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In Singapore, we get to enjoy one of the most efficient healthcare systems. According to the Bloomberg Healthcare Efficiency ranking published in 2020, Singapore came in second for the most efficient healthcare system in the world.
The Ministry of Health (MOH) also shared that, while our country only spends about 4% of our GDP annually on healthcare, compared to 8% in the UK and 16% in the USA, we still achieve comparable outcomes with many developed countries. With an average life expectancy of 84.07 (as of 2022) that is one of the world’s highest, we are also seeing how the efficiency of our healthcare system can translate into tangible outcomes.
While some of us may think that such quality healthcare outcomes are the sole efforts of public hospitals, this isn’t necessarily true. In fact, there are occasions when public hospitals are stretched and not able to meet the demands of our nation.
As shown during the pandemic, public healthcare resources are not infinite. Senior Minister Tharman Shanmugaratnam shared in parliament in June 2020 that, due to COVID-19, many elective surgeries were put on hold since February that year. At that time, the Ministry of Health announced that medical procedures for patients with higher needs will resume from 2 June 2020, while the less urgent elective medical procedures may continue to be deferred.
In a parliamentary response published on 10 March 2022, it was also shared that “based on MOH’s modelling, the annual average public hospital bed occupancy rate (BOR) over the next five years would be around 80%.” According to international healthcare standards, hospitals are recommended to sustain a BOR of less than 85%. This means that the public hospitals are likely to reach ‘full’ capacity for years to come.
Private Hospitals In Singapore Play A Vital Role In Supporting Singapore’s Healthcare System
In Singapore, private hospitals play an invaluable role in supporting Singapore’s healthcare system. As of 2020, there are 7 private acute hospitals in Singapore with the biggest brand, IHH Healthcare, which has more than 1,000 beds – close to half of all private hospital beds in the country – which are Gleneagles Hospital, Mount Elizabeth Hospital, Mount Elizabeth Novena Hospital and Parkway East Hospital.
The role that private hospitals, like the IHH Healthcare group, play cannot be understated. For example, during the pandemic, private hospitals help take in patients to ease the burden on the public healthcare system. Due to the long waiting time at public hospitals, more patients, particularly those who are covered under private insurance, choose to seek for treatment at private hospitals.
This is why beyond the mandatory MediShield Life coverage that subsidises all Singaporeans and Permanent Residents for large public hospital bills (Class B2/C wards), we also have the option of purchasing a private integrated shield plan (IP) to extend our coverage to Class A/B1 wards at public and private hospitals. Though optional, purchasing an IP allows us to be covered for hospital bills at a private hospital.
Are Private Hospitals Too Expensive?
One perception that some of us may have is that private hospitals are expensive and unaffordable. However, this isn’t necessarily true. Depending on the private integrated shield plan coverage that we have, our private hospital bills could be a lot lower than what most of us expect.
Using the MOH Fee Benchmarks and Bill Amount Information, we can get a gauge of how much a specific treatment or surgery would cost us at public and private hospitals.
For example, a knee replacement surgery at Class A and B1 wards in a public hospital have a median fee of $23,017 and $21,000 respectively.
A similar surgery at a private hospital would have a median fee of $35,764.
One thing worth noting is that the bill amount shown is not always the amount we actually pay. The bills shown are before any subsidy from insurance coverage, such as the MediShield Life, which all Singaporeans and PRs would already have. Thus, while it gives us an estimate of the hospital bill, this isn’t what we may end up paying.
The fact of the matter is that the out-of-pocket expenses that we end up paying in a private hospital is largely dependent on the hospital insurance coverage that we have. If we only have MediShield Life, then the coverage we get from our insurance plan will be limited for private hospital bills (which means our cash outlay will be high).
However, if we have an integrated shield plan with a rider that covers us substantially for private hospitals, then the cash outlay that we may need to fork out would be minimal.
Estimating Our Costs At Private Hospitals
To enjoy a peace of mind, it’s good to have a bill check whenever possible before we go for an elective surgery at a private hospital. This will help us to estimate the hospital bill, and more importantly, the amount we can expect to pay based on the private integrated shield plan that we have.
IHH hospitals, such as Gleneagles Hospital, Mount Elizabeth Hospital, Mount Elizabeth Novena Hospital and Parkway East Hospital, provide a hospital bill estimator that gives us an estimate of the out-of-pocket expenses that we can expect to pay for common surgical procedures.
For example, if I am intending to go to Gleneagles Hospital for a knee replacement surgery, I can estimate my out-of-pocket expenses based on the insurance plan that I currently have using the hospital bill estimator for Gleneagles.
Step 1: Select a Body Part
Step 2: Select a Procedure
Step 3: Select our Private Integrated Shield Plan
Since insurers may offer different benefits for their private integrated shield plans, this will affect how much coverage we get.
Step 4: Choose the rider that we have
In our case, we selected the Income Enhanced IncomeShield Preferred with the Assist Rider.
Step 5: Get our Estimated Bill Size and Out-of-Pocket Costs
With the inputs we have provided, the bill estimator will tell us how much the estimated bill size would be, and more importantly, how much we are likely to pay. Do note that the hospital bill estimator uses information that is gathered from past historical bills.
In our hypothetical example, while the estimated bill size for the surgery is $34,480, the estimated out-of-pocket costs that we pay for the approved panel doctors would be only $3,000 (co-payment is $3,448 but is capped at $3,000 per policy year). If we choose non-panel doctors, the bill would be $5,428.
If we only have the Income Enhanced IncomeShield Preferred plan without a rider, our estimated out-of-pocket expenses would be higher at $6,598.
Our Insurance Coverage Largely Determines How Much We Pay At Private Hospital
Whether it’s public or private hospitals, the biggest factor that will determine how much we end up paying for our hospital bills is likely to be the integrated shield plan that we have.
There are 3 types of plans with different coverage that we can purchase:
Standard Integrated Shield Plan (Standard IP): Standard IP provides coverage for policyholders for Class B1 wards at public hospitals. Benefits provided by the Standard IP are identical across all IP insurers.
Class A Plans: Class A plans provide coverage for policyholders for Class A wards at public hospitals. Benefits provided by the plan may differ from insurers.
Private Hospital Plans: Private hospital plans provide coverage for policyholders at private hospitals. Similar to Class A plans, benefits provided may differ from insurers.
It’s worth noting that, even if we don’t have a private integrated shield plan that covers us specifically for private hospitals (e.g. we have a standard IP or a Class A plan), it doesn’t mean that we don’t get any coverage at all for our private hospital bills. Rather, the coverage that we receive would be sized to what we would have received had we gone to a Class A or B1 ward at a public hospital.
So rather than think about how private hospitals are too expensive and out of reach for us, what we can do is find out the type of private integrated shield plan we have (if any), and the level of coverage that we can enjoy if we were to seek treatment and surgery at a private hospital.
After all, while opting for private hospitals may cost more compared to public hospitals, the amount that we, as patients, may end up paying may not be much more as the final cost depends on the insurance policies that we have. To have a peace of mind on the estimated amount we may need to pay, do check out the various bill estimators from Gleneagles Hospital, Mount Elizabeth Hospital, Mount Elizabeth Novena Hospital and Parkway East Hospital prior to undertaking any treatments in the hospitals.
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