,” said Mr Ong, who spoke during a debate on the programme’s White Paper in Parliament on Tuesday.
What is Healthier SG?
The Healthier SG programme was announced by Mr Ong during his ministry’s Committee of Supply debates in March this year, and will be rolled out from next year.
Under the proposal for Healthier SG, residents will, among other things, be encouraged to choose and enrol with a family doctor, who will then serve as a first point-of-contact to holistically manage their health.
Singapore citizens who have enrolled can then receive fully subsidised nationally recommended screenings and vaccinations.
MOH will introduce a new drug subsidy tier under the Community Health Assist Scheme (Chas) for a list of drugs that are used to manage chronic diseases, so that their prices at private GP clinics are comparable with those at polyclinics.
Higher budget for preventive care
Providing an overview of the financial cost of the programme, Mr Ong said that the Government intends to increase its budget on preventive care, which currently makes up about 6 per cent of the healthcare budget yearly, to 12 per cent of the budget.
“In making these investments, our main and primary motivation is to reduce disease burden and reduce the suffering of people and their loved ones,” said Mr Ong in his opening statement during the debate.
Impact on general practitioners
To “fairly compensate” GPs in delivering preventive care, the ministry will extend yearly service fee payments for each resident who enrols with a GP, said Mr Ong.
This means that MOH will not pay for every consultation, test or service they provide. Instead, MOH will pay GPs a base standard fee for each enrolled patient. This fee will cover regular check-ins, ensuring residents adhere to their health plans, associated administrative work, and reviewing the health plan annually, said Mr Ong.
The annual service fee is over and above subsidies for health screening and medication, which are separately funded, he added.
Mr Ong acknowledged that the administrative workload for GPs will increase as the ministry needs the medical data of patients to be in the national health record system, and paperwork is required for payment claims.
Nevertheless, MOH will try to ease this load by providing grants to each GP clinic to help their IT systems be ready for the programme, he said.
Too early to estimate financial impact of Healthier SG
On whether Healthier SG will reduce healthcare spending in future, Mr Ong said it was “too early to give a realistic estimate” as any impact will be discernible only eight or 10 years later.
Nevertheless, the Government cannot reverse the rise in healthcare spending given Singapore’s ageing population.
“What we can hope for is to slow down the rate of increase of healthcare spending,” said Mr Ong.
He said that he expects the national healthcare expenditure, which is expected to be about S$22 billion a year, to multiply threefold to S$60 billion in 2030.
But if the national healthcare expenditure doubles instead of triples during this period, the Government would have saved much more than what it is planning to spend on preventive care, he added.
Giving the example of kidney dialysis patients who regretted not taking preventive action, Mr Ong said that if they had done so, by seeing their GPs periodically for advice and moderating their food intake, it would have cost them “very little in effort and in money”.
However, when the disease is allowed to reach the point of dialysis treatment, the cost comes up to about S$25,000 a year, which has to be supported with funds from taxpayers and donors, said Mr Ong.
Warning against a mentality where people choose to avoid preventive care or health screening so as not to go through expensive treatment, Mr Ong said that people will eventually learn of their diseases and face more expensive suffering, both financially and emotionally. — TODAY
