Triple pre-funding of personal healthcare costs, How much pre-funding is enough?

[bic_cherry]

Triple pre-funding of personal healthcare costs, How much pre-funding will settle the

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/singapore/medishield-and-obamacare/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