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Old 7th June 2014, 01:19 AM   #1 (permalink)
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Prefunding Risks Medishield-life Degenerating into a Bankrupt-Ponzi-Scheme of unending premium incre

Mr Tan KL's concerns are prescient: Prefunding Risks Medishield-life Degenerating into a Bankrupt-Ponzi-Scheme of unending premium increases if it is designed after a one-incident-only-claim 'whole life' insurance policy/scheme.

Mr Tan Kin Lian wrote Pre-funding not feasible for MediShield Life:
The Straits Times; Published on Nov 25, 2013
Pre-funding not feasible for MediShield Life
CURRENTLY, MediShield requires an annual premium that varies according to age. Younger people pay a lower premium, while older people pay a higher sum.
The Government is now planning to introduce MediShield Life, which covers people for life.
There has been some discussion about pre-funding for MediShield Life ("Problems with pre-funding" by Mr David Boey, last Tuesday; "Merits of pre-funding" by Ms Maria Loh Mun Foong; last Thursday; and "Caring for the old should be the norm" by Mr Geoffrey Kung; Forum Online, last Thursday).
The aim is for the insured person to pay a level premium to cover him for life. This is akin to a life insurance policy.
In both cases, the claim rate is lower for younger people and higher for older people. Pre-funding allows a person to pay a level premium that is deemed by an actuary to be sufficient for his lifetime.
There is, however, one key difference that makes pre-funding not feasible for MediShield Life.
In a whole-life policy, the sum assured is fixed for the duration of the contract.
For medical insurance, the cost of treatment is expected to rise over the years due to inflation. Also, the cost depends on the choice of hospital and specialists, and can vary significantly from one claim to another.
Some countries have adopted measures to make medical treatment more affordable for older people through cross-subsidies and supported by general taxation. They do not try to achieve this goal by using pre-funding under individual contracts.

Tan Kin Lian
Copyright © 2014 Singapore Press Holdings. All rights reserved.
Pre-funding not feasible for MediShield Life
Already, the element of prefunding exists in the form of medisave, whereby individuals involuntarily contribute to a medical savings account with extremely limited usage options unless they have proven terminal illness conditions of extremely short life-expectancy: e.g. strict claim limits, limits based upon claim type/ treatment incident: e.g. in-patient vs out-patient, claim per chemotherapy treatment; ban on claims for cosmetic treatments, acute illnesses(cough n colds etc) etc.

Compared to whole life insurance (insurance on life or the occurrence of a terminal illness), insurance covering medical treatment is a whole lot more complex if not unpredictable with the possibility of involving unlimited claim incidences depending on the onset, severity and permanence of the medical condition (e.g. kidney dialysis which last lifetime). Life insurance on the other hand is one of the simplest forms of insurance, contractually involving ONLY ONE POSSIBLE CLAIM: I.e. a FIXED, PRE-AGREED lump sum benefit payable upon a terminal event/incident (death or terminal, incurable illness); henforth after the claim, the life-insurance policy/contract is ceased (payee is either terminally ill but 'paid', or else dead in sudden accident (estate gets paid): the sum assured is FIXED (or equals the total amount of accrued principle including bonus eqrned over years if the policy value exceeds the guaranteed death/ terminal illness payout sum.)

In medical insurance however, the total payout sum is IMPOSSIBLE TO PREDICT due to advances in medical technology, medical costs inflation, lifespan of the individual, quality of care expected, frequency of hospitalisation, availability of domestic help (some people cannot be discharged because care givers not free/ 'busy' etc):
Just like NHS in the UK/ USA national pension schemes, bankruptcy awaits due to an excessive claims to premiums record: with even government support doing little to improve finances when claims eventually far outpace all premiums paid.

Medishield-life sows the seeds of failed promises. There is no free lunch in this world; no solution to an unhealthy lifestyle (diabetes, smoking, obesity etc). Where preventive healthcare fails, no insurance scheme can restore the loss without the high risk of bankruptcy or extremely high running costs.

Prefunding already exists in the claims restricted nature of the CPF medisave account. If gahmen focuses on healthy lifestyle/ preventive healrthcare amongst all, boosts up medifund to fund the medical cost of the needy only, then there is reduced need to prefund the moral hazard of what is basically a fools errand to manage (prefunded Medishield-life premiums), and thus reduce the risk of medishield/ worse: compulsory Medishield-life eventually succumbing to become another bankrupt/exposed ponzi scheme.

