Feb 15, 2011

Healthcare for Singaporeans in Malaysia

This is one of the rare occasions on which I disagree with Lucky Tan (who is, by the way, one of the most read-worthy bloggers in Singapore).

In a recent post, Lucky discusses a New Paper article which talks about Singaporeans being able to use their own Medisave savings to seek medical treatment in Malaysia. Lucky writes:

If your healthcare system is not universal and becomes so expensive that citizens have to go to a developing country for treatment, it is a tragedy, not an achievement. However, if you read today's New Paper, it seems to be saying the MOH has helped Singaporeans to save money by allowing them to use their Medisave for hospitalisation in Malaysia. All of us have to thank Minister Khaw for this flexibility of being able to save money by travelling to Malaysia when we get sick.

The article doesn't ask about adequency of govt support for poorer Singaporeans when the cost of private care in Malaysia is less than half (according to New Paper) that of subsidised care in Singapore. It doesn't ask why these people have to go to Malaysia to save money when Minister Khaw can get his heart fixed for $8....so poor people pay more and rich millionaires like Khaw get cheap healthcare - there is certainly a moral issue here.

The New Paper article is filled with smiling patients who are happy to save money going to Malaysia for treatment but I believe the story in many real cases sound more like tragedies. Take Singapore singer Yue Lei case as an example[Link]. He had to sell his home and go to Mahkota Hospital for cancer treatment because healthcare in Singapore is too expensive. Singapore often boasts of having one of the highest standards of medical care in the world but when the govt wants to keep its expenditure on subsidies down by sending poorer sick Singaporeans to Malaysia, it says the standard of care in a developing country is just as good as Singapore's.

Being able to get poor Singaporeans to go to developing countries for medical care takes the pressure off the govt to do more to contain costs and ensure universality in our system. We shouldn't have allowed this ...it is a tragic development for poor Singaporeans who get sick and don't get adequate help.

I disagree with Lucky, because I think that the New Paper article did the public an excellent service, by highlighting the fact that Singaporeans can use their Medisave to seek medical treatment in Malaysia.

It is important for more Singaporeans to be aware of this, especially because the costs of healthcare in Singapore can be so high. It is useful for all of us to know that there are viable alternatives for us, just across the Causeway.

Lucky goes on harping and complaining about why isn't the Singapore government providing affordable healthcare for Singaporeans in our country. These are ridiculous assertions and the sooner you realise it, the better for you.

The government isn't here to take care of you. The government isn't here to serve Singaporeans. The government isn't here to care for the poor and the sick.

The government is just a large, unwieldy, faceless piece of machinery programmed to carry out its own political agenda; pursue its own policies; and serve its own interests. Those interests may or may not coincide with your interests. If they do, well, that's just a coincidence.

YOU need to take care of you. The sooner you understand this, the better for you. You will see the pointlessness of complaining about why the government is not providing affordable healthcare to Singaporeans. You will see the value of gathering knowledge about how to better survive on your own resources.

Knowledge such as how to go to Malaysia and get medical treatment there.


Anonymous said...

Mr Wang,a govt is elected by the people to serve the people.It's time to change the govt if it's not full-filling its basic task.

Anonymous said...

Lucky is an idealistic cynic. Mr Wang is a pragmatic cynic. I think both perspectives are good - take care of yourself, and hold the government accountable to yourself.

Anonymous said...

Mr. Wang,

I not sure if your comments on Lucky Tan's article are meant to be satirical, but I find them difficult to swallow.

Yes, any entity, including governments, will pursue its self-interest.

But just because it is natural doesn't mean it is right.

The onus should be on the government to provide reasonably afforable health care, not on the populace to sniff out cheaper hospitals across the causeway.

Yes, the New Paper article does helpfully point out that our Medisave funds can be put to work in Malaysia.

But it remains a tragegy that less well-off, sick Singaporeans will have to resort to doing so.

The free market doesn't always work--the subprime crisis has laid that bare.

There is a role for governments to play in providing affordable health care. It's surely one of the core reasons for having a government in the first place.

