Right after an uneventful Budget Speech, the hopeless PM is now preparing the cows for milking, this time from Health Care.
It seems Health Care is unsustainable and hard choices will be made, presumably more taxes, Health COE, and whatever it takes to push the buck back to the people.
What is not said is that, he will continue to accumulate billions in Budget surpluses to be channeled to external investments via Temasek and GIC that don't benefit the people in general.
If resources are not managed properly and prudently, nothing is sustainable.
For example, the billions spent on defence. How is it sustainable and is for what? While necessary, but why the huge part of our budget? It can't even deter the Malaysian govt boats encroaching into our water.
And of course what is really unsustainable by any world standard, is the huge cost of our Cabinet and the astronomical ministers' pay, in particular white elephants like Senior Ministers and ESMs. If we are a Meritocracy, then where or what is the merit for their existence?
SINGAPORE: Hard choices will have to be made as the Government considers ways to fund future healthcare spending, said Prime Minister Lee Hsien Loong on Saturday (Mar 23).
Healthcare expenditure currently exceeds S$9 billion and is set to rise even further.
Eventually, this will be unsustainable, Mr Lee said.
“In the medium term, we have to find new ways to fund this healthcare spending.
But at the same time, we have to think hard about what we must spend on, and which drugs and procedures are cost-effective,” he added.
“Hard choices weill need to be made, and I hope we will have the support of Singaporeans in making them.”
Mr Lee was speaking at the opening ceremony of Sengkang General Hospital and Sengkang Community Hospital.
Now with 189 confirmed locally-transmitted cases. Certainly, there are many more still unknown and yet to come.
In fact, its spread had already been happening for a while under our noses. The Zika test takes three hours to show if a patient is positive or negative for the virus. The first suspicion was on Aug 22, when a GP in Aljunied raised the alarm over a series of suspicious cases to MOH. MOH believed it was a mild viral illness, and asked that further cases be brought to the Communicable Disease Centre (CDC). Then on Aug 25, a 47-year-old woman, Patient A, was referred to the CDC and was confirmed to be infected (ST’s report said she went to CDC on Aug 26, Today says Aug 25). All past cases in the area were dug up and tested and it turned out that people were being infected as far back as July 31. MOH announced Patient A on Aug 27. The other 55 cases were announced on Aug 28 and Aug 29.
The answer to questions posed to MOH about why two days passed between Patient A presenting herself to the CDC and the first announcement was vague.
Since Zika was “almost inevitable”, and since an imported case had already been reported in May, shouldn’t the ministry already have been expecting to see locally-transmitted cases? Why were blood tests not carried out as soon as the GP in Aljunied reported a suspicious trend of viral infections? Why were blood tests not carried out for all individuals presenting such symptoms – did the ministry have to wait for a trend to develop?
MOH said that since the affected persons did not travel to infected countries, they were considered low-risk. This is why they did not test them immediately. The ministry chose to wait and see. Yet it is known that only one in five Zika-infected persons actually presents symptoms. With confirmed infections in places like Thailand and Vietnam, should Singapore not already have begun to treat Zika symptoms more seriously? Why was an individual’s lack of travel to Zika-affected areas a factor that puts them at low risk?
MOH said that there was no cover up for the rash of Zika infections, a question raised in light of the Hepatitis C outbreak last year. In that case, 16 ministry and hospital staff were disciplined for, among other faults, withholding the announcement of the outbreak.
But it is hard to test for a disease that doesn’t present itself in a very unique way. Sometimes the fever is not present. It is hard, but should MOH have set a higher bar?
Dr Leong Hoe Nam, the infectious diseases specialist at Mount Elizabeth Novena Hospital who diagnosed Singapore’s first Zika case in May, thinks that MOH should have done better.
“Every single mild case of fever, they should have investigated,” said Dr Leong, “It was a chance to break the cycle. Kudos to the GP who picked up the trend. We must remember that Zika is very mild, compared to dengue. Patients may not be sick enough to go to hospital but to the GP instead. So the GP now is the gatekeeper.”
