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The healthcare financing in Singapore – to show how the Singapore PAP government is making Singaporeans double-pay for healthcare, so that the PAP government can earn.

Please see below the short description and references:

In 2016, CPF members contributed S$35,852 million into the CPF.
https://www.cpf.gov.sg/Assets/common/PublishingImages/CPFStatistics/Sub_Contributions.jpg

Part of the CPF goes into the Medisave scheme for healthcare, but there is no breakdown as to how much actually goes into Medisave.

According to the CPF Board, CPF members aged 35 years and below pay 21.62% of their total CPF into the Medisave, and this is the lowest level at which the Medisave contribution is, as it increases to 24.32% for those above 35 to 45, and to 84% at its highest for those above 65.
https://www.cpf.gov.sg/Assets/employers/Documents/Table%2011_Pte%20and%20Npen_CPF%20Allocation%20Rates%20Jan%202016.pdf

Taking 24.32% as the lowest denominator, CPF members would have paid S$7,751 million into the Medisave in 2016.

But if we were to break down the Medisave contributions according to the labour force by age, and by the Medisave contributions according to age, CPF members would have contributed S$14,407 million into the Medisave in 2016.
https://stats.mom.gov.sg/Pages/Labour-Force-In-Singapore-2018.aspx

The actual amount that CPF members pay into Medisave would be somewhere in between, between $7,751 million and S$14,407 million. As the PAP government has chosen not to be transparent about the figures, this is the best estimate we are able to get.

In 2016, CPF members were able to withdrew only S$931 million from their Medisave for direct medical expenses.
https://www.moh.gov.sg/resources-statistics/singapore-health-facts/government-health-expenditure-and-healthcare-financing

Accordingly, this would mean CPF members only withdrew between 6.6% and 12.0% of what they paid into Medisave in 2016 for direct medical expenses (using S41,407 million and S$7,751, respectively, for comparison).

For the purposes of the video – for ease of comparison, the figures are rounded up to show that CPF members are using only 5% to 10% of what they paid into Medisave every year for actual direct medical expenses.

In 2016, the PAP government also reports government health expenditure of S$9,293.3 million in 2016, or what the government uses Singapore taxpayers’ taxes to pay for healthcare.
https://www.moh.gov.sg/resources-statistics/singapore-health-facts/government-health-expenditure-and-healthcare-financing

This would mean that what CPF members pay into Medisave in 2016 (between $7,751 million and S$14,407 million) would be enough to cover for the government health expenditure.

Or in other words, what CPF members are paying in Medisave can cover for the whole amount the government uses our taxes to pay for healthcare.

The first question then is, why is the government making Singaporeans pay for taxes, and then for Medisave, when Singaporeans are already paying enough for either to pay for this portion of healthcare – noting that in Medisave, we are even only being returned 5% to 10% of what we pay in a year, for actual direct medical expenses?

Is the Singapore government then making Singaporeans double pay for healthcare?

Based on the World Health Organization’s statistics, about 50% of Singapore’s total health expenditure is covered by the government using taxes paid via Singapore’s taxpayers monies.
http://apps.who.int/nha/database/country_profile/Index/en

Based on an IPS study, about 5% of the total health expenditure in Singapore is covered by Medisave.

In other words, CPF members are only able to access only 5% to 10% of what they pay into Medisave for direct medical expenses, and this only covers for 5% of total health expenditure.

The IPS study also showed that MediShield (another healthcare scheme) only covers for 2.1% of total health expenditure.

World Health Organization figures also show that Singaporeans pay another 30% out of their own pockets for the total healthcare expenditure.

30% is 6 times the 5% that Medisave covers for.

This means that if the Medisave actually used to pay for direct medical expenses, is increased by another 6 times to pay for the current out-of-pocket expenditure that Singaporeans are paying, it would be able to give free healthcare for Singaporeans today.

Even by increasing it by 6 times, we would still be using only about 40% to 80% of Medisave for medical expenses (using S41,407 million and S$7,751, respectively, for comparison), and be able to still save enough inside the Medisave to allow it to accumulate, for longevity purposes.

However, instead, the Singapore PAP government chooses to let Singaporeans only access 5% to 10% of the Medisave they contribute in a year for direct medical expenses, and then make Singaporeans pay another 30% for out-of-pocket expenditure.

