Fate has it that 2 days after penning a
healthcare article, Humpty Dumpty me slipped and fell on a rainy afternoon. A
fractured finger and two damaged ligaments left me walking with crutches for 10
days and two fingers with limited utility for 8 weeks. The mountain of
medical bills caused a free flow of ideals (not ideas) case for socializing
healthcare cost and universal healthcare in my abode between my blood brain
barrier putting both in sync ripe for physical impacts into the cerebral sphere
thereafter into the physical resulting in this write-up.
The city state of Singapore that I share
with about 5M more souls as home where ruling party PAP has not only a simple
but two third majority since eons and a doctrine of party whip to complete the
control. Small can be advantageous coupled with good political control makes
her an ideal test bed for novel policies making reversals and titrations more
viable with less extensive and tolerable collateral damage. Coincidentally or
deliberately, Obama Care and Medishield Life universal healthcare was made law on
the same day about a year ago on 1 Nov 2015.
Obama Care took nearly 2 presidential term of
gestation in the senate and a somewhat pro-longed and dangerous birthing
witnessed by intense congressional lobbying, horse trading and threat of
presidential veto. Medishield Life entry was hardly noticeable except for a
front page headline in the local press and of course months of public education
campaign prior to that.
The passage of Obama Care is clearly over
done as what The Economist term as Vetocracy the result of which could be
compromised outcome. Medishield Life most probably represents the other extreme
lack of feedbacks and robust parliamentary debate. With diverse parties having
vested interest in it chief amongst which are healthcare, managed care and insurance
providers, employers, employees, labour unions and last and most importantly
90% of the populace from the uninsured, unemployed, under-employed to the
sandwich class, it certainly warrants a more robust debate in the case of
Medishield Life but not to the extremities of Obama Care.
Two books were instrumental in shaping my
ideological during my teens. Free to Choose which was also made into a ten-part
TV serial (also broadcasted in Singapore I suspect as propaganda) by far right
University of Chicago Professor Milton Friedman. The other centre left leaning
Social Democracy The Singapore Way by our past president Devan Nair.
This cocktail unfortunately formed an
ultra-right democratic capitalist psyche in me. As I mellowed, although still a
deeply rooted democratic capitalist, I began to see the cracks in certain parts
of my doctrine that might need to be supplemented (not supplanted) by socialism
in some shape and form. Chief amongst which was Healthcare, Education and
Welfare (HEW). Friedman commented that in one of the ten-part serial that it
was ridiculous that the budget of USA Department of Health, Education and
Welfare was larger than the GDP of USSR which covers a bigger patch previously
before the dis-integration of USSR. Briefly, education is a great social
leveller and welfare because the humanity in us will not allow us to deny the
under-class the most basic essential for a humane existence.
Although universal healthcare has not attained
universality, the very fact that it occupies agenda of many healthcare interest
groups itself is a major milestone and human development index. At this stage,
it mirrors the Chinese toy 不倒翁.
It is easily swayed by any effort to topple it but will bounce back in no time.
In the same breath, efforts to advance its cause is also easily reversed.
Perhaps the case for universal healthcare is compelling with little or no
alternatives in sight. The basic principles and doctrines needlessly complex
and contentious. Given such a canvas that the actual mechanical operatives must
operate on, it is easy to understand why universal healthcare whilst not easily
defeated and erased off the global agenda is also 747 too heavy for lift off.
In-spite of the situation, universal healthcare has
taken some promising shape or form although not in its totality in some
countries like USA, Canada and Singapore.
Medishield Life as our flavour of universal
healthcare in Singapore is most probably one small step for man but a giant leap
for man-kind.
Just after a year into its existence,
issues have surfaced. Chief amongst which are hike in premiums for Integrated
Shield Plans which are an optional private plans, buffet syndrome of over consumption
for Integrated Shield Plans which have no co-payment component and lastly,
pay-out to premium ratios for the six participating private insurers are mostly
in line with each other, the public Medishield Life is way below norm. Reasons
abound for the differential from premium pricing, coverage, co-payment and
lastly underwriting in the case of Integrated Shield Plan as MediShield Life
being a universal healthcare insurance has no under-writing.
As we get our feet wet as we progress into
the less chartered waters of universal healthcare with an aging demography,
perhaps, it is too early to pop that champagne.
Peter Lye aka lkypeter
lkypeter@gmail.com Safe Harbor. Please note that information contained in these pages are of a personal nature and does not necessarily reflect that of any companies, organizations or individuals. In addition, some of these opinions are of a forward looking nature. Lastly the facts and opinions contained in these pages might not have been verified for correctness, so please use with caution. Happy Reading. Peter Lye (c) Peter Lye 2014
Peter Lye aka lkypeter