Ms Tin Pei Ling, who is the MP for the ward that Patient A lives in, said, “It would have been most ideal to take a more conservative approach at that point in time, if there had been early suspicion, to check if there were any positive cases. But I suppose MOH would have taken the balanced approach between alarming everyone and doing proper checks.”
Would we have been alarmed? The number of cases, 41, is high compared to other countries in the region. It is low, however, when compared with the more deadly dengue, for which there have been nearly 11,000 cases, of which majority were probably locally-transmitted, since the start of this year.
Perhaps it is time we started acting as if Zika could well have traveled beyond the Aljunied cluster. That’s how it got spread so far in the first place, isn’t it?
UK, US, Australia, Japan and Taiwan issue travel advisories for Singapore as Zika cases rise.
AUSTRALIA TRAVEL ADVISORY:
There is ongoing transmission of Zika virus in Singapore. All travellers should protect themselves from mosquito bites. Adopt additional measures advised by the Department of Health, including deferring non-essential travel if pregnant, avoiding pregnancy for two months following your return and other advice for both males and females (see Health). The level of advice has not changed. We continue to advise Australians to exercise normal safety precautions in Singapore.
Pregnant woman in S'pore tests positive for Zika
UPDATED: AUGUST 31, 2016
SINGAPORE — A pregnant woman living in the Aljunied Crescent/Sims Drive area has tested positive for Zika virus infection, the Ministry of Health (MOH) announced on Wednesday (Aug 31) night. This is the first such case in Singapore.
“Her doctor is following up close with her to monitor her health and the development of her baby,” said the MOH. The woman, who tested positive on Wednesday, will be referred to a maternal-foetal medicine specialist for counselling and advice, said the ministry.
The news comes a day after the MOH announced free testing at public healthcare institutions for pregnant women with Zika symptoms or who have partners with the virus, as well as those recommended by their doctors.
The MOH had also issued an advisory on pregnancy and Zika on Tuesday. Noting that Zika could have more serious consequences for pregnant women — their children could be born with microcephaly — the MOH said that pregnant women diagnosed with Zika would be referred to a maternal-foetal medicine specialist for counselling and advice.
MORE ON THE DANGER OF ZIKA:
Much of the focus around the mosquito-borne Zika virus has been on pregnant women and brain abnormalities in fetuses, but now scientists think some adult brain cells could be vulnerable too. Infections may even be as destructive as Alzheimer’s disease.
By engineering mice to mimic the human Zika infection, and using fluorescent biomarkers to tag infection sites, scientists at the Rockefeller University and La Jolla Institute for Allergy and Immunology found that adult neural progenitor cells could be hijacked by the virus, leading to brain shrinkage and mental impairment.
“Our results are pretty dramatic – in the parts of the brain that lit up, it was like a Christmas tree,” said Professor Joseph Gleeson, head of Laboratory of Pediatric Brain Disease at The Rockefeller University, in a released statement about the new study. “It was very clear that the virus wasn't affecting the whole brain evenly, like people are seeing in the fetus.”
Gleeson said in healthy individuals, neural progenitor cells become fully formed neurons and are resistant to Zika, but for some people with weakened immune systems, they may be vulnerable to the virus.
The mature brain, Gleeson said, is learning, and memory that is impacted by Zika could bring about a cognitive decline that is normally associated with Alzheimer's disease or depression.
“In the adult, it's only these two populations that are very specific to the stem cells that are affected by virus. These cells are special, and somehow very susceptible to the infection,” Gleeson said. “Based on our findings, getting infected with Zika as an adult may not be as innocuous as people think.”
“Zika can clearly enter the brain of adults and can wreck havoc,” said Sujan Shresta, a professor at the La Jolla Institute of Allergy and Immunology. “But it’s a complex disease. It’s catastrophic for early brain development, yet the majority of adults who are infected with Zika rarely show detectable symptoms. Its effect on the adult brain may be more subtle, and now we know what to look for.”
But scientists said it raises the disturbing possibility of long term mental impairment in Zika-infected adults.
“The virus seems to be travelling quite a bit as people move around the world,” said Gleeson. “Given this study, I think the public health enterprise should consider monitoring for Zika infections in all groups, not just pregnant women.”
The epicenter of the current Zika epidemic is Brazil, where the Olympic Games were in full swing in Rio de Janeiro just a couple of weeks ago.