In effect, the Singapore PAP government is making Singaporeans double pay for healthcare.

Back to the Medisave, by 2016, CPF members have accumulated a total of S$82,944.1 million in the Medisave, since it was started in 1984.
https://www.cpf.gov.sg/Assets/common/PublishingImages/CPFStatistics/Sub_Balances.jpg

This means that of the S$931 million that CPF members are able to retrieve for direct medical expenses, this is only 1.1% of the total Medisave balance that has been accumulated since 1984.

In sum, for the Medisave, CPF members are only able to use 5% to 10% what they pay into Medisave a year for direct medical expenses, and only 1% of the total Medisave balance, for medical direct expenses.

But what the Medisave balance has accumulated as of 2016 would be about 4 to 5 times the total health expenditure in Singapore in 2016.

In other words, the total Medisave balance would be sufficient to give free healthcare to Singaporeans for 4 to 5 years, or more.

Or, if excluding for the taxes Singaporeans already pay for healthcare, the total Medisave balance would have been sufficient to give Singaporeans free healthcare for 8 to 10 years, or more. (this is not mentioned in the video)

Other than the direct medical expenses, CPF members’ Medisave is also withdrawn to pay for MediShield Life premiums (S$999.3 million) and another S$1,064 million is also withdrawn for premiums for other schemes, such as ElderShield (S$1,995.4 million – S$934 million), or a total of S$2,063.7 million that is withdrawn to pay for MediShield Life and ElderShield premiums, etc.
https://www.cpf.gov.sg/Assets/common/PublishingImages/CPFStatistics/Sub_Healthcare.jpg

This amount is more than 2 times what Singaporeans get to use for actual direct medical expenses.

According to the government, it is subsidizing 44% of the MediShield Life premiums, but after these subsidies are removed, the premiums paid could go up to S$4 billion, or 4 times what CPF members are able to receive for actual direct medical expenses.
https://www.moh.gov.sg/medishield-life/what-is-medishield-life/about-the-medishield-life-fund

But the question is – if Medisave is already enough to cover for Singapore’s health expenditure, if risk-pooled, then why are Singaporeans made to pay for additional schemes, where the premiums could be 4 times more than what CPF members are actually able to get back in terms of actual medical expenses?

If the money paid into premiums are directly used to cover for direct medical expenses, it would reduce Singapore’s out-of-pocket expenses drastically.

Instead, since CPF members are able to only access 1% to 10% of their Medisave for direct medical expenses, the PAP government gets to take 90% to 99% of the Medisave to earn, by channelling the Medisave surplus into government bonds, and then into the national reserves, and into GIC, of which Temasek Holdings has access to this money, to let them earn, which has helped them become the top 10 richest sovereign wealth funds in the world.
https://www.swfinstitute.org/fund-rankings/sovereign-wealth-fund

Meanwhile, Singaporeans are left with having to pay for one of the most expensive out-of-pocket healthcare expenditure in the world. (this is not mentioned in the video).
http://apps.who.int/nha/database/Home/Index/en/

On top of it, there is very little transparency in how the GIC and Temasek are using Singaporeans’ Medisave to earn, and what they are investing it in, or how much they are earning using Singaporeans’ monies.

Finally, Singapore residents are also paying an additional of $1.42 billion for private insurance Integrated Shield Plans.

In summary:
(1) Singaporeans are paying enough into Medisave which would allow Singaporeans to have free healthcare every year.
(2) Instead, the PAP government makes Singaporeans pay another 30% for out-of-pocket healthcare expenditure.
(3) The PAP government then makes Singaporeans another 2 to 4 times more what is taken out of Medisave for direct medical expenses, for other healthcare schemes like MediShield Life and ElderShield premiums, etc, when there is no need for other healthcare schemes, because what is paid into Medisave is already enough to let Singaporeans have free healthcare, if risk-pooled. And after paying for these premiums, MediShield still covers for only 2% of Singapore’s total health expenditure.
(4) As a result, Singaporeans have to also pay additional in private healthcare insurance, because their Medisave is not returned to them.

In sum, Singaporeans are double-paying into healthcare every year, and the PAP government knows this.

Singaporeans today can have free healthcare if their Medisave is returned to them. Instead, the PAP government has chosen to take 90% to 99% of Singaporeans’ Medisave to earn, and to let the GIC and Temasek Holdings become the top 10 richest sovereign wealth funds in the world, while Singaporeans have to pay one of the most expensive out-of-pocket healthcare expenditure in the world.