What would be interesting is if there is an article comparing health-care afforability in Singapore with that in other countries.


Anonymous said...

Mr Wang is right .... You cannot really expect the government to look after Singaporeans.

Nowadays they want you to make more love and give birth to babies ... Is that for the sake of your personal happiness and wellbeing?

LOL, of course not, it is just because they are concerned about the economic problems of an aging population. If you grow old and have no children to look after you, GAAASSP!!, the government might actually have to look after you!

Better encourage you to make more love and bear your own children.

Anonymous said...

Mr Wang, what u wrote about the responsiblity of government applies uniquely to Singapore. In Australia, many parts of Europe and even China, the main focus of the government is to take care of the citizens. If not they will be voted out. Simple as that. LKY has manipulated the system in Singapore to deprive Singaporeans of this leverage on the government. Time for Singaporeans to correct this political indecency.

Anonymous said...

Mr Wang, have you been seriously ill before? If you have friends who have illness that requires constant treatment and thus frequent trips to the hospital, you will understand then how physically tiring it is to even get to the local hospital let alone do that frequent trip on public transport to one overseas.It's already depressing to be in a physically unfit situation, to have to make the trek over to malaysia each time can't be helpful.

Anonymous said...

"The government is just a large, unwieldy, faceless piece of machinery programmed to carry out its own political agenda; pursue its own policies; and serve its own interests."
Mr Wang

No lah, don't say government serve its own interests, should say serve national interests. Sounds better, isn't it? And also still correct what, right?

Like the following also serves national interest.

1. Ministers should be paid in the millions.
2. Singaporean males should serve NS.
3. Foreign talents are welcome to work and live here but no need to serve NS.
4. Having legalised casinos.
5. Having the GRC system

Of course these may not coincide with your own interest.

But doesn't matter as long as 66% voted in the national interest.

Anonymous said...

Strange assumptions and arrived at conclusions made by a number of the posters here...

They seem to have forgotten who is actually paying the upkeep and maintenance of the "government" of singapore...

You mean all these monies "paid out" and always "in advance" to the gov't is just so much air?

Gosh...then how do the civil service and gov't officials lived on? On air is it?

And how about the NS chaps/lady regulars who serve singapore and indirectly it's government too who died or got permanently injured is also nothing then..just so much air too?

So then who are they defending actually in the end...the people of singapore or is it the gov't of singapore who thinks so little of the people "supporting" it?

Speaks volumes doesn't it...need more re-thinking and perhaps real wisdom here...

Good day all.

Anonymous said...

zmorgish...it means the singapore government is living off it's people...this is sooooo pathetic...

Anonymous said...

Mr Wang, there is a big hole in your argument.

Firstly we are not talking about Singaporeans simply going to Malaysia for treatment.

We are talking about the government specifically allowing Singaporeans to use their MEDISAVE funds for treatment in Singapore and Malaysia.

What was the objective of MEDISAVE? To help Singaporeans afford healthcare in Malaysia?

Time to relook the MEDISAVE scheme.

Anonymous said...

What's wrong with using Medisave for medical treatment in Malaysia?

Haven't you all heard of this tide called globalisation?

Meaning money, services, talent etc freely moving across national boundaries seeking the best mutual benefits and returns.

How can you stop the tide in this Internet and virtual Age?

It is precisely this that SIngapore can survive and prosper. Not necessarily so for individuals but as a nation of course. As one poster said, "national interests".

Anonymous said...

What is the use of a surviving and prosperous nation, if its people are not surviving and not prosperous??

Anonymous said...

Stupid question.

It is of great use, if you are a minister earning very high salary and your KPIs are "economic growth" and "minimal medical subsidy".

Gilbert Koh aka Mr Wang said...

"Meaning money, services, talent etc freely moving across national boundaries seeking the best mutual benefits and returns.

How can you stop the tide in this Internet and virtual Age?"

Errr, quite easy, for the money part.

First, pass a law saying that everybody has to set aside 20% of their salary every month.

Next, say that they cannot withdraw their money until they are 55 years old.

Then, change it to 60 years.

Next, change it to 62 years.

Next, change it to 75 years.

