Since my last article in which I wrote about the bills for my two medical procedures – an angiography (including a percutaneous coronary intervention) and a coronary heart bypass surgery (CABG) – some have criticised the Medishield Life scheme for not paying out enough in situations such as mine.
Just to recap, the bills are as follows. I am including the PCI as a separate item:
Misc (medication, ward charges, etc): $2,954.24
Medishield Life payout: $720
CABG (including 6 day ICU/ward charges): $4,903.63
Medishield Life payout: $4,529.15
GRAND TOTAL: $15,630.72
I won’t go into the details of the numbers and how they are derived as I have already explained it in my previous article. (Please click here.)
For the first bill, I had to pay $3,928 ($2,348.00 net bill + $1,500 deductible & $80 co-insurance).
For the second bill, I had to pay $380 (through Medisave).
So, the total I had to pay (whether through Medisave or in cash) is: $4,308.00
Now, this is in the context of a total bill (for the two procedures) of $15,630.72.
The amount I pay is therefore about 27% of the total bill.
Is this a fair amount for a patient to pay?
Some have criticised Medishield Life (MSL) for not paying enough.
In my case, MSL paid a total of $5,249.15 for the two bills.
That’s 34% of $15,630.72.
The rest were paid by government grants or government subsidies.
I think before we answer the criticisms that MSL is not paying enough, we have to understand what MSL actually is and what it is aimed at.
The answer to the first is that MSL is a BASIC health insurance plan. I think this needs repeating: Medishield Life is a BASIC health insurance plan. It is NOT meant to be a comprehensive insurance plan.
Second, MSL is aimed at larger bills. And this is why there is a deductible and a 10% co-insurance for the first claim in a policy year. (In my case, I had to pay these two items for my angiogram, which was the first procedure done on me.)
For my second procedure (the bypass surgery) MSL actually paid 92% of the total bill. (And I did not have to pay the deductible and 10% co-insurance.)
Third, it is the Government’s intention that patients co-pay healthcare costs. This is to encourage everyone to take care of their health. And this is something I agree with.
To me, I don’t look for free medical care because I do think there must be some element of encouraging people to take care of their own health.
Having said that, however, there are of course instances where unexpected things do happen, even when we pay great attention to our health, and live and eat healthy. This only means that we have to make sure we are adequately covered by health insurance.
I think at the end of the day, our health is our personal responsibility.
So, while we can point out the flaws in govt health schemes, it is also important to make sure you have adequate contingencies such as health insurance.
I know there are accounts by some people of their own experience with Medishield Life, and I empathise with them. Each one’s situation is different and by putting my own experience out there, I am by no means dismissing the problems the scheme obviously has, or the stories of those who find that Medishield Life is not adequate to meet their needs.
But despite these, I feel that Medishield Life is nonetheless an important scheme which can help those who are not so well off, especially when there is also government grants to offset medical costs.
Not everyone can afford private insurance, and this is why MSL is helpful. (For those who may not be able to pay the premiums, they can apply for assistance.)
Also, if you can’t pay your bills in one lump sum, you can apply to pay by installments. It is an easy process of filling out a form. It took me less than 10 minutes to do at SGH. You can pay installments for up to 24 months.
Whatever it is, at the end of the day, it is our personal responsibility to take care of our own health by living healthy, eating healthy and exercising regularly; and to also make sure we have adequate health insurance.
And, for example, if you smoke heavily, and do not care about your personal health, then all the coverage in the world may not help you ultimately.
So, go get checked regularly, and keep healthy.
And if you are a smoker, snub it out already!
So, is Medishield Life a rip-off?
I’ll leave that to your judgement.
For me, I don’t think it is.