Singapore’s Ministry of Health (MOH) has assured Singaporeans that no Singaporean will be denied access to appropriate healthcare because of an inability to pay. MOH was responding to a letter writer in the Today newspaper who said that Medisave withdrawal cap for chemotherapy should be doubled.

Medisave is a national medical savings scheme. The letter writer, David Soh Poh Huat, pointed out that withdrawals for chemotherapy from MediSave are capped at S$1,200 a month. Relating the experiences of his relative (and other patients he spoke to), David said that the Medisave withdrawal caps for chemotherapy is barely enough to cover costs of cancer treatment.

David added that the MediSave cap has been in place for many years and has not factored in increases due to inflation.

“Each chemotherapy session can cost S$4,000 or more, depending on the drug. While patients may also tap the MediShield Life health-insurance plan for chemotherapy — capped at S$3,000 a month — the Ministry of Health (MOH) should review the MediSave cap and double it to at least S$2,400. This is because patients undergo an average of two chemotherapy sessions a month, which can cost up to S$10,000.”

David Soh Poh Huat

David said that unlike treatments such as dialysis, where costs largely remain fixed, the cost of chemotherapy, with new drugs being introduced over the years, has been on the rise and has taken a toll on patients. Incidental medical expenses arising from the side effects of chemotherapy, also add to the burden of cancer patients, David said. David called on the MOH to expand MediShield Life to help patients to pay for other types of treatment to counter these side effects.

Responding to David, MOH said it adopts a multi-tiered financing framework to support the healthcare expenses of Singaporeans. Patients who receive outpatient chemotherapy at public healthcare institutions can receive subsidies of up to 75 per cent, MOH assured. Adding that they can also tap MediShield Life, the national basic health-insurance plan, and MediSave, Singapore’s medical-savings scheme, to defray outpatient chemotherapy costs.

“To enhance affordability, the MOH in 2015 raised MediShield Life claim limits for chemotherapy from S$1,240 for every 21-day or 28-day cycle to S$3,000 a month. Patients can use MediSave to pay for any outstanding amount after MediShield Life, up to a withdrawal limit of S$1,200 a month.

“The MediShield Life and MediSave limits are generally sized to be adequate for subsidised treatments. Together, the MediShield Life and MediSave monthly limits were enough to fully cover chemotherapy costs for nine in 10 subsidised patients in 2017.

“In addition to chemotherapy, patients can use MediSave to cover the costs of scans and other diagnostics needed for cancer treatment, up to a withdrawal limit of S$600 a year. This is designed to provide further peace of mind through different stages of recovery.”

MOH assured that it will continue to review its financing frameworks to provide comprehensive support for patients, and that those facing difficulties with medical bills after government subsidies may approach medical social workers at public healthcare institutions for help.

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