There, you've done it! You've stopped money from moving freely across national boundaries seeking the best benefits and returns!

Anonymous said...

"The government isn't here to take care of you. The government isn't here to serve Singaporeans. The government isn't here to care for the poor and the sick.

The government is just a large, unwieldy, faceless piece of machinery programmed to carry out its own political agenda; pursue its own policies; and serve its own interests. Those interests may or may not coincide with your interests. If they do, well, that's just a coincidence."

Is it then a coincidence they are are taking such great care of my CPF money, my very own money?

On the contrary the govt is NOT a faceless piece of machinery. Instead it is those few at the top running it who must be held accountable.

Anonymous said...

Mr Wang,

Seems like you are toeing the govt line by advocating self reliance. (:

Gilbert Koh aka Mr Wang said...


I see self-reliance as the key.

Because I think that the Singapore government is unreliable.

Anonymous said...

Health care and housing are basic needs. If the current government won't take care of its citizens on these needs, then why should we let them stay in power?

Parka said...

Precisely. The first thought that came to my mind when I read Lucky Tan's article is that there are alternative's to healthcare besides Singapore.

It's just like how people like to go JB for shopping or petrol. Alternatives are great.

Anonymous said...

Mr Wang assumes everyone is well read like him and are able to manage their own welfare. Mr Wang is preachng its now everyman for himself.

Lucky Tan is thinking about others. He assumes there are people out there who really need help - the poor, the elderly, the illiterate, the physically and mentally challenged. Therein lies the difference.

Anonymous said...

So "What would you defend?", should now be "Singapore, JB, and some say Batam" ?

Anonymous said...

hahahahahahaha. GOOD ONE.

Godwin said...


I thought Singaporeans liked going over to Malaysia to buy cheap stuff: cheap groceries, cheap food, cheap petrol... Why not cheap healthcare?

Anonymous said...

Mr Wang

You are wrong.

Anonymous said...

"cheap groceries, cheap food, cheap petrol... Why not cheap healthcare?"

Similarly, why not go over for their cheap schooling.

Do the acid test, ask the malaysians. Where would they prefer to have their healthcare done & schooling.

Amused said...

Malaysia government should put a tax on Singaporean seeking healthcare in their country. The flood of Singapore patients will only drive up the cost for locals.

Now you not only send the old people to retire there, you are also sending the sick over. Next the disabled, the weak, the poor, the underachievers, and the criminals are going there.

We should just be part of Malaysia since Singaporeans cannot manage its own affairs.

Anonymous said...

Let's have a cheaper government too. Kick out the overpaid leeches we have now.

Lucky Tan said...


Mr. Wang is right. The govt is a faceless, weildy machine only interested in growing the GDP. Its basically "you die your business". So you better make sure you're covered top to bottom, front back and center. I've already spent plenty of time on my blog to point out the cracks in our system so make sure you have ENHANCED MEDISHILED + a few riders, forget BASIC MEDISHIELD (it should be renamed INADEQUATE SHIELD).

Be self-reliant and resilent otherwise you can't tahan the pain in this system. Unfortunately a large segment of the population have stagnant wages and "C" hospital changes have doubled in the past 4 years. If I belonged to the bottom 20%, I would also go to Malacca to save some money because I'm poor and my govt won;t take care of me ...not because I like Mahkota Hospital or think it is on par with Singapore hospitals.

What does a person do at the ballot box when he feels that the govt does not take care of him when he is sick? ...and he is suppose to defend this country and system with his life?

We should be more resilent and self-reliant...and we should be smart enough to take care of ourselves by getting them to fix system before it forces more of us to go to Mahkota when we get sick.

The PAP doesn't need to change anything when it doesn't want to only because 66% faithfully supported them in last elections giving them the mandate to what they want. You don't want to go to Mahkota when you're sick...you don't want your fellow Singaporeans to have developing country standard of care when they are sick...I suggest you think hard about where to mark the X on election day.

Anonymous said...