Senior generation Singaporeans should also not ill forget the words of Lee Kuan Yew as they marvel at his son's mathematical acrobatics as he "derails the idea of having individual accounts for CPF and Medisave.":
Lee Kuan Yew:
My major objective in the early days was to make sure that nobody derails the idea of having individual accounts for CPF and Medisave. Whatever you earn, it’s yours. Because once you have that individual account, any suggestion that you put it into a common pool and everybody takes out from it (as with other welfare systems) is bound to lose you votes.
So if Low Thia Khiang says now, let’s set up a common pool, I think he’ll lose votes in the next election. Are you prepared to put your money into a common pool, having slogged and built up your CPF nest egg? It’s yours and if you don’t use it, you can leave it to your children or your relatives or whoever you like. Why should you put it into a common pool and everybody draws out at your expense, which is what’s happening in some Western countries? The system has collapsed.
From Lee Kuan Yew : Hard truths to keep Singapore going. (Eds Han FK, Z Ibrahim, Chua MH, L Lim, I Low, R Lin, R Chan) Straits Times Press 2011
Source: Are Singaporeans being set up for disappointment? | Insights Health Associates
The seeds of destruction are being sown, young Singaporeans should prepare themselves for some rather lean years ahead as with the indiscriminate forced collection of prefunded Medishield-life premiums on top of a prefunded CPF Medisave scheme, moral hazard is greatly increased....

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Old 17th June 2014, 01:51 PM   #2 (permalink)
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Healthy lifestyle choice: the main insurance against bankruptcy of Medishield-life and unaffordable

Healthy lifestyle choice: the main insurance against bankruptcy of Medishield-life and unaffordable healthcare costs.
Originally Posted by cancer81
Fr Thread (HWZ): Prefunding risk Medishield-life degenerating into a Bankrupt Ponzi Scheme.
even do IPPT (which has a side effect of making sure people keep themselves healthy) is not a easy thing to accept...

gahment cutting funding on medical care and preaching (literally) to people to live more healthy live (eat less oily, salty, sweet and exercise more) is going to lose PAP votes :s22:
I didn't say cut medical care funding overnight, but that gahmen should sponsor more research into preventive health: e.g. effect of healthy-lifestyle on blood pressure, cholesterol levels, obesity, diabetes etc. If smoking is bad, than just tell 'world tobacco Asia' conference organisers that they are not welcomed here, rather than welcome them to Marina Bay Sands in Nov to have their big tobacco extravaganza.(see letter below).

Ultimately, PAP gahmen is trying to con medisave$$$ out of Sinkie's by using 'pre-funding' concept which is obviously misplaced because healthcare costs CAN ONLY GO UP and unlike whole life insurance, claims are not limited to a fixed one-time payout amount of $XXX(+ some bonus for those who lived long and paid premiums for whole life insurance policy all along)[Ref: TKL/ST: Pre-funding not feasible for MediShield Life]. Ultimately, Sinkie's will find themselves conned by this prefunding scam theory (even LKY was against excessive socialism in healthcare costs (he introduced medisave for that reason: to keep costs individualised): let alone this prefunding excuse to collect high premiums from younger generation). The younger generation today will soon enough SMELL A RAT and therefore, I believe that with Medishield-life (prefunding), the PAP are digging their own political graves and it wouldn't be too soon before the PAP loses its right to govern as the young of today declare PAP incompetent (e.g. if Medishield-life goes bankrupt DESPITE collecting double premiums from young members to promise much lower/ discounted premiums when they are old).

Robbing Peter to pay Paul only serves to destroy any credibility PAP has that the LKY era earned them...

Making Singapore the HQ of tobacco promotion/ distribution to the world...

The Straits Times, Published on May 26, 2014
Tobacco fair contradicts anti-smoking efforts
WORLD No Tobacco Day is coming up on May 31, but there is little reason for cheer.
One of the largest trade fairs in the tobacco industry, the World Tobacco Asia 2014, is set to take place in Singapore in November, after being rejected by Indonesia.
As a party to the World Health Organisation's (WHO) Framework Convention on Tobacco Control (FCTC), Singapore is required to meet its obligations under Article 13 of the FCTC.
The WHO states that a comprehensive ban on tobacco advertising, promotion and sponsorship should cover:
- All advertising and promotion, as well as sponsorship, without exception;
- Acts that aim at promotion and acts that have, or are likely to have, a promotional effect;
- Promotion of tobacco products and the use of tobacco;
- Commercial communications and commercial recommendations and actions;
- Advertising and promotion of tobacco brand names and all corporate promotion.
Holding the fair would result in Singapore contravening the above obligations under Article 13.
After successfully hosting the World Conference on Tobacco or Health in 2012 and pledging to reduce smoking prevalence to below 10 per cent by 2020, staging the tobacco industry's trade show here would be absurd.
The fair is not a closed-door event accessible exclusively to industry players. Members of the public would inadvertently be exposed to otherwise banned tobacco advertising.
How can the Health Sciences Authority ensure that tobacco products which are prohibited in Singapore would not be imported, promoted and given out as samples at the fair?
How can the authorities prevent such illegal products from being surreptitiously sold here after the trade show ends?
The Government must remain resolute in its stand against tobacco and protect Singaporeans from all forms of tobacco promotion without exception.
Liu I-Chun (Ms)
Copyright © 2014 Singapore Press Holdings. All rights reserved.
Tobacco fair contradicts anti-smoking efforts
Then again, with self-serving/ corrupt politicians of the following sort, one does not expect too much.
"If the annual salary of the Minister of Information, Communication and Arts is only $500,000, it may pose some problems when he discuss policies with media CEOs who earn millions of dollars because they need not listen to the minister's ideas and proposals. Hence, a reasonable payout will help to maintain a bit of dignity."
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- 'fixing the opposition':

