The boon of Singaporean medical care, is also at the same time, its bane: It calls for individual and family responsibility first. If that fails, only then will government assistance be provided.
How many times have you heard the rumour that “You can die, but you can’t afford to get sick”. To be fair to the system, that is not true at all. MediShield picks up most of the tab for high-cost bills and MediFund pays for those who absolutely cannot afford it. Soon, MediShield Life will boost whatever is lacking in high expense medical procedures.
But the “can die cannot get sick” saying is not without merit.
Family is the first line of financial support the State expects you to have before they render help and there’s one thing that policy makers must understand, is the iron strong Asian will to be independent. To rather suffer than seek help from children.
Worse, if these are single parent families – where one child looks after an aged parent. This one child must bear the financial weight of bread-winning, looking after his/her own exigencies, planning for the future, getting married…and at the same time mirror all these concerns of his/her parent. With the rate of divorces increasing, this problem can only deepen in the future.
It is a noble thing to be able to look after your own family, to pay for their needs first before tapping into State funds. If one is able, surely one would rather pay it off than to deal with troublesome bureaucracy to apply for assistance.
The issue of “face” is another attitude that drive our actions, and it is not a trivial thing. Let me point out a few examples I met whilst doing community work:
I have met elderly have said that they are at their wits end because they are unable to pay for medication and are silent about it so as not to “trouble” their children.
I know of this one grandmother who refuses to go to the hospital because she knows it will be expensive and worries unnecessarily about sending her children into bankruptcy.
There is a diabetic woman, both legs amputated and in her 70s, unwilling to seek family help because she is just too headstrong.
A stroke victim, in her 40s has a five figure sum in her bank account and living in a 4 room flat. She has to live a very, very, very frugal life because she fears the next medical disaster.
Some of these examples I’ve mentioned above will fail means testing. They may not qualify for government assistance because someone in their family has an income. A what we call “not-here-not-there” income. You’ll frequently hear the common plea: “Aiyah, my children have their own problems to take care of, I don’t want to burden them lah…”
I think the medical care system has to be appreciated in totality. It is not just hospitalisation and big treatments that burden you. Consumables (such as diapers, liquid diets etc) can be very expensive and need to be paid for over a long period of time. Tests, scans, appointments, consultations and so on can total up quite a bit. If someone in your family has a small income, you won’t pass means testing.
There is the CHAS (Community Health Assist), which is a powerful card that enables the holder to free outpatient treatments to common illnesses and even dental treatment. Without CHAS, these treatments cannot be paid by MediSave/Shield. Problem is, CHAS is also modelled after the same principals as means testing. If someone in your family earns more than $1800, you don’t qualify.