In February, the World Health Organization declared the outbreak a “public health emergency of international concern,” as evidence grew of Zika's association with birth defects.
The virus is chiefly spread by the Aedes aegypti mosquito, which is common throughout the tropical and subtropical Americas.
The new findings were published in Cell Stem Cell on August 18.
HEALTH-CARE subsidies for permanent residents (PRs) are set to be cut further, in line with the Government's bid to boost the distinction between citizens and foreigners here.
Currently, PRs get subsidies for class B2 and C wards in public hospitals and specialist outpatient clinics that are 10 percentage points lower than those given to citizens.
The Health Ministry will widen the difference to 20 percentage points by 2012, Health Minister Khaw Boon Wan said yesterday after donating blood at the Health Sciences Authority.
This will be carried out in two stages, in January and July next year, to make it easier for PRs to adjust to the cuts.
From July next year, a PR will have his bill for a class C ward subsidised by up to 60 per cent, compared with up to 80 per cent for citizens.
Subsidies for PRs in nursing homes and community hospitals will also be cut, with the first 5-percentage-point reduction to take effect in July next year, and the second in January 2012.
In December 2006, the Government had announced subsidy cuts for PRs, while foreigners had to pay medical bills in full at public hospitals.
Mr Khaw called the latest move a "meaningful refinement" of current policy that would save the Government about $7 million a year. The money can instead be used to subsidise citizens.
However, he said the Government will ensure that health care remains affordable for PRs.
About 6 per cent of all subsidised patients are PRs, he said.
Latest official statistics show that 533,200 PRs live here.
The move comes on top of recent government measures to further distinguish between PRs and citizens.
On Wednesday, the Housing Board said that it is considering whether to introduce a separate ethnic quota for PRs to prevent them from forming enclaves in public housing estates.
And last month, the Education Ministry announced that school fees for the children of PRs will be raised next year.
Some PRs, like Ms Susan Lee from Malaysia, were disturbed by the subsidy cuts.
Said the 29-year-old civil servant: "After all, we pay taxes, just as citizens do. Aren't we allowed to enjoy similar benefits?
And health care is something basic and important."
Other PRs - like lawyer Judy Yeo, 46, from Malaysia - said they understood the Government's need to take care of its citizens first. The cuts would not affect them much as they frequent private hospitals and are covered by company health insurance.
However, Mrs Yeo said: "Unless there is really a need for the cuts, it should not be done for the purpose of differentiation or to make citizens happy."
Yesterday, Mr Khaw also revealed his plan to set a 10-year roadmap for the development of Singapore's health-care system during next month's Budget session.
A possible change is an increase in Central Provident Fund Medisave contributions, to ensure that Singaporeans have enough money for longterm care as the population ages.
The current rate of 6.5 to 9 per cent is for acute hospitalisation and may not cover big medical bills and long-term care, said Mr Khaw.
In the future, lower-middle and middle-income patients may be allowed to tap Medifund for expensive drugs. Medifund is normally reserved for needy Singaporeans to help them pay medical bills.
Instead of subsidising these drugs, the Health Ministry is exploring this option for such Singaporeans, whose monthly salary may easily be wiped out if they require expensive drugs such as those used in cancer treatment, Mr Khaw said.
From: The Cynic Subject: Re: PR's health subsidies to be cut
This is an indication of an approaching general election. The health- care subsidy reduction for PRs comes in the heels of a statement from a very senior man who said recently that the number of foreign workers will be reduced in the coming years. At last the PAP hierarchy has finally woken up to the widespread resentment among locals against transplanted parasites. In the recent past, some overly paid smart alecks, in trying to defend their foreign import policy, gave ridiculous justification, eg foreign mei meis created jobs for locals, PRs cannot buy HDB flats. There will be soon other measures wooing the electorate to vote for the PAP. Let's wait and see.
Subject: 750,000 Singaporeans have no health insurance
the health situation in singapore is worst than the usa and yet somehow lky managed to con the americans into believing that singapore has a better health system. in america it is an open society so their problems are on the surface for all to see. in singapore it is a closed and non-transperant society, so all the problems is hidden underneath the nice and highly police veneer.
