Healthcare for People with Special Needs

Thank you, Sir. MediShield today still does not cover congenital and pre-existing conditions. In the face of escalating healthcare costs, it is very worrisome to live without healthcare insurance. This is very much so for families with children born with special needs or disabilities.

The situation is even worse in the case of Singaporean children born with more severe conditions, such as rare genetic conditions. I know of some families whose Medisave balances are wiped out.

Sir, we must rise above the response of "it's just too bad" or that "covering them would burden everyone else", “we will have to pay higher premiums for them”. Should the decision to extend MediShield to those with congenital or pre-existing conditions be made through public consultation, as suggested by the Minister? Ask everyone to agree to pay higher premiums? Or should the incremental costs be covered by the MOH budget, just like the way we take care of the vulnerable and those more at risk in our country?

And even if we start off with at least the same MediShield coverage – ceiling that is enjoyed by typical Singaporeans – that would assure couples contemplating babies that whatever condition their newborns turn out to be, they still have access to basic healthcare insurance. I, therefore, urge the Ministry to instil a sense of urgency to ensure MediShield includes all Singaporeans, especially those born with special needs.

Lastly, on early detection. One of the critical success factors to improve prognosis of children with special needs is early detection and quality early intervention. Although screenings are now conducted during health checks, and especially when the kids are due for immunisation, outcomes have been mixed. Detection later in pre-school and formal schools is not systemic and dependent very much on the experience, workload and proactivity of the teaching staff. I, therefore, urge the MOH to improve the current system so that the children might have a better head-start and access to intervention earlier.

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Additional Query

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Sir I would like to seek clarification on the MediShield review which does not cover those with congenital and pre-existing conditions. I would like to ask the Minister to clarify when the review for the MediShield coverage for those with congenital and pre-existing conditions be completed. The review has been going on for some years now. I wonder if it can be brought forward, because basic healthcare is not a "nice-to-have" item. It is a basic essential service. And I also worry about the traditional paradigm and the narrative that if we want to include people with congenital or pre-existing conditions, then the fee will have to come out directly from the pockets of other Singaporeans. I find this underlying assumption not acceptable because, for example, in education, we never say that if we want to help the weaker students, then we ask those who are more able to pay higher school fees. Hence, I would like Minister to clarify and consider, in the review, to include people with congenital and pre-existing conditions earlier in the MediShield scheme.