TR EMERITUS

A Washington-based non-profit organization, Fund For Peace (FFP), has ranked Singapore as one of the top 10 most worsened countries by score in its Failed States Index between 2013 and 2014 [Link]. Founded in 1957, FFP "works to prevent violent conflict and promote sustainable security". It works towards sustainable security and development in failed states by focusing on conflict assessment and early warning, transnational threats, peacekeeping, and security and human rights. FFP publishes the annual Failed States Index (FSI), used by researchers, educators, and governments across the world. FSI assesses the pressures experienced by nations based on social, economic and political indicators such as demographic pressures, refugee flows, uneven economic development or severe economic decline, political impasse and human rights, among others. The index is based on 12 social, economic and political indicators. In terms of ranking, South Sudan is ranked 1st with its fractious leadership, mass killings and ethnic violence. It is ranked as the world's most fragile nations, said FFP. Somalia's fall to 2nd place is due to its "trajectory of improvement," despite lawlessness, terrorism and ineffective government, the group said. Other countries in the top 10 are the Central African Republic, Democratic Republic of Congo, Sudan, Chad, Afghanistan, Yemen, Haiti and Pakistan. Singapore is ranked 158th from a list of 178 countries [Link], far from the top. However, it is in the top 10 list of worsening countries. Among the top 10 countries that have worsened the most over the past year are France, US, Thailand and Singapore. FFP said, "But this year’s Index demonstrates that even developed countries are not immune to significant pressures. France was the 7th-most worsened country in 2014, largely as a result of a political and economic malaise, with a similar situation befalling the United States, which was tied at equal 8th most-worsened along with Singapore." "The FSI continues to demonstrate some key lessons about development and stability. Countries like South Sudan, the Central African Republic, and Syria demonstrate how all-consuming and damaging conflict is. Countries such as Libya and Tunisia further demonstrate that just when we think that conflict is over, it can for a long-time remain an ever-present specter that can continually threaten to re-emerge. The recent worsening of the United States, France, and Singapore also shows us that instability is not exclusive to developing countries," it added. Overall, Singapore's trend has been worsening since 2006: The chart above demonstrates the long-term trend, year-to-year, for Singapore. Upward movements represent worsening trends, while downward movements represent improving trends. Two indicators stood out showing worsening trends - Human Flight and Uneven Economic Development: The chart above demonstrates the long-term trends, year-to-year, for the Social and Economic Indicators for Singapore. Upward movements represent worsening trends, while downward movements represent improving trends. Three indicators stood out showing worsening trends - Human Rights and Rule of Law, Security Apparatus and Public Services: The chart above demonstrates the long-term trends, year-to-year, for the Political and Military Indicators for Singapore. Upward movements represent worsening trends, while downward movements represent improving trends.  Read More →

At its core, universal health coverage (UHC) is about giving the individual and his family access to health care and preventing them from facing financial ruin that can come from unexpected illness and disability. At least that was what Prussian chancellor Otto von Bismarck, widely credited as the intellectual father of today's UHC programmes, had in mind when he introduced national compulsory coverage for workers. Profit was never the motive. Last year, Medishield premiums were quietly increased without much fanfare. Han Fook Kwang himself woke up to discover that his MediShield premium had jumped to $1,589, double what was deducted ($800) from his Medisave account previously. Before you could even contemplate bailing out of the scam, they introduced the compulsory Medishield Life to skim you off for perpetuity. For a while now, the spiel was about additional benefits, never about whether we need them or are prepared to pay for the extras. They can hide the numbers only for so long. Now the secret is out. As expected, leopards never change their spots. Medisave, one component    of the Central Provident Fund (CPF), is also supposed to be our money, but that never stopped the grubby greedy hands from  helping themselves to the loot. Discounting the placebo of the subsidies, valid only for a temporal