--------------------- Sickness in Wealth and Poverty....
The story about Tang Wee Sung's kidney transplant over the weekend[Link] probably helped the public to understand the pain that Mr. Tang had to go through before he received his kidney. The full story itself is an interesting one and can used to illustrate various aspects and features of our system.
In June 2008, Mr. Tang was caught trying to buy a kidney for transplant from an Indonesian. He was jailed for one day and fined $17,000 for that offence. The case involved one of our top private hospitals. Following the case, the law was changed to allow people who donate their kidneys to get monetary compensation from the recipient or a voluntary organisation. A similar case involving a liver transplant in one of the 2 Slim 10 victims did not trigger such a debate or change in 2002. There were 2 victims of the side effects Slim 10 - an actress known as Andrea De Cruz and another woman called Selvarani Raja. Raja's family found a willing donor[Link] but the MOH refused to allow the transplant. There 500+ patients waiting for kidney transplants every year but only 80 transplants are done in Singapore. It is an open secret that richer kidney patients have been going to China & Phillipines for kidneys. The poorer ones on dialysis die earlier because they can't afford to go overseas. ..and this has been going on for many years. Somehow, it is only when the same tragedy befell on Tang, a retail tycoon, that the govt felt motivated enough to change the laws. In an incredible twist of fate, Tang received the kidney of one of Singapore's most notorious criminals, former triad leader, Tan Chor Jin aka One Eyed Dragon who was executed for murder.
There is only country in the developed world where the income inequality is higher than that of America - that country is Singapore. In Singapore, there are 750,000 uninsured citizens this number is far higher per capita than the number of uninsured people that trigger the healthcare crisis in America[Link]. In Obama's health care plan, there will be coverage for those with pre-existing conditions - this problem remains unsolved in Singapore - thousands of people with pre-existing conditions cannot get insurance and face the risk of financial distress and ruin. Under Obama's health care plan, there will be limits to what a person has to pay at hospital out of his own pocket. In Singapore, we are all painted this beautiful picture of a wonderful health care system that is the envy of the world - one that works and is affordable. Many people believe this because they have not gotten ill or have fallen through one of its cracks.
From: Siansiansian Date: Thu, 3 Dec 2009 08:37:48 -0800 (PST) Local: Fri, Dec 4 2009 12:37 am Subject: Re: Why no free medical for Singapore Children?
On Dec 3, 11:43 pm, "AleXX" wrote:
> "Siansiansian" wrote in message
> > Almost all developed and undeveloped countries in the world offer Free > > medical care for Baby and Children. Why our Singaporean Government > > refuses to provide Free medical care for all Singaporean baby and > > Children? Instead, they are charging sky high medical fee that one may > > have to give up medical care for their loved ones simply they can't > > afford to pay for the sky-high expensive medical bills.
> > I am shamed for our policy makers on this issues. .
> Pap government needs citizens' money. How to give freely? > They need to pay huge salaries for:
> 1 Prime Minister > 2 Deputy Prime Ministers > 1 Senior Minister > 2 Mentor Ministers (note: the ex-law minister Keling Kia Jayakumar + LKY) > 1 Istana Kekling Kia
> Plus many more Ministers + Top civil servants > On top of this, Temasek needs money to loss. > They need more taxes from GST, ERP (100% tax on petrol sales), GST... > License fees, etc.., etc.
And also their perform or non-perform bonuses just get them become rciher and richer, and we becomes poorer and poorer.
From: Siansiansian Date: Fri, 20 Nov 2009 01:24:38 -0800 (PST) Local: Fri, Nov 20 2009 5:24 pm Subject: Re: "Better to die than be sick."
If you don't have the money, no hospital here will treat you as priority. My brother's son was hit by a car few years ago, and he was admitted to NUH where he was left on the bed for 5 days 5 nights with his painful broken leg, before he was operated on by a doctor. It is simply so because my brother is a taxi driver, and he has empty medisvae account. And his family will be treated at lowest possible priority when it comes to the medical needs.
It is true that in Singapore you got to be able to work and earn for yourselves and family. You don't rely on those people who are only doing wayang shows to sent rice and daily food to your door steps during their "charity" campaign.