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Old 25th June 2014, 05:28 PM   #3 (permalink)
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Medishield-life was created to help gahmen save $$$ on Medifund disbursements is it???!!

Medishield-life was created to help gahmen save $$$ on Medifund disbursements is it???!!

For the record:
Medifund disbursed S$90million in FY ending 2012 (see below):
I wonder if Medishield-life is expected to reduce the amount disbursed from Medifund since a large number of persons dependent on Medifund are probably folks who REFUSED to join medishield, dropped out halfway because they couldn't afford to pay the higher premiums associated with older age ($1190@90yrs) or exceeded the qualification age (>/= 90yrs)(MediShield Premiums(2013)).

Given that Medishield-life will absorb many of these current non-members into the fold, the question remains if medifund disbursements are expected to fall, and if so, by how much? Also, whether whatever savings from decrease medifund disbursements will be sufficient to cover for those who cannot afford the raised premiums of Medishield-life, or Medishield-life be sustained upon the deception based Ponzi concept of 'pre-funding' for healthcare: such that the younger generation is expected to foot the healthcare bills of the elderly/ the old. (as Mr Tan Kin Lian said in 'Pre-funding not feasible for MediShield Life', medishield life is much too complex to adopt the 'pre-funding' concept that medisave already well serves)

Current Medishield Premiums (2013):
(MediShield Premiums (2013))

Medifund payout up 16% to $90m
Tuesday, Feb 26, 2013; The New Paper

SINGAPORE - Medifund supported more needy patients in the 2011 financial year and paid out more money as well.
The endowment fund, set up in 1993 to help Singaporeans who cannot pay their medical bills, disbursed more than $90 million in aid between April 2011 and the end of March last year.
This was 16 per cent more than in the previous 12 months (FY2010).
There were 518,000 successful applications in FY2011, an increase of 8 per cent from FY2010.
Of these, more than 93 per cent had their entire outstanding subsidised bill paid by the fund, the Ministry of Health said on Saturday.
On average, inpatients received $1,295 and outpatients $103 each time they sought aid.
The elderly received $28 million of Medifund assistance, a 20 per cent increase from the previous year.
For this financial year (FY2012), poor patients being cared for at home, rather than in an institution, are also eligible for Medifund help.
Children needing financial help for medical bills will have $10 million to call on from next month from a fund specially set up for them, called Medifund Junior.
In the last five years, the Government has pumped in about $1.6 billion into Medifund and Medifund Silver (which is for the elderly) and the capital sum now stands at $3 billion.
The Government "will continue to strengthen the social safety net to make sure no needy Singapore citizen is denied healthcare due to the inability to pay", the ministry said.
http://yourhealth.asiaone.com/conten...-payout-16-90m

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Old 25th June 2014, 06:43 PM   #4 (permalink)
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Triple pre-funding of personal healthcare costs, How much pre-funding will settle the bill?

Triple pre-funding of personal healthcare costs, How much pre-funding will settle the bill? (...to avoid tapping into medifund?)

1st level of pre-funding:
" '(Obamacare)Insurers that do not spend 80 per cent to 85 per cent of premiums on healthcare costs must now issue rebates to consumers, and these are all commerical insurers, not social health insurance,' he said, adding that MediShield’s loss ratio averaged 63 per cent over the last 11 years." (Gerald Giam, NCMP, Parliament 28May2014)
So 37% p.a. of medishield revenue over last 11 years has gone into its reserves to 'pre-fund' future claims.

