Do overseas SGs risk being outlawed with MediShield Life?

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An honorable member of the Coffee Shop Has Just Posted the Following:

http://www.tremeritus.com/2015/08/14...dishield-life/

Do overseas SGs risk being outlawed with MediShield Life?


August 14th, 2015 |
Author: Contributions



Juliet
Low has been working in the US and the UK for more than a decade, and never had
to worry about high cost of treatment for her chronic illnesses. As a
Singaporean working overseas, she is currently subscribed to the
UK’s mandatory National Insurance, which covers the cost of her treatments in
full. When she travels to Singapore for visits, she covers herself with travel
insurance.

She has never relied on her Medisave in her working life. Not having worked
much in Singapore, she does not have much in her Central Provident Fund account,
which is currently used to make transfers into Medisave.

But that is set to change when the MediShield Life scheme comes into effect
in November 2015, to supposedly provide universal healthcare coverage for all
Singaporeans.

Under the MediShield
Life Scheme Act passed in January 2015, all Singaporeans are required to pay
premiums for the scheme and anyone who has not paid his/her premiums and who
attempts to leave Singapore – which is very likely the case for Juliet
– could be subject to severe penalties as a payment defaulter.


A defaulter who, knowing that a direction has been issued under this section
to prevent the defaulter’s departure from Singapore, voluntarily leaves or
attempts to leave Singapore without paying the outstanding premium or furnishing
security to the recovery body’s satisfaction for that payment —
(a) shall be guilty of an offence and shall be liable on conviction to a fine
not exceeding $5,000 or to imprisonment for a term not exceeding 12 months or to
both; and
(b) may be arrested, without warrant, by any police officer or immigration
officer.
The Act also grants authority to the police and the immigration office to
“take such measures as may be necessary to prevent the defaulter from leaving
Singapore until every outstanding premium has been paid or secured.”

These measure include “the use of such force as may be necessary” and “if
appropriate, the detention of any passport, certificate of identity or travel
document and any exit permit or other document authorising the defaulter to
leave Singapore.” The government also retains the right to sue for recovery of
outstanding premiums, although it is not stated in the Act if they can do so
against Singaporeans residing overseas.

The Act could potentially affect Singaporeans residing overseas, which
currently numbers more than 200,000 according to statistics from the National
Population and Talent Division, and is growing by the thousands each year.

A group of Singaporeans living overseas, including Juliet and her friends,
are now up in arms over the government’s threat to impose fines and imprisonment
on those who fail to pay premiums. This is especially because Singaporeans who
reside overseas are unlikely to benefit from MediShield Life.

But for Juliet and other overseas Singaporeans, the issue is not about being
“recalcitrant” or not – she is more than happy that the scheme covers her
parents, as it benefits them directly – but the idea of paying
into a scheme that she does not use, does not even help with her real
life medical expenses, and does not even resemble anything close to a healthcare
plan.

“I don’t think the implementation is done by people who actually understand
insurance,” she said. “I don’t think they are able to tell the difference in
actuarial methods between life and health insurance.”

“Health insurance is like car insurance, which covers you on a year by year
basis, unlike life insurance where you pay cumulative premiums over your
lifetime in order to ensure coverage. If you don’t have a car, would you be
expected to pay for insurance because you will get one at a future date? We
should only pay for the relevant period of health insurance we wish to be
insured.”

Indeed, the FAQ
for the scheme suggests that the system has no provision as a life insurance
plan, with no amount that can be returned to the payee or his/her family
members.

“What everyone in the same age group pays ahead in premiums are pooled to
help cushion the future increases in premiums during older ages. While some
members may pass on earlier, the remaining pool of funds will need to help those
of the same age who live longer and need to draw on more rebates.”

Many Singaporeans overseas already pay for mandatory insurance in their
country of residence and for them, MediShield Life will unfairly increase their
financial burden, especially since they would have no reason to use it.