On Nov 20, 12:08 pm, "truth" wrote:
- Hide quoted text - - Show quoted text - > http://www.temasekreview.com/2009/11/20/70-year-old-breast-cancer-pat... > November 20, 2009 by admin > Filed under Top News
> Leave a comment
> Written by our Correspondent
> A 70 year-old breast cancer patient has chosen to end her life by leaping to > her death from a HDB flat.
> Madam Chen Baozhu used to sell prawn noodles with her husband Mr Yan Qingji > in Geylang. They live together with a son who suffers from cerebral palsy.
> Due to their ill-health, they have to stop working and depend on public > assistance from the government to support themselves. Mr Yan had a stroke > three months ago and is still recuperating.
> According to her nephew, Madam Chen was worried her medical bills may impose > a financial burden on the family.
> Mr Yan has been sent to a old folks' home and his son to a nursing home. > There is nobody else in the family to take care of them.
> As recipients of public assistance, both Mr Yan and Madam Chen would have > received a monthly allowance of $330 from the state and they do not have to > pay for their medical bills at government clinics and hospitals.
> Singapore's aging population is a perennial headache for the government > which is exacerbated by the declining birth rates.
> The government has encouraged Singaporeans to work as long as they can. > Retirement age is extended to 62 and eventually to 67.
> Immigration is also encouraged as a means to increasing the flagging > population. 36 per cent of Singapore's population now consists of > foreigners.
> There are few social welfare benefits for Singapore citizens. CPF, which is > originally intended as a pension fund is now deemed inadequate to meet the > retirement needs of Singaporeans.
> Singapore's cash-rich government has so far refrained from expanding the > social safety net out of fear that it will lead to a crutch mentality among > the populace.
> "Welfare" is a taboo in Singapore officialdom which has consistently > exhorted Singaporeans to be self-reliant.
> Singapore's income gap has widened considerably in the last decade. It is > the second highest among the thirty most developed economies after Hong Kong > whose result was skewed by the extraordinarily large numbers of > billionaires.
> MM Lee Kuan Yew brushed aside the widening income gap as an issue of concern > during a recent forum saying that it "does not matter" for long as the > government continues to create jobs for Singaporeans.
SOME 30,000 elderly folk, who are living alone, or are divorced, widowed or in poor health, face social isolation, said Minister for Community Development, Youth and Sports Vivian Balakrishnan.
To reach out to them, he said various befriending and couselling services are available to them, said the minister in his reply to a question in Parliament on Monday from Nominated MP Terry Lee, who had asked if there were recent studies done on the day-to-day living conditions of the aged, especially those in destitute.
Dr Balakrishnan said the needs of the elderly poor are multi-faceted and his ministry is committed to supporting them in three key areas - by giving them financial aid, affordable and accessible health and long-term care; and helping them to stay active and socially engaged.
He also highlighted various schemes to help the needy elderly financially and improving their living conditions.
The Government is also developing a healthcare system that is relevant to Singapore's ageing demography and will provide more opportunities for active ageing, he added.
Sawatdee Kid, you have brought up an issue which needs to be emphasised. This doctor-minister Balakrishnanan is a very intelligent innovative man - if he can make the alleviation of miseries and hardship for this group of forsaken lonely old folks a mission he will make his mark as a worthy politician and leader of S'pore in the traditions of the Hipporatic Oath he took.
I suggest he clarify the various schemes available for the lay public for these group in our population and telescope it into a a single "institution and government endeavour" identifiably. There is this suggestion I wish to make i.e. also invite the emphatic members of our more fortunate S'poreans to volunteer to help by effort or donate in kind without the suspicion that monies donated will be overly used or abused for "administration or aggrandisations".