The question you have to ask is – is this fair?

As Lee Hsien Yang asked, “is this the kind of government that you want”, that turns you into their guinea pigs, for them to slice you up and to earn from you?

That turns you into their money trees, while you become poorer and poorer?

It’s Not The End of SINGAPORE 🇸🇬.

Ministers of Singapore, STOP comparing with others.
Before attempting to compare look at the mirror and ask yourselves are the salaries of your HK and Japan counterparts the same with yours?
Are your People getting the same salaries of People of HK and Japan?

STOP 🛑 such comparisons immediately.
Learn to speak with poise.
Remember All the day when another colleague sarcastically asked whether our needy and poor want meals to be served in restaurants, food courts or hawker centres.
It reverberate to this day.
Wasn’t this what an arrogant Queen Antoinette did (no bread 🥖 buy cakes 🍰) in France before the Bastille was stormed and she and her husband were taken as prisoners and heard of No More?

Ruling a Nation is a serious business.
It’s not a game of blaming and comparing.
You ALL have AGREED to a handsome salary and great perks. Be reasonable to the taxpayers and fully-aware that there are better, more able and dedicated citizens willing to do your jobs at a much lower pay.
Leaders must not only be competent to lead Ministries under them but must also ensure that they and their Heads of Departments (HODs) are really working: NOT Hardly-Working.
Remember the TWO golden words – Accountability and Transparency.
You may check the meaning on Google!

Start to rectify whatever needs immediate attention.
Reveal the TRUE situation, however grim it may be.
Attend Parliament sessions without fail.
Be humble and ask if in doubt.
Stop 🛑 Un-necessary wastage of Public Funds.

Many capable Singaporeans are ready to come forward to take over.
I have spoken to many and daresay that they have better ideas and plans to jumpstart the systems.
Nothing is impossible.
Stop ✋ 🛑 criticising the Opposition and admit that they are far better then many of you sitting (or sleeping) in Parliament.

It’s Not The End of SINGAPORE 🇸🇬.

Sukhdev Singh Gill

I CAN’T AGREE MORE!

What happens when politics becomes a stepping stone to riches?*

Published on 2018-07-13 by The Online Citizen by Augustine Low

Singapore stands alone on the global stage as a country which rewards its politicians and top civil servants so handsomely that it becomes a stepping stone to riches.

If money could buy passion and commitment and proficiency, wouldn’t every country on earth follow the Singapore model?
The hard truth is that money alone cannot be a substitute for that genuine call to service and to do greater good for the country, which comes naturally only to some.

One of Switzerland’s top civil servants, the Attorney-General leading investigations into 1MDB, is an example of someone who eschews greed for that higher calling. Mr Michael Lauber, who met Malaysia’s new Attorney-General, Tommy Thomas recently, said he was impressed: “What we need is good governance, the right people who can resist greed. When I met my counterpart, I saw his will – he is also very down to earth, it’s a very, very good start.”

After seven years on the job, the Swiss Attorney-General said he was still full of energy, and has modest means and aspirations: “I have a small apartment in Zurich where I live, I have no car, no bicycle, not even a boat. All I have is what you see on me, that’s it.”

He is a man with a passion and a purpose, and motivated for selfless reasons.

The danger of turning politics from a calling into a multi-million dollar profession (like what has happened in Singapore) is that we could end up attracting people without the passion to serve.

Do you get the sense that the cries of Singaporeans are increasingly not being heard?
For instance, no matter what the people say about the proposed GST hike, it looks like it’s going ahead for sure. So much for the pledge to listen with humility and respect. They have already reiterated time and again the need for a hike, brushing aside all arguments against it.

Even the most facetious reasons are being given, like the fact that the GST hike needs to be supported so that “our elderly population can be well taken care of.”

That call, by the way, came from the wife of the Prime Minister, whose own salary at Temasek is kept tightly under wraps. Do you get the sense that they are in an ivory tower, with no inkling of the real needs and struggles of the people?

When Minister Chan Chun Sing starts giving his usual motherhood spin this week in Parliament about cost of living being a “multi-dimensional issue,” and amounting to a gap between people’s aspirations and their ability to fulfil them, you know that either he just doesn’t get it or he tries to turn something simple into something incomprehensible.

