Singapore not giving free treatment to anti-vaxxers

[Whose]

stops paying for Covid treatment for people who are unvaccinated by choice | The Independent" www.independent.co.uk/asia/southeast-asia/singapore-free-covid-treatment-unvaccinated-b1954077.html?amp

AIBU to think this fair enough?

Currently, unvaccinated persons make up a sizeable majority of those who require intensive inpatient care, and disproportionately contribute to the strain on our healthcare resources,

(Those who haven't had the vaccine because they medically can't are excluded from this)

@WindyWindsor

No it's not fair enough. I've had my vaccinations but if we were to do this then we also should start making other people who make unhealthy choices pay for their healthcare too like smokers or obese people. I'm sure a lot of people have opinions on that and rightly so.

Medical care isn't selective and shouldn't be.

Fgs, they do make other people pay their healthcare, including dirty smokers and fatties. Singapore don't have a 'free' healthcare system. They are now offering (or planning to offer) free covid-related healthcare for those who have been vaccinated.

As, in this thread you've not read, they offer free healthcare to a generation of people born within certain years. There may be other schemes or grants that cover other groups of people.

But in general terms, the health system there is funded through insurance and self-funded savings. No-one is being withheld care because they aren't vaccinated

@Nanny0gg It was ranked as most efficient healthcare system in 1 ranking as it accounts for a much smaller percentage of GDP on it. It was 4.5% of GDP in 2018 (accounting for both government and private spending). Compare that to uk which is 10.43% of GDP.

Singapore public hospitals have an incentive to keep costs as low as possible as they have to publish their price lists for various treatments. Singaporeans can hence 'shop around' the various hospitals, easy to do that when you are a tiny island.

But in Singapore, you don't have the same peace of mind as in the UK. In the UK, you can feel comforted in the fact that assuming that the NHS is not overwhelmed at that particular point in time you contract the worse illness in the world requiring the most expensive medications and the most intensive treatments, it is 100% free. Even if you have never worked a day in your life. In Singapore, if you contract such an illness, I would not dare to say that the subsidies, basic health insurance plan and your health savings accounts would cover you to the extent you don't need to cough up some cash. In fact I can almost guarantee that you would need additional money. Singaporeans do pay less tax than Brits and also have subsidized housing so most people do know this and prepare for this eventuality including buying supplemental insurance. They also pick the class of ward that they can afford. Members of my family has always gone for C class ward even though they could afford a better class, cos we want to be conservative, we know that the medical bills can certainly pile up so its good to save money this way as there is the same quality of medical treatment across all wards.

Basically unlike the UK where the welfare system mainly benefits the poor, disabled and chronically ill, the welfare system in Singapore mainly benefit the middle income working families. Families with some healthcare needs but where any benefit of it being 100% free is offset by the higher taxes/opportunity cost of not being able to spend on any other initiatives. Middle income families benefit much more from subsidized home ownership than completely free healthcare; the Singapore government builds 3 bedroom flats and sells them at a subsidized rate to citizens, resulting in 92% home ownership rate. On the other hand, the flat I bought in London zone 3 cost £100k more than the starter government flat my cousin bought with her fiancee in Singapore and I am not sure whether I would ever pay the equivalent £100k in medical costs if the NHS was not free. The UK system and the Singapore system are very different; there is no right or wrong, it is what you prioritize as a society.

@DumplingsAndStew sadly though, the people born before 1949 do not get free healthcare. They get top ups on their health savings account and subsidies and paid for premiums. My grandma was born in 1934 and my dad had to pay out £5k or SGD 10k for her medical treatment(stroke) even though she was insured. Of course she did live in private housing so qualified for less subsidy. It is quite unfair for those old people who live in private housing as many of them live with their kids or bought their houses when they were much cheaper but it isn't such a huge issue because 85% of singaporeans live in government housing.

So yes hopefully not many of the unvaccinated are penniless oldies living in private houses they bought in 1969 (when singapore was a third world country) and without children to support them.Even if they get government subsidies and help, ICU treatment is very expensive.

www.straitstimes.com/singapore/health/covid-19-icu-patients-who-choose-to-be-unvaccinated-could-face-median-bill-of-25000
Covid-19 patients who are unvaccinated by choice and end up in the intensive care unit (ICU) could be looking at a bill of around $25,000 before subsidies.

