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Thursday September 21st 2017

Why sometimes its better to die with a major illness than going to the hospital

Mr Ridwan’s daughter Bella messaged me few days ago about the emergency donation of $600 for his father’s pet scan at NUH before a bone marrow transplant. The scan is crucial as it will certify that he is well and physically ready for the transplant.

It is also a common procedure for those who have contracted cancer and a check shows that a total of 40,000 cancer patients will withdraw $25 million from Medisave each year for the scan procedure (The Straits Times, 31 Jan 2008). It is unsure why the government has capped Medisave withdrawal of $600 each year for the cost of $1800 for a pet scan procedure necessary for most cancer patients before they can progress further in any treatment.

As for Mr Ridwan who is suffering from stage 4 lyphoma, it was a bitter-sweet experience as its apparent that his Medisave account is nearing zero and none of his family members also have that amount in their own Medisave. So where can he seek for assistance now?

It seems that his only option probably is to resort to borrowing from friends or relatives as his life is at stake.

Despite the frantic search for cash during the past few days, Bella managed to forward me a photo of him with her and the grand kids. They look great together as a family and how I wish the 53-year-old will be able to clear this huge hurdle of medical turmoil that can deepen the stress for any strong family and hopefully he can spend more quality time with his lovely grand kids after the bone marrow transplant.

Having one’s loved one contracting a dreaded disease is a stressful family affair as emotionally the children struggle to come to terms that they may lose their father eventually to the disease and the financial duress just adds on to the psychological well-being of family members.

Moreover, the patient himself will also feel bad for putting the whole family into a financial turmoil further adding on to his stress level. That is why some patients refuse to go for expensive medical treatment as they know jolly well that they don’t have the resources within the family and probably have to resort to borrowing to stay on top.

My eyes welled up in the midst of this case as I recalled how my dad struggled with lung and stomach cancer almost thirty years ago and he subsequently passed away after a relapse at the tender age of 61 years old. I was only 23 years old and has just started working after my national service.

It was challenging going up to the hospital for the daily visit when he was admitted and you also try your best to put up a strong front for the whole family. I only cried once in the tiolet initially when I knew that he has lung cancer and during the 2-year ordeal managed to spend some quality time with my dad before his final demise.

Fortunately, everything could be settled by the hospital then and there was very little cash transaction necessary.

As for Bella, a trip to the medical social worker at NUH also does not end well as Medifund does not cover pet scan costing and only $600 can be utlilised for the whole year from the Medisave account. The total cost of the pet scan costs $1800.

It is apparent that Mr Ridwan does not have the $600 in his Medisave account including from any of his children – so they need cold hard cash for the deposit.

I forwarded the appeal to a few of our regular donors but they have committed themselves for the month financially so we could not really raise anything for the family a day before the scan.

On the actual day of the scan, Bella forwarded me a message from NUH and it literally knocked me off my chair – the hospital will be cancelling his crucial pet scan test due to his failure to deposit $600 for the procedure.

The message seems robotic and even merciless and of course from the hundreds of comments gathered once the story broke out on FB that was the turning point against the hospital for adopting a very bureaucratic hard-hearted approach towards patients.

Many have commented that hospitals won’t behave this way as their first priority is to care for the patient first even if he has no money to pay for any medical procedure but the mechanical text message from NUH seems merciless and even unreal.

In fact, we pray that the text message is not real as it will probably restore our faith back to the hospital and humanity. No hospital should do this to any of their patients as it goes against any professional ethics and humanity. We have yet to hear from the hospital officially yet on this matter.

Nevertheless, in a society which thrives on the powerful mechanics of co-payment and personal independent dignity, any welfarism can be frowned upon as a sign of weakness. Our government has gleaned the population well not to wholly depend on the state to pay for any medical procedure so that the people can be dignified and independent.

From the compulsory Medisave CPF saving to the national insurance Medishield, it has all along advocate for self-dependency and personal dignity. The Medisave of our loved ones can also be used if ours have being exhausted during the course of the treatment. Its a dignified system as co-payment gives us back control of our own life and destiny but the buck stops here – what if they and their family members have nothing left to pay anymore from their Medisave account?

