Kenneth Jeyaretnam voices concern over Singaporeans’ medical costs as some forgo treatment

SINGAPORE: Mr Kenneth Jeyaretnam, Secretary-General of the Reform Party, expressed concern over a recent case involving a terminally ill Singaporean taxi driver who chose to forgo treatment due to the financial strain it would impose on his family.

Mr Jeyaretnam highlighted a stark contrast between Singapore’s healthcare system and that of the United Kingdom, citing the instances where individuals in Singapore opt out of treatment for chronic conditions to alleviate financial burdens.

In a recent Facebook post, Mr Jeyaretnam addressed Law and Home Affairs Minister K Shanmugam’s criticism of The Economist, accusing the publication’s commentators of being resentful of Singapore’s achievements.

Minister Shanmugam emphasized Singapore’s stable political environment and its ability to surpass the UK in various aspects, including per capita GDP, public safety, housing, education, and healthcare.

However, Mr Jeyaretnam countered Shanmugam’s claims by referencing a recent report in Singapore’s state-owned Chinese media regarding the taxi driver’s story, arguing that this illustrates the “falsehood or disingenuousness” of Shanmugam’s statements.

According to Shin Min Daily News, despite being diagnosed with kidney disease requiring treatment, 46-year-old taxi driver Soh Zhiyong declined medical intervention.

Soh expressed concern over the exorbitant cost of dialysis, expressing reluctance to burden his family further financially.

Instead, he organized an appreciation dinner for his loved ones, donated S$3,000 to charity, and made arrangements for his own funeral.

Mr Jeyaretnam highlighted the disparity with the United Kingdom, where dialysis is provided free of charge as the National Health Service (NHS) pays for the cost for patients.

He voiced concern over the taxi driver, who had already lost two toes to diabetes, as an example of the lack of continuity of care in Singapore, where people forego treatment for chronic conditions to save money.

He remarked, “This would be unlikely to happen in the UK where his GP is responsible for monitoring his condition and could be sued if there is a lapse in his care. ”

Mr Jeyaretnam believed that many of Soh’s conditions were manageable but were allowed to deteriorate until his kidneys failed.

Additionally, Mr Jeyaretnam criticized Lawrence Wong, sarcastically referring to him as a PM-to-be who would be paid S$2.2 million a year to play the guitar, highlighting the apparent disparity in priorities.

He reiterated his ongoing concern regarding the expenditure of Singapore’s Ministry of Health (MOH) on the public healthcare system.

He questioned the rationale behind allocating only S$7 billion in subsidies out of a S$18.4 billion budget in 2021 for the public healthcare system.

He noted that he had to pay to access the MOH Holdings’s accounts, which are not publicly disclosed.

Mr Jeyaretnam highlighted the disparities between MOH’s reported spending and the subsidies received by MOH Holdings, the holding company overseeing the allocation of resources for Singapore’s public healthcare institutions.

In a prior statement, he underscored that the government provided approximately S$7 billion in subsidies to MOH Holdings for the fiscal year ending on 31 March 2022.

Consequently, he urged Lawrence Wong to elucidate how the government allocated the remaining S$11 billion, suggesting a deficiency in clarity and accountability regarding healthcare spending reporting.

The total expenditure of MOH for fiscal year 2024 is projected to reach S$18.77 billion, marking an increase of S$825.84 million or 4.6% compared to the revised total expenditure for the fiscal year 2023.

This rise is primarily attributed to the establishment of new facilities such as the Sembawang and Tampines North polyclinics, the expansion of capacity in the new Woodlands Health campus, and enhancements in the long-term care sector.

Out of the S$18.77 billion, S$17.40 billion or 92.7% is allocated for operating expenditure, while S$1.37 billion or 7.3% is designated for development expenditure.

Dialysis treatment expenses in Singapore

According to the National Kidney Foundation, Singapore ranks 2nd globally in the prevalence of kidney failure, with approximately 500,000 individuals in the country suffering from kidney disease, placing them at a heightened risk of progressing to kidney failure.

Presently, Singapore hosts over 9,000 dialysis patients. The cost of dialysis treatment in Singapore varies depending on factors such as the type of dialysis and whether the treatment centre operates for profit or is voluntary. Costs can range from S$1,100 to S$2,500 per month or even higher.

For instance, hemodialysis (HD) typically begins at S$2,500 per month, whereas peritoneal dialysis (PD), which is a needle-free treatment conducted at home, can cost between S$1,300 and S$2,000.

In 2020, Workers’ Party Member of Parliament Gerald Giam submitted a Parliamentary question inquiring about the number of patients who had reached their monthly S$450 MediSave withdrawal limit for renal dialysis outpatient treatment and their monthly S$1,200 MediSave withdrawal limit for chemotherapy over the past five years.

Minister Ong Ye Kung responded by stating that Singaporeans could claim up to $1,000 monthly from MediShield Life and withdraw up to S$450 monthly from their own MediSave accounts for renal dialysis treatment.

“From 2015 to 2019, fewer than 1 in 5 patients reached the $450 monthly withdrawal for renal dialysis treatment.  This proportion has remained stable year on year, ” he said in a written reply.

According to MOH, the Singapore government offers subsidies for community hemodialysis and peritoneal dialysis services through government-funded Long-Term Care providers.

The monthly subsidy rates for Singapore citizens with a monthly household income of less than S$2,800 range from S$385 to S$1,322 for hemodialysis and S$435 to S$1,372 for peritoneal dialysis.