With subsidies and insurance, the amount payable is significantly lower, the Ministry of Health (MOH) told The Straits Times.

The $25,000 is the median acute hospital bill size for those who require both ICU care and Covid-19 therapeutics, MOH said. “Means-tested government subsidies and MediShield Life coverage can reduce the bill to about $2,000 to $4,000 for eligible Singaporeans in subsidised wards.”

Covid-19 patients can use their MediSave balance to help fund this remaining amount, said an MOH spokesman.

Depending on the severity of the patient’s condition and the type of Covid-19 facility where care is rendered, the bill size would vary, said the spokesman.

The authorities announced recently that from Dec 8, those who are unvaccinated will have to foot their own medical bill if they become ill with Covid-19.

These are the people who can get vaccinated but choose not to do so. They form a big group of the Covid-19 patients who end up in the ICU.

If these people are sent to a Covid-19 treatment facility, the bill there is expected to be around $4,500 for a seven-day stay, the MOH spokesman said.

“For Singapore citizens, after subsidies and MediShield Life where applicable, the co-payment is around $1,000.”

Those who are partially vaccinated will not be charged until Dec 31 to allow them time to be fully vaccinated.

There are also community isolation facilities (CIFs) here. Currently, travellers and short-term visit pass holders are charged for CIF stays.

“At the moment, unvaccinated persons who are Singapore citizens, permanent residents and long-term pass holders and have not travelled in the last 14 days are not charged for CIF stays, should a CIF stay be required,” the spokesman said.

As expected, the bill would be in the thousands at least- GBP1000-2000 which can also be claimed from the mandatory savings account assuming there was enough in it.

@Lockheart

No, sorry. I don't agree with anti-vaxxers in any way but nor do I believe healthcare should be withheld because we disagree with others moral choices. Doesn't matter if it's vaccinations, organ donations, blood donations, what charities you donate to or what companies you work for. Accessible healthcare is either a basic right or it is not. I would hope we all agree it is.

Well yes, but your last sentence about how it should be accessible to all - unvaccinated people are putting an unnecessary strain on the system in countries where it is free - therefore causing healthcare to be unavailable or delayed for people that are vaccinated but, for example, having a heart attack.

in countries where it is free

It's not free. It's free at the point of use but it's paid for through taxation, and taxation doesn't discriminate on the basis of vaccine status.

Well done, good for them.

For anyone who thinks Singapore is being extreme by refusing to pay for medical treatment for anti vaxxers ( in a country where medical care is not free in the first place), I give you Austria.

www.theguardian.com/world/2021/nov/12/austria-province-to-place-millions-of-unvaccinated-people-in-covid-lockdown

Austria is to introduce a lockdown for unvaccinated people in two of Europe’s worst-hit coronavirus regions from Monday and could extend it across the country, the chancellor, Alexander Schallenberg, has said.

Millions of people not fully vaccinated against Covid in the regions of Upper Austria and Salzburg will be allowed to leave their homes only for reasons considered essential to life, such as going to work, grocery shopping or visiting the doctor, Schallenberg said – measures believed to be unprecedented in Europe.

I think the death penalty, lashes on the table for some crimes and gay sex illegal are extreme but well maybe I'm old fashioned.

@CheeseMmmm ummm there are plenty of gay people in Singapore who have sex lives and they don't get arrested.

The caning and death penalty- I am against it as well but most Singaporeans do think its a deterrent against crime. I mean, in london I feel like I can't even trust the police after what happened to Sarah everard but in Singapore, women feel so comfortable that women can go out any time at night, I used to take shortcuts through parks that were so dark I couldn't even see my fingertips when I was 16 and my parents never worried, I even know women in singapore who used to leave their Louis Vuitton wallets lying around while they bought food cos they were so trusting that no one would steal it. And when I was in school, no one was on drugs (indeed singapore has one of the lowest drug consumption rates in the world).

I am not saying Singapore is perfect but there is a reason why many well travelled Singaporeans who have lived abroad (I lived in 2 European countries including UK) aren't opposed to such laws. It is not because we don't believe in freedom and proportionality of law. It's because we know of the flipside of freedom, having experienced it in the UK/USA and we think that our sheltered compatriots back home are happy as they are. Equally, I wouldn't want UK to be like Singapore either; it wouldn't work here.

Yes I've been there it's lovely.

Fact is that the law is on the books though which is not fab.