Medishield for all the publicity and propaganda it has generated is a white elephant which benefitted only a small section of the population.  In a damning report on The Independent Sg, a Singaporean wrote how he was only covered $300 from a $5000 medical bill with zero subsidy for his $900 medication from Medishield Life.

Many readers have also commented that there is a service called the Medical Social Worker but a text message we received confirmed that the pet scan is something that Medifund can’t cover even though the government lauded that $129 million of Medifund was used for the poor in FY 2015 compared to 135 million in FY 2014 – a drop of $6 million when our population is fast ageing and people are hampered by the rising cost of living. Surprisingly, FY 2016 has no Medifund expenditure report on any government website drawing suspicion that perhaps the figure has gone down once more as the government has made it tough for the poor to apply for Medifund.

It also boasted that 99.9% of the Medifund applications received were approved in FY 2015. But it bears reminding again that Mr Ridwan’s pet scan is not covered under Medifund and it has to be cold hard cash.

I remembered paying for my late month’s $8000 hospitalisation expenses from my Medisave after deduction from staying in a ward C in the hospital. It felt good that you have sufficient funds to pay for the bill and it was right. But I have the funds and God knows what will happen if I don’t…

However, many we know resort to borrowing to pay for a medical procedure or hospitalisation and some have no choice but to wait at home bidding their death amidst poverty and helplessness.

They have probably exhausted all avenues of borrowing and relatives even avoided them for fear that they will stretch out their hand again.

The government has always push for the comprehensive national Medishield so that we can have a basic coverage in the event that we in medical need but there are apparent loopholes here and there. A pet scan seems to be a basic medical procedure for cancer patients and without it a patient has no way to progress further in any medical treatment.

Our fear is that many poor vulnerable Singaporeans will be left behind as they could raise the necessary cash for the scan and Medifund will be useless here.

Our gleaming restructured hospitals now seem very cold and even hard-hearted and as the country struggles with under-employment and the ever-rising cost of living, our medical subsidy and funding seriously do need a thorough revamp. For FY 2015, 12.9% ($8.7 billion) of our governmental expenditure is placed on healthcare – a figure that is shockingly unchanged from FY 2014. In FY 2013, it was 11.5%.

It is a meagre 2.1% if measured against our country’s GDP. Compared to Australia (6.3%), Norway (8.3%), France (9%) and New Zealand (9.1%) we are like light years away. Of course, these developed countries pay hefty taxes in order to be able to provide deep coffers for healthcare programme for it’s own people and we should not use the taxation excuse to do so for our population especially those who are needy.

We just need to spend less on our ministerial salaries or expensive dustbins next to the Parliament!

As for Mr Ridwan who has just gone for his pet scan yesterday after a Good Samaritan donated $700 to his cause, our heart goes out to him and we hope that he will not be left behind in the near future just because he does not have the money for his treatment.

Written by: Gilbert Goh

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3 Responses to “Why sometimes its better to die with a major illness than going to the hospital”

  1. @No Emoji In little Red Dot says:

    It really saddened me when we read the above incident from time to time. This little red dot garmen is like a cartoon with full of unreal emoji less the heart part. Its a kind of a robotic society & every thing r measured in dollars and cents. It’s a pity to see a First World nation degrading into a Third World nation. A place where the Heartless & Selfish ones lives, where the garmen busy taking Selfies & put it in Facebook,Instagram or Twitter for every one to see but lacks compassion & heart. This little red dot is still a loong way to go in building a caring society..

  2. Insurance says:

    Treatment of stage 4 Lymphoma was expensive every where in the world. After $700 pet scan, what is the cost of further treatment?

    I used to sell insurance. Some customers have the thinking that almighty god/gods will take care of me. They did not take up private insurance to cover major illnesses. I do not mean Living policy, but insurance like NTUC integrated shield plan that cover your medical bill.There are rider available too.

    Financial Planing Education is very important, this subject should be taught in School when children are young.

  3. Richard says:

    Seriously ? NUH sent that message ? I sincerely pray to God this is a mis-understanding … If NUH behaves like that, what hope’s left for Singapore and PAP government ?

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