grace period, the numbers are higher than present (already inflated) Medishield premiums. The only important table is the set of before and after numbers. Other than per capita household income, the determining factor for entitlement to a "discount" is the Annual Value (AV) of one's home. The retiree living in his old house with no source of income will still have to pay full rate. Ditto the sickly and handicapped, those in dire need of affordable medicare, will just have to downgrade to the void deck to qualify for a miserly handout. The key to the grand scheme of things is the MediShield Life Review Committee (MLRC)'s suggestion  to work with private insurers to review the "landscape and features" of Integrated Shield Plans (IPs). You bet these private insurers, working in cahoots with the compliant Government appointees, will be laughing all the way to the bank. And you thought it was all about providing affordable health care. Bobby Chin, the Chairman of the MediShield Life Review Committee has even suggested that those who default on their premiums for MediShield Life should be penalised: "If you don't pay, the government will look into certain enforcement." Speaking from the safety of several thousand miles away, the prime minister said, "You will have to pay somewhat more premiums but the premiums are affordable." Probably as affordable as those 35 year mortgages for a leasehold public housing unit. Tattler * The writer blogs at http://singaporedesk.blogspot.com  Read More →

A reader has forwarded his friend's letter to TRE, just to show how heartless our "privatized" hospitals have become. Alexandra Health Pte Ltd, which operates Khoo Teck Puat Hospital, has engaged debt collector Accolade Advisory Asia Pte Ltd to collect an outstanding balance of $621.20 from the reader's friend. According to its website [Link], Accolade Advisory Asia provides "total receivables management solutions to the risk manager". It said, "Companies and financial institutions have turned to us for debt management, debt recovery as well as the specialised/customised research capabilities required for effective receivables management." It also said that it has established "reliable and experienced associates around the world" to help recover overseas debts. Hence, if someone was to skip town, the company can engage their overseas associates to trace and find him. The letter ended by saying: "If we do not receive your payment within (7) days from the date of this letter, action will be taken to recover the debt without further reference to you." Privatization of our public hospitals To help make our hospitals more "efficient", the government has embarked on a "privatization" programme. The government set up a private company called, "MOH Holdings Pte Ltd" (MOHH) to oversee all the public health institutions in Singapore. MOHH is legally owned by [Link]: Chua Geok Wah – 1 share Minister for Finance – 672,866,308 shares (Chua Geok Wah is the Accountant-General of Singapore) According to its website information [Link], MOHH is the holding company of Singapore’s public healthcare assets. MOHH currently undertakes strategic initiatives for the Ministry of Health and the public healthcare institutions. These include: Common employment of junior doctors to ensure effective allocation and training of our medical manpower; Developing a national IT framework for Singapore’s public healthcare sector; Providing a system for joint recruitment of healthcare professionals for Singapore’s public healthcare institutions; Developing and operationalising a talent management and HR framework for the entire public healthcare spectrum; Optimising selected finance-related functions within the MOHH Group, such as central treasury; Providing corporate advisory and support to MOHH’s subsidiaries, and creating a corporate development system to support future organisational developments in the MOHH Group; and, Providing strategic and operational Board secretarial support for MOHH’s Group of entities. Our public hospitals within MOHH are divided into six broad clusters. They include: National University Health System (NUHS) National Healthcare Group (NHG) Singapore Health Services (SHS) Alexandra Health System (AHPL) Jurong Health Services (JHS) Eastern Health Alliance (EHA) Liak Teng Lit is the CEO of Alexandra Health Liak Teng Lit Alexandra Health was established on 1 April 2008, as a healthcare cluster in the north that currently manages the Khoo Teck Puat Hospital. As part of an integrated healthcare system to serve the community in the region, Alexandra Health will build and oversee the Yishun Community Hospital, Admiralty Medical Centre and an Integrated Healthcare Development @ Woodlands. This integrated healthcare network will be operational