From: Zanzibar Date: Tue, 25 Aug 2009 08:02:35 -0700 (PDT) Local: Tues, Aug 25 2009 11:02 pm Subject: Re: Another tough life in LHL's Eden
On Aug 25, 10:17 pm, "truth" wrote:
> "Why won't they give me an opportunity?" > Tuesday, 25 August 2009, 1:47 pm | 810 views
> The worst is over for the Singapore economy and the labour market has > stabilised, Prime Minister Lee Hsien Loong said in his National Day Rally > speech. (Straits Times)
> "Now the eye of the storm has passed.. Our labour situation has stabilised. > Unemployment is not too high. Companies - some of them are hiring again, > although still not in large numbers. Third quarter should be all right." > (PMO)
> The Prime Minister's reassurance brings little comfort to Nur (not her real > name). What she faces is not unemployment through retrenchment but > discrimination at the work place. Nur, 28, a single mother with a seven-year > old daughter, works as an admin staff in a local company. In the last eight > months, she was twice asked to leave her jobs as her employers did not want > to extend her contract. Now Nur may again be asked to leave her third job > this year.
> You see, Nur is a kidney patient. She first discovered she had kidney > problems in both her kidneys in 2005. Since then, she has had to visit the > dialysis centre, run by the National Kidney Foundation, three times a week, > each time spending four hours in dialysis treatment. She does this in the > evenings, after work, on Mondays, Wednesdays and Fridays. She starts work at > 8.30am and finishes at 6pm. In order to be on time for her treatment, she > leaves work half an hour earlier, at 5.30pm. It was this which her employers > found disagreeable. "They told me that since I cannot be around all the time > they cannot extend my contract," Nur explained, visibly upset. With a four > hour treatment, she sometimes ends up reaching home close to midnight, and > has little time to spend with her daughter.
> She works on a contract basis and has had to endure her contracts not being > renewed several times this year, even though her employers did not find her > work performance lacking.
> Such experiences with employers have led her to lie during job interviews > when she looked for new jobs. "If I tell them the truth, they will not hire > me," she says. And even when she is successful in her job applications, she > would continue to make up excuses in order to go for her treatment. "I would > tell them I need to fetch my daughter from school," she says. . "I have to > work because I need to give [money] to my mother and I have to take care of > my daughter," she adds.
> Once, after she had been on the job for two months, she decided to tell her > manager the truth - and she ended up losing her job.
> So why doesn't she make arrangements with the centre to start her dialysis > later so that she doesn't have to leave her workplace half an hour early? > The problem is that dialysis sessions do not always start on time, Nur > explains. For example, during the recent H1N1 outbreak, sessions at the > centre were delayed as precautionary measures had to be adhered to. This > meant that Nur would end her dialysis much later, almost around midnight.
> "It is very tiring, you know?" she says. She explains that already with the > travelling to the centre and then onwards to her home, the entire process > would take a total of close to six hours. She goes to bed past midnight but > has to wake up at 6.30am to prepare to go to work again.
> In the last job which she was asked to leave, her employer recruited another > person to replace her. To Nur, this showed that it was not because the > company needed to cut staff to save cost or that her performance was > unsatisfactory, but that the company was discriminating against her because > of her medical condition. In fact, several of her former employers had given > this as their reasons for not renewing her contract.
> In August, her supervisor informed her that the company may not renew her > current contract. When she asked if the company was unhappy with her > performance, her supervisor said no, but did not elaborate further.
> In desperation, Nur went to see her Member of Parliament during his > Meet-The-People session. He promised to get back to her but did not. When > she visited him a second time, she was told by the MP's assistants, "Sorry. > MP cannot help you." She was then advised to look for a job herself.
> Nur has tried looking for a 9-to-5 job but she has not been successful so > far. With the current economic situation, her search is made harder.
> Several weeks ago, she approached the Community Development Council (CDC) > for help but was told that they were not able to find her a job. The CDC > advised her to wait and that she will be informed if it comes across any > available jobs for her.
> As she shows me the fremitus or thrill embedded in her left arm, above the > elbow, a device which makes it easier to locate small veins in patients, Nur > explains that she hardly misses work. This is because as a contract worker, > she only gets paid when she shows up at the office. "This is why I'll force > myself to go to work even when I'm sick," she says.
> For now, she is at her wits' end. Nur yearns for stability in her job so > that she can better manage her life, and care for her daughter. All she > seeks is a fair opportunity from employers and for understanding. "Why won't > they give me an opportunity?" she asks.
Why can't she use her brain properly... the simple way to think out of the box... is to find a job that is near to her house, and near to the dailysis centre.