Whether you think Mr Wang is being satirical or cynical or just plain pragmatic, since the Gov't cannot or will not provide affordable healthcare for all citizens, at least the less well-off have an avenue for cheaper healthcare. Hope that cheaper does not equate bad quality.

Bravo to the Gov't critics. Whether the Gov't meant to do it or not, this is a gross admission of failure of a major policy. Loyality to country has erroded somewhat.

Anonymous said...

Are you a stayer or a quitter?

I'm a quitter and a happy one at that.

If you are a stayer, then you best find out how to fend for yourself. Especially if you keep voting for the same party over and over again.

And stop complaining.

Anonymous said...

"Health care and housing are basic needs. If the current government won't take care of its citizens on these needs, then why should we let them stay in power?". Unquote.

66% had disagreed with You and the majority will still disagree with You in the Coming Election.

Anonymous said...

The trick is to at least take care of basic needs of the majority lah, say 66%.

Luckily only 5 million people, so not so bad lah. In other countries, no big deal, just a city mayor level only. But whole country with 80 or 100 million people, problem man, right or not?

So those critical bloggers out there, please see things in perspective. Maybe not really that bad or diffcult to solve, after all.

Roy said...

Actually, Lucky was trying to say that the healthcare policies are screwy and it should not be so, and Mr Wang advised that because they are screwy, people should take care of themselves. Same directions.

We all know how Singaporeans had voted, so chances are the same old story will be propagated in years to come. In short, Lucky is idealistic and Wang is pragmatic. But both agree that the system is screwed.


Melbourne said...

@Mr Wang 15/2/2011 4:17

And then you take that money, invest it internationally seeking the best rate of return, and arbitrage the difference.

Oh, and finally you proudly publish in the local press that Temasek has achieved an annual return of 16% YOY since its inception, knowing that not too many people will be able to figure out what that actually means.

Winking Doll said...

Mr Wang wrote: "The government isn't here to serve Singaporeans. The government isn't here to care for the poor and the sick. ... The government... serve its own interests. Those interests may or may not coincide with your interests."

Bravo! You hit straight to the point. In other 1st world democracies and even in China, it is in enlightened self-interest that the government takes care of the poor and sick. The PAP "you-die-your-business" approach is Uniquely Singapore.

I agree with Anonymous at February 16, 2011 6:52 AM, I am also a quitter. If you decide to stay, think about what Lucky Tan commented at February 15, 2011 11:21 PM: "...think hard about where to mark the X on election day."

Anonymous said...

If you have no job and zero income, you will be forced to sell your home because you cannot get subsidy for hospital treatment.

So it is better to take up some work to file an income tax statement. Some income is better zero income. The govt helps those with some income but nothing for those with zero income.

From MOH Website, its said
How much subsidies will patients with no income, such as housewives, children, retirees and the unemployed receive?
Patients who do not have an income will receive full subsidy (65% for Class B and 80% for Class C) unless they live in a property with AV exceeding $11,000. The latter will receive subsidy at 50% (at Class B2) at 65% (at Class C).

How will children be means tested?
Children under the age of 21 will be assessed based on the AV of their residence. For those who have not obtained their NRIC, it will be based on the residence as stated in their Birth Certificate or NRIC of the parent.

Anonymous said...

Someone on TOC found a gem and I share it here


Anonymous said...

Mr Wang

Your recent articles seem to have taken quite a shift in views as compared to those that you have written a few years ago.

This "tone" in this article seems jaded. hhhhmmmmmm.

Anonymous said...

I don't always agree with you but i think you are spot on this time, Mr Wang.

Anonymous said...

In times of need I feel that I can rely on the health care services of Singapore.

Until recently an ex-classmate died on the 4th day of Chinese New year. He was feeling unwell and was referred to the Singapore General Hospital after the local gp cannot find anything wrong with him.

The doctors at SGH gave him pain killers and then he went to sleep. He never woke up. Inside SGH's report, the cause of death is unknown. The body is quickly release, so fast that I didn't think the doctors had a chance to do a through investigation on his body.

Poor chap's wife is expecting and his kid is due next month.

Is this some sick doctor covering up for his negligence? Maybe we all should seek healthcare in Malaysia.