The bottom line is, something is just not right when politics is no more seen as a calling but as just an extravagantly paid profession. The most pitiful part is that in our country, we just do not know anymore whether the men and women are doing it for the right reasons.

Former head of the Civil Service, Mr Ngiam Tong Dow said in an interview, In the early days, Lim Kim San and Goh Keng Swee worked night and day, and they were truly dedicated. I don’t know whether Lee Kuan Yew will agree but it started going downhill when we started to raise ministers’ salaries, not even pegging them to the national salary but aligning them with the top ten.
When you raise ministers’ salaries to the point that they’re earning millions of dollar, every minister – no matter how much he wants to turn up and tell Hsien Loong off or whatever – will hesitate when he thinks of his million-dollar salary. Even if he wants to do it, his wife will stop him.

Lim Kim San used to tell me, “Ngiam, if you want to leave your job, make sure you have enough walkaway money.”
When the salary is so high, which minister dares to leave, unless they decide to become the opposition party? As a result, the entire political arena has become a civil service, and I don’t see anyone speaking up anymore

A member of the public, Paul Chan Poh Hoi, wrote to ST Forum on Thu (18 Jul) arguing that profitability should not be main concern for the rail operators in Singapore.

Given the “public” nature of public transport, a rail system should be measured by its ability to serve the people, and not its ability to generate additional wealth for the operators of state-owned assets, Mr Chan said.

“It is the fiduciary duty of public transport operators to plan for adequate preventive maintenance and remedial work, failing which costs are covered by the public purse, as with recent projects and rolling stock procurement,” he added.

Mr Chan also noted that in 2016, the Hong Kong MTR achieved a high score of 124 per cent and Tokyo Metro 119 per cent, while SMRT only achieved 101 per cent (2017). Obviously, the Hong Kong MTR and Tokyo Metro operate their rail system much better than Singapore does.

In any case, Mr Chan wants the rail operators not to raise fares, “It would be unwise to raise fares until the economic situation recovers. If rail operators cannot get by without a few dollars more, neither can commuters.”

The Transport Ministry quickly responded to Mr Chan’s letter today (20 Jul) “assuring” that profitability of rail operations is, indeed, not the main concern.

Senior Director of Corporate Communications at the Ministry of Transport, Christine Yap, said, “We agree with Mr Paul Chan Poh Hoi that profitability should not be the main concern for rail operators. Their primary objective is to provide a safe and reliable MRT service.”

“But if they keep incurring losses because revenue does not fully cover operating cost, they will not be able to deliver safe and reliable services,” she added with a qualification.

With regard to Mr Chan’s view that Hong Kong and Tokyo metros as possible financing models for Singapore, Senior Director Christine Yap said, “They are indeed good operators with healthy bottom lines and they run their trains well. They also charge fares which are significantly higher than in Singapore.”

According to a recent OCBC’s Financial Wellness Index survey, the majority of working adults in Singapore are financially unprepared for retirement (‘Most working adults not financially ready for retirement‘, 16 Jul).

The survey polled 2,000 working adults in Singapore between the ages of 21 to 65, asking about the state of their financial health.

In particular, half of those among the sandwiched generation – people who are supporting both ageing parents and their own children at the same time – struggle to cope, with significantly greater worries about their financial status.

The study also found that Singaporeans save an average of 26 per cent of their salary, with 82 per cent who proactively have insurance coverage. About a third do not invest and think of investing as a form of gambling, while almost half have no passive income. Passive income refers to income from rental, dividends, interest income, royalties, payout from annuities and so on.

Most are not well-prepared for retirement, the study said. Almost three-quarters are not on track with their retirement plans. Some 65 per cent said they are not accumulating enough funds to maintain their lifestyle after retirement.

In particular, the sandwiched generation was found to have more financial worries compared to the rest, with half of them finding it tough to support both their parents and children at the same time. Out of the half who find it difficult, some 63 per cent are concerned that they are not able to spend comfortably beyond the basics.

Interestingly, respondents’ ideal retirement age went up with age. Among those in the 20s age group, the average age that they want to retire is 56. In contrast, people who are 55 and older wish to retire at 67.

The government is looking to increase the age of retirement and re-employment age which is currently at 62 and 67 respectively in light of the increasing average life expectancy of the Singapore population.