from end December 2015 to 2022. The Group Chief Executive Officer of Alexandra Health System is Mr Liak Teng Lit. He is also the Deputy Chairman of NEA. Last month, he scolded Singaporeans for their "poor upbringing" in response to some patrons who did not want to return trays at hawker centres ('NEA Dty Chairman scolds S’poreans for poor upbringing'), Mr Liak then said, “If you all eat properly and not eat until a mess, how will you dirty your hands (for returning trays)? It’s problem of upbringing. Everyone should depend on oneself (to return trays). Don’t depend on others. Everyone should really reflect on this.” Last year, in an interview with the Straits Times (ST) [Link], he also said of Singaporeans, “In hawker centres we eat like pigs, with food and tissue all over the tables. It’s a disgrace. We don’t eat like that at home." Mr Liak also frowns on subsidising healthcare. In an interview with ST on 20 July 2012 (‘Why the dung beetle is his hero ‘), it was reported: He (Liak) frowns upon how subsidies have inflated the demand for health care and led to shortages: ‘The truth is when we go for a buffet, almost all of us eat a little bit more than we normally do. If you subsidise something, at the margin, there will always be more demand.’ Subsidised wards are so cheap, some children may prefer their elderly parents to stay a day or two longer. But if every patient delays discharge by just half a day, Singapore will need to build another Singapore General Hospital that costs $2 billion, and about half a billion a year in subsidies, to run. The demand for subsidies is a ‘bottomless pit’, he warns. ‘If you’re going to subsidise my petrol, I won’t drive the Toyota Prius, I will drive the Lexus 460. ‘Follow the British National Health Service? That may mean that the Government has to increase the goods and services tax to, say, 20 per cent to cover the cost of these additional beds,’ he says, adding that Singapore’s 3M framework – Medisave, MediShield and Medifund – is sound. As diseases are increasingly diagnosed at the molecular level with more expensive drugs, costs will shoot through the roof. His fear for Singaporeans today is that they clamour for their rights but disown their responsibilities. ‘In cyberspace, there are howling monkeys who scream, shout and demoralise others. ‘My worry is that everybody is screaming about his rights as a citizen to get subsidies, but he doesn’t feel he has a responsibility to contribute or pay his taxes. They have the right to treatment but don’t have a responsibility to take care of their health,’ he says. In that interview, he also told the ST reporter that his hero is the dung beetle: He (Liak) says straight-faced that his hero is the dung beetle, which feeds on faeces. ‘They walk the ground, burrow underground, clean up the environment, recycle nutrients and improve soil aeration. Most of all, they solve problems others leave behind.’ The reader who wrote to TRE said, "I am very disappointed that KTPH SEND such a letter to my friend to chase for the outstanding payments." It's not known how and why our public health system has transformed itself into such commercialized one, even engaging debt collectors with international linkages and issuing letters of demand to its citizen patients. During the National Day Rally last year, PM Lee promised: "Besides housing, we will also give Singaporeans more assurance over life’s uncertainties, especially healthcare. Working adults feel the pressure taking care of growing children, also looking after elderly parents. People with chronic illnesses worry, worry about the cost of consultations, the cost of medicines, maybe a few cents a day but day after day, year after year. When you have high blood pressure, the doctor prescribes something to you. He says, please take this, please take this for the rest of your life and you have to take it seriously. Older people worry about the medical bills which they may face and worry about the burden which they may place on their children. So we will improve healthcare financing to give Singaporeans more peace of mind." Later, the MediShield Life Review Committee (MLRC) was formed to review Singapore's healthcare financing and on Friday (27 Jun), the Government announced that it has accepted all the recommendations by the Committee with regard to the new MediShield Life scheme ('Medishield Life: ‘Premiums will need to increase’'). MediShield Life will roll out in end-2015 next year. It remains to be seen if after the implementation of MediShield Life, Singaporeans will still be chased by debt collectors sent-in by our public hospitals, since PM Lee promised that the new improved healthcare financing will give Singaporeans "more peace of mind". What do you think?  Read More →