2nd level of pre-funding:
Add to above overcharged premiums and under provided benifits by 37% every year, MOH wants to charge the young EXTRA with Medishield-life: "With pre-funding, members pay higher premiums during their working ages and, in return, can receive rebates to offset their own future premiums when they grow old."['Role of pre-funding' (ST, 27Nov2013)]

3rd level of pre-funding:
Medisave, a compulsory healthcare savings scheme is itself a mode of pre-funding. MOH says: "Medisave, introduced in April 1984, is a national medical savings scheme which helps individuals put aside part of their income into their Medisave Accounts to meet their future personal or immediate family's hospitalization, day surgery and certain outpatient expenses."The current withdrawal limits to ration/ stretch out medisave use to cover for elder years can be viewed @ [Medisave Withdrawal Limits ]

Of course, proudly, the last (current 4th level) of the 3M is medifund, defined as : "Medifund is an endowment fund set up by the Government to help needy Singaporeans who are unable to pay for their medical expenses. Medifund acts as a safety net for those who cannot afford the subsidised bill charges, despite Medisave and MediShield coverage. Set up in April 1993...": seems like the retirement age/ CPF withdrawal age: always beyond reach of most people, with so many new/extra rules (Pre-funding #1, #2, #3 in-between)... ...

Rather than helping to pre-fund and pre-fund the pre-funded. I think a smaller gahmen, more focused upon helping the poor (boost Medifund) rather than wayang show to snatch middle class votes, would be much better for all.
After all, Jesus Christ teaches: ~ Matthew 25:40: "The King will reply, 'I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.'"- (NIV): by the time we have mathematically calculated pre-funding and pre-funding the pre-funded medishield-life, many poor people will be dead cold by then...

Okay, I need to go for my regular exercise n eat my fruit/vegetables now (don't want to burden Medishield/Medifund/ misuse hospital subsidies with avoidable claims)...

2c
B.C.

Reference:
- Mr Tan Kin Lian (ST forum): 'Pre-funding not feasible for MediShield Life' (25Nov2013)


MediShield and Obamacare comparison not valid: MP
By John Leong and Chitra Kumar
POSTED: 29 May 2014 04:47
URL: http://www.channelnewsasia.com/news/...e/1124264.html
MP Dr Janil Puthucheary and NCMP Gerald Giam had a verbal sparring match over the issue of MediShield in Parliament.
SINGAPORE: Member of Parliament Dr Janil Puthucheary and Non-Constituency Member of Parliament Gerald Giam had a verbal sparring match over the issue of MediShield in Parliament today (May 27).
Dr Puthucheary took issue with Mr Giam’s comments that MediShield “is collecting a lot more in premiums than it is paying out in claims", despite being a risk-sharing scheme that is “supposed to be a form of social health insurance”.
Dr Putucheary argued that premiums were higher than payouts because Singapore’s population is ageing. “There are uncertain risks in the future, there are likely to be rising costs,” he said, and there are risks that come with ensuring payouts equal to premiums that would not be good for the long-term health of the nation.
Mr Giam cited the example of the United States’ Affordable Care Act – popularly known as Obamacare – which he says mandates a minimum loss ratio of 80 to 85 per cent. “Insurers that do not spend 80 per cent to 85 per cent of premiums on healthcare costs must now issue rebates to consumers, and these are all commerical insurers, not social health insurance,” he said, adding that MediShield’s loss ratio averaged 63 per cent over the last 11 years.
The comparison with Obamacare drew criticism from Dr Puthucheary, who did not believe it was valid to compare a public social insurance scheme like MediShield with the private, for-profit insurance environment in the US. “Even the policy-makers and office-holders in the US readily admit that a short-term electoral outlook significantly constrains their ability to take a long-term strategic vision for healthcare system of their nation.”
In his view, the worst-case scenario for a system where the payouts are far less than the premiums collected is that “we save a little bit too much”, whereas the worst-case scenario for increasing payouts is an insolvent public healthcare financing system that is unable to support the healthcare needs of the population.
“The intellectually honest thing to do is to compare risks versus risks, benefits versus benefits, worst-case scenario against worst-case scenario; not to cherry-pick the benefits of your proposal against the potential risks of the proposal in front of you,” he said.
Mr Giam maintained that a not-for-profit social insurance scheme like MediShield should have a much higher loss ratio than a commercial insurance scheme, adding that it is now relatively easy to project likely payouts based on the way medical expenses are trending.
If an unusual event such as SARS occurred in a certain year, for example, “then we have a situation where the Government would have to step in and subsidise a bit more of the cost”, said Mr Giam. “Then the premiums can rise behind the increase in cost, not before you know that the cost is going to increase, then you raise the premiums.”
Dr Puthucheary disagreed strongly with this, asserting that there is a lot of uncertainty about how medical costs will increase. “SARS is a great example. It is precisely because of the prudent, conservative, risk-averse approach we take on a day-to-day basis that when someting like SARS comes along, the government is able to step in and do what needs to be done.”
He reiterated that it is important to to take a “longer-term prudent approach past one electoral cycle” as the thing at stake was the “social public good”.
- CNA/xy

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