Actually, everything she says here can be easily dispelled when you look at the developments in other high-income democracies.

What the PAP doesn’t tell you and what they have failed in their thinking to see, is that, when there is greater equality, and when everyone are given the same resources to excel, society as a whole is uplifted and becomes richer for it. They will be shared prosperity – as a Norwegian friend told me, everyone in Norway is rich, because the wealth is shared.

Meanwhile, Singapore still uses this cutthroat model where if I don’t get ahead, you will steal my lunch, so I need to cannibalize you so I can get ahead – all these Singapore’s prime minister wrongly advocates.

No, when there is greater equality, I will support you to get ahead, you will support me to get ahead, and when we put our heads together, we can develop even better solutions, create more developments and benefit from them – together.

Fact is, Singapore is earning enough for everyone to become rich, but it is this failed thinking by the PAP elites where the wealth needs to accrue to the top that has enabled them to get richer and richer, all these at the expense of taking away from the lower- and middle-income who have to contend with stagnant wages.

This is wrong. When you change your mindset and realize that if I don’t take away everything from the people, and when I share, not only when everyone get richer, because they prosper, the economy prosper, I can get even richer precisely because we keep pushing ahead together.

But today, in their fear of losing what they have, the PAP believes in rewarding themselves more, believing that only they have the best brains to keep things moving.

Well, it’s no longer working, so the question is, when are we all going to wake up and realize that we need a model of shared wealth and prosperity, so that the country can truly move forward, so that we can have a country we can truly be proud of, because we made it happen.

You need to make it happen.

https://www.channelnewsasia.com/news/singapore/singapore-social-service-inequality-indranee-rajah-nus-11731180

I was in Hong Kong and was interviewed by a journalist from an Asian Finance magazine, about Hyflux. Here is a summary of some of the points I talked about: – Leong Sze Hian, past president of the Society of Financial Service Professionals commented – Hyflux would have done the cashflow projections when the $500 million perpetual securities were offered to the public in May 2016, and these would have been given to the issuers. What does the issuer’s internal analyst report say? In this connection – “Issuers and their advisers must bear full responsibility for ensuring adequate and accurate disclosures, and will be subject to civil and criminal liabilities for false or misleading statements in or omissions from a prospectus. ” – SECURITIES AND FUTURES ACT (CHAPTER 289) FREQUENTLY ASKED QUESTIONS”.

Its profits had collapsed from less than $10 million in 2016 to a loss of $116 million in 2017. and $1.1 billion for the first three quarters of 2018.

According to DrWealth – “Negative Free Cash Flow destroying Hyflux’s financial strength since 2013.Hyflux paying 1 time its net income in 2013. 1.4 times its net income in 2014. And a staggering 4.9 times its net income in 2015. This precipitated the crash.”

The auditors signed off on the 2017 annual report on 22 March 2018, and about two months later – Hyflux announced the suspension of the trading of its shares and securities.

Over the last eight years, the earnings per share showed a steady downward trend after 2012, before turning negative in 2016. Even in 2016 when Hyflux reported record revenues, profits were rather modest — in fact, they exhibited a decline over the years prior to 2016 (source: Channel NewsAsia, Mar 8, 2019).

According to professor Loh of NUS – their Risk Management Committee only met once in the year of 2017, which in my view is arguably, quite unacceptable given the size of its debt and gearing.

This is the biggest financial loss (about 50,000 investors lost an estimated $1.4 billion). We must get to the bottom of “why and how it happened” – so that it will never happen again.

Where was the media all these years? Is it any wonder why our Press Freedom Ranking is at 151st?

As to “But the plant has had operational issues since early 2017, and Hyflux lacked the funds to resolve these issues. It has been unable to replace poor-performing membranes in its ultra-filtration and reverse osmosis systems promptly, which affected the quantity and quality of the water produced. It has also failed to supply PUB with 70 mgd of desalinated water on numerous occasions.

Mr Koh, speaking to reporters on Tuesday morning, said: “Membranes replacement is necessary to ensure that plant capacity remains at designed capacity… Certain membranes need to be cleaned regularly. If not maintained, their performance will deteriorate faster… The default was that the concession company was unable to deliver the required capacity when needed.” He declined to give details of the production shortfall” (source: Straits Times, May 21) – were the various parties involved aware of this eventuality when the perpetual securities were offered in 2016?