Critics have carefully argued that with Medisave now allowed for use in selected Malaysian hospitals for outpatient and day treatment, it rightly means that Singaporeans are priced out of our own healthcare system, and that Malaysian hospitals will now reap the benefits. How the local hospitals will react is uncertain for now – will they try to compete with the 12 Malaysian healthcare providers or just let those who cannot afford cross over, after all, there are limits to Medisave usage for in Malaysia.
Digging deeper, the 12 healthcare providers might all be Malaysian subsidiaries or partners of Singapore companies. For instance, Health Management International’s Regency Specialist Hospital in Johor Baru and Mahkota Medical Centre in Malacca will be part of the Malaysian Medisave scheme, while Parkway Holdings is tying up with Gleneagles KL. A common fear, whether unfounded or not, is that potential patients are unsure of the standard of healthcare in Malaysia. Hence, such tie-ups with local brands would be some comfort to Singaporeans who head over for day surgery and perhaps a short holiday at the same time. The tie-ups with the Malaysian hospitals and their Singapore centres are –
Health Management International referral centre: Balestier Clinic and Health Screening Centre (221 Balestier Road, #03-04 ROCCA Balestier)
1. Regency Specialist Hospital (Johor Baru)
2. Mahkota Medical Centre (Malacca)
Parkway Holdings referral centre: East Shore Hospital (321 Joo Chiat Place)
1. Gleneagles Intan Medical Centre (Kuala Lumpur)
2. Pantai Hospital Kuala Lumpur
3. Pantai Hospital Cheras
4. Pantai Hospital Ampang
5. Pantai Hospital Klang
6. Pantai Hospital Ipoh
7. Pantai Hospital Ayer Keroh
8. Pantai Hospital Penang
9. Pantai Hospital Batu Pahat
10. Pantai Hospital Sungai Petani
Whether the Malaysian Medisave scheme is it a glass half empty or half full depends on whether we are nationalistic about healthcare or prefer choices in how money is better spent. The latter is arguably more important as Medisave is the contributors’ own money reserved for healthcare and it should not be restricted to geography. The contributor should have more say in how and where that medical purse is spent, especially if cost is a factor. If a person wants a cheaper alternative, that patient should have the right to do so. It does not necessarily mean that Singaporeans cannot afford healthcare in Singapore per se. Instead, it could suggest that Singaporeans can now choose cheaper treatment overseas as well. Choice on how to spend our own money is usually a good thing.
… but hospitalisation, day surgeries covered for now in JB, Malacca, KL05:55 AM Feb 11, 2010
SINGAPORE – Almost a year after the announcement was made to allow Medisave for overseas use, the Ministry of Health (MOH) revealed details yesterday of how this will be done.
From next month, Singapore residents will be allowed to use Medisave for hospitalisation and day surgeries in overseas hospitals that have an approved arrangement with a Medisave-accredited centre in Singapore.
This means that patients have to approach appointed local providers – for now, they are Health Management International (HMI) and Parkway Holdings – which will then refer these patients to the overseas hospital via the Medisave-accredited referral centre that they have each set up recently.
Each centre must assess patients before admitting them as well as provide financial counselling. It will be accountable for patient satisfaction and clinical outcomes, said MOH.
HMI will work with its two subsidiaries, Regency Specialist Hospital in Johor Baru and Mahkota Medical Centre in Malacca, while Parkway will partner nine hospitals under the Pantai group as well as the Gleneagles Intan Medical Centre in Kuala Lumpur.
Medisave, however, cannot be used for outpatient treatment overseas as “it will be harder for us to audit or regulate the general practitioners overseas”, said an MOH spokesperson.
In Singapore, patients can tap on Medisave for certain outpatient treatments, such as for chronic diseases and Hepatitis B vaccination.
The new Medisave scheme is open only to citizens and permanent residents here. Currently, Medisave can only be used overseas for emergency hospitalisation.
In his blog post yesterday, Health Minister Khaw Boon Wan said that MOH had decided to “give the idea a try, closely monitor it, and to make refinements if necessary”. “The upside is that it gives Singaporeans more choices, and presumably lower-cost choices, thus saving them money too,” he wrote.
At Parkway’s local hospitals, a total hip replacement surgery costs about $19,000, but at Pantai hospitals, it costs about RM32,000 ($13,200). At HMI’s two subsidiaries, it costs between RM15,000 and RM25,000.
“But patients must be aware of possible downsides … They should consult their family GPs for a second opinion,” cautioned Mr Khaw.
Patients’ insurance policies, or their employers’, may not cover overseas treatment, for instance.
MOH’s spokesperson added: “If the treatment leads to complications or if there are alleged medical misconduct, costs may rise, and any legal follow-up across border may be complicated.”
Other potential areas of abuse could be fraudulent claims or over-servicing by unethical doctors.
Mr Khaw doubts that subsidised patients in public hospitals will be the ones interested in taking up this latest initiative, as “there will be no cost savings for them if they go overseas”.
“But even if the scheme only benefits a small number of patients, I think it’s still worthwhile as it gives Singaporeans more choices,” he added.
According to MOH, private hospitals currently take in about 20 per cent of total hospital admissions.
Both providers have promised to ensure good clinical outcomes and high service standards.
Parkway said it is the only private healthcare provider to publish data of its clinical outcomes through its in-house publication.
Meanwhile, HMI said its two subsidiaries offer “Singapore-style management and comparable standards of nursing care” and will go undergo regular audits by MOH and the Central Provident Fund Board.
It offers door-to-door shuttle service for patients wishing to go to Regency in JB, while its Malacca subsidiary received 500 Singaporeans last year.
Company director Paul Sykes, 40, said he is looking forward to using Medisave for future treatments overseas. He had paid about $1,400 for his surgery at Regency last month. A private hospital in Singapore quoted him $3,000, he said.
While he had concerns over communication and the hospital’s competency, his fears were unfounded, said the Singapore PR. In fact, his recuperation is two weeks ahead of schedule, Mr Sykes added.
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