The scheme has irked Juliet sufficiently for her to write to the Ministry
of Health for clarification, but the answer has not been very different from
what we
have read in the news so far.

“We wish to share that MediShield Life was introduced to provide assurance to
all Singapore Residents against large hospital bills for life, regardless of any
changes in their health or life circumstances,” came the reply from MOH. “This
enables all Singapore Residents to share in the national risk pool and play our
part in supporting our healthcare costs.”

Singaporeans have been encouraged to write in to have their situation
considered on a “case-by-case basis” but it is becoming apparent that many
overseas Singaporeans who have contacted MOH or CPF have received the same email
template with irrelevant references to the scheme, and have not had their
situations considered at all.

Juliet has since reached out to the Singapore embassy in the UK, and has been
informed that they have contacted MOH on her behalf. The embassy has not
received a reply from MOH as of 9 August 2015.

She has even engaged Prime Minster Lee Hsien Loong on Facebook, with a
response by the page administrator to assist. But again, nothing thereafter.

For
her, Singaporeans based overseas are facing a very real slippery slope as many
do not actively contribute to their CPF accounts and hence do not enjoy the
automated deductions towards Medishield Life premiums – they have no need to
think about health coverage at home, as most host countries have strict
requirements for them to purchase such coverage in order to work there.

But they now face a very real situation of being detained against their will
should they return for a visit, or have government letters repeatedly served to
their family members demanding them to help pay for premiums that will never be
used.

Frustrated, she and a few others decided to start
a petition to increase awareness about the situation that awaits overseas
Singaporeans and to lobby the government to grant temporary exemptions for those
already covered in their host country, and hence are in no way a liability
to Medishield Life.

“The
petition is not to challenge the government in implementing this as it is useful
for those residing in Singapore, but it just doesn’t make sense for us (who are
working overseas),” said Justina Lee, another Singaporean working overseas who
is also raising awareness for the petition.

“We are not asking for full exemption,” said Juliet. “We are asking for an
opt-out, (even to pay) a small admin fee, if we are sufficiently able to prove
we will not need to use Singapore healthcare because we are covered. I do not
believe this is unreasonable. If we decide to return to Singapore, we will then
opt-in again and pay premiums for the relevant period.”

As the November 2015 deadline draws near, any promise by the authorities
to consider the situation of overseas Singaporeans on a case-by-case basis have
appeared to be ineffective, and many overseas Singaporeans have begun to feel
that healthcare coverage could be the tipping point for many Singaporeans who
have been out of the country for decades.

“I fear that the brain drain will become permanent as many have spoken about
relinquishing their citizenship altogether,” said Juliet.

“I love my country and I want to remain a Singaporean for the rest of my
life, but I simply can’t afford to pay for medical insurance in two different
countries,” said Justina. “If this goes ahead, I fear I will be forced to give
up my citizenship which is also my roots and identity.”

Juliet also questioned the logic of scheme trying to cover Singaporeans
working overseas. “Why would overseas Singaporeans, who are fully covered in
their local jurisdiction, rationally return to Singapore to use the healthcare
there? Why force us to pay for something that we would never use? Who is in the
committee that they say are actually considering our appeals on a case-by-case
basis?”

She and other overseas Singaporeans are also eager to open the doors of
consultation between overseas Singaporeans and the CPF Board, MOH and the
MediShield Life Council in order to reach an amicable solution.

“We are educated and well-travelled,” said Juliet. “We have experienced
medical systems from around the world. We can help provide guidance for a better
implementation of this scheme. Let us help. But first, hear our voice. Do you
really wish to imprison us all?”

To support Juliet’s petition and share her concerns, you can
sign
the petition online.

TOC has approached the Ministry of Health for clarification on this
matter. At time of publishing, we have yet to receive a reply, but have received
a commitment that they will respond. We will include their response once
received.

Howard
Lee

Source: The Online Citizen


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