SINGAPORE: Those who enrol under Healthier SG - a voluntary national primary care programme - will be able to undergo free screenings for three common chronic conditions as well as three types of cancers, announced Health Minister Ong Ye Kung on Tuesday (Oct 4).
They are: Type 2 diabetes, hypertension, and hyperlipidaemia as well as breast, cervical, and colorectal cancer.
As for those with specific risk factors, they may be referred for further tests.
Noting that complex screenings such as colonoscopy may not be appropriate to be made a standard screening for everyone, he said these will not be free but will continue to be heavily subsidised in hospitals.
Mr Ong was speaking in Parliament, where he led a motion to endorse a White Paper on Healthier SG as the basis of the transformation of Singapore’s healthcare system.
It comes as the country races to tackle the challenges of an ageing population and the rising impact of chronic disease.
The new strategy aims to have citizens take charge of their own healthcare, where they can enrol with a single doctor who will support them in their health needs throughout their lives. This can either be a general practitioner or a polyclinic doctor.
Under proposed plans, those who choose to enrol in Healthier SG will be able to schedule face-to-face onboarding health consultation, which will be paid for by the Government.
They can then develop health plans with their doctors, who will continue to monitor the resident's progress via follow-ups. This will provide an overview of their health status, medical needs as well as health goals, followed by an action plan, such as lifestyle adjustments or weight management.
First announced during the Ministry of Health’s (MOH) Committee of Supply debate in March, Healthier SG - which is voluntary - will be open to those aged 60 and above to enrol in the second half of 2023.
It will gradually be made available to those between 40 and 59 years old in the next two years.
ADDITIONAL SUBSIDIES AND USING MEDISAVE
An additional subsidy tier will be added to the Community Health Assist Scheme (CHAS) for common chronic drugs and drug price limits.
This is to level the significant price difference of drugs between GP clinics and polyclinics, so that residents will be encouraged to stick with the family doctor of their choice.
All enrolled Singaporean CHAS card holders, including Pioneer Generation and Merdeka Generation card holders, will be able to benefit from this.
Mr Ong pointed out that the price will not be able to equalise "down to the last cent" as the basis of calculating subsidies at Polyclinics and for CHAS are different.
However, the current difference in drug prices between Polyclinics and private GP clinics will be "substantively" removed, he said.
Another key change under the Healthier SG initiative is that those using MediSave to pay for the treatment of chronic illnesses will no longer have to co-pay 15 per cent of the bill using cash. Instead, they will be able to pay the full amount with MediSave.
Noting that most Government subsidy schemes require some co-payment from residents to reflect a "sharing of responsibility", Mr Ong said this further subsidy is justified as it will result in personal actions to make changes and lead a healthier life.
He added that community partners such as the People's Association and Sport Singapore will organise more health-related activities to support active lifestyles.
The Healthy 365 app, which is currently used for initiatives such as the National Steps Challenge and the Eat Drink Shop Healthy Challenge, will also be enhanced to include features such as tracking calorie intake.
SPENDING MORE ON PREVENTIVE CARE
Today, Singapore's national healthcare expenditure is expected to be about S$22 billion a year however, this is expected to nearly triple to S$60 billion in 2030.
To slow down the rate of increase in healthcare spending, the Government is focusing more on preventive care in hopes of helping citizens become healthier.
Currently, about 6 per cent of Singapore’s annual healthcare budget is spent on preventive care such as funding the Health Promotion Board (HPB). However, Mr Ong said the hope is to increase this under the new healthcare reform initiative.
“With Healthier SG, in the coming few years, we will and we want to grow this - perhaps to double the share of total healthcare expenditure,” said Mr Ong.
He added that the set-up cost of Healthier SG is estimated to cost more than S$1 billion over the next three to four years. This will be used to fund new IT systems, ground support capabilities, and to give general practitioners (GPs) a “one-time support” for the necessary IT enhancements to bring them on board.
Beyond this, there will also be recurrent costs, he said.
This includes funding support measures for residents and the annual service fee for GPs, he said, adding that this is estimated to cost another S$400 million per year.
“In making these investments, our primary motivation is to reduce disease burden, reduce the suffering of our people and their loved ones,” he said.
“If this national medical bill instead of tripling, doubles in the next ten years - we would have saved much more than what we are planning to spend on preventive care,” he added.