My point is and has been all through thread that it's a totally different country. Enormously different. So while interesting to discuss, the comments are surely mainly not based in the broad context of that society.

But there seems to be little acknowledgement of that.

Agree with your point 2 though!

I also wouldn't want UK to be like Singapore (not that it ever could be really!).

@CheeseMmmm the Tories are huge admirers of some Singaporean policies though! Lifetime ISA is a poor copycat version of the CPF - long term savings for a property and retirement that is topped up by government and can't be withdrawn for other purposes. They admire Singapore low tax rates. Free ports- that's basically what Singapore has too. Sajid Javid has said before that his time in Singapore has made him think that in UK we should be more responsible for our elderly like in Singapore (he means the plebs should quit their jobs to look after elderly?). The Tories were talking about giving money to the overweight to reward them for losing weight as a response to the obesity crisis- I think Singapore had a similar policy, we were also giving money to men who passed their yearly physical fitness test during reservist training. Singapore was giving out free credits for exercise at one point, my parents got free gym memberships, can quite imagine the Tories thinking this is a good idea.

I mean for this specific policy of making the unvaccinated pay for their healthcare, a few Australian politicians think this is a great idea The way the NHS is set up means that it would be tricky to charge people for any kind of healthcare and the NHS is a bit of a sacred cow here. But it doesn't mean that the Tories wouldn't try to implement any Singaporean - lite authoritarian measures if they thought it would save them money/be more practical/gain popular support from the authoritarian minded.

Well they might want to be like Singapore but that's not at all realistic is it.

We have totally different.. everything. It's a totally different society economy population size I mean just so much. It's just not realistic to say well why don't we just do same as. Sweden, Singapore, new Zealand etc etc.

@KylieKoKo

Do you think it's fair to not give free treatment to other people who have taken risks? Perhaps those who chose to play a dangerous sport? Or a child who chooses to climb a high tree? What about someone who steps out into the road with our looking? Or perhaps someone who doesn't eat fruit and vegetables?

All these things are choices that carry a risk. Why is not having a vaccination different?

The choices you reference don't spread a deadly respiratory disease.

No but I explained how they harmed others a few posts ago.

@onlychildhamster - I think the term circuit-breaker got ported over to U.K. (but not really implemented in the same way). They also had the congestion charge and Oyster card ages ago (though probably not unique to Singapore - I’m sure Hong Kong and other places had similar)

Maybe their Housing Development Board idea would be nice in U.K. - a National body to build affordable housing stock for the population. But probably unpopular with lots of Tory donors.

@CheeseMmmm - I think also society has changed a lot over a short space of time even in U.K. People talk about coronavirus restrictions - but in WW2 curfew rules sounded like they were more restrictive. U.K. still has some public health rules about isolation/treatment of active TB. And I’m pretty sure that if coronavirus was more like ebola, there would be more support for restrictive rules. I guess as a society we adapt to the problems we’re facing and there is a tension between the needs of different groups etc.

Why does ww2 come up so much? Just an observation.

We don't have more restrictive rules for measles and there have been outbreaks, increasingly so.

I don't think as a society the plan to refuse NHS treatment to non jabbed for certain things would fly tbh.

There's the slippery slope thing as well...

@Namenic the housing development board was a British thing- it was started by the British colonial government when they were in power as rental housing for the residents of former slums. After independence it was expanded. The ruling party in Singapore were originally Fabian socialists, our first prime minister campaigned for labour when he was studying in Cambridge and the people action party's constitution was based on the Labour party constitution. Of course rental housing for the masses was sold off in order to encourage mass home ownership and then in the 2000s, the ruling party turned pretty neoliberal and the focus became asset enhancement- persuading the masses that their humble government flat could be financial assets that would grow in value. But despite all this, the home ownership rate in Singapore is still 92% even if house prices have grown; the cheaper 3 bedroom flats in suburban locations are still affordable for young couples at the equivalent of £150k-200k but the most expensive government flats in the best locations can be £500k or a million SGD (this is still affordable compared to the luxury condos on the private market which can be in the millions so there is still a segment of the population who earn too much for the basic flats but too little to afford the luxury condos).

I think HDB would be a nice idea if (a) the government owned lots of land and (b) we could get middle class professionals to move into government housing. That is the key to HDB, people of all backgrounds buy HDB flats (lawyers and doctors live next to taxi drivers and shopkeepers) and hence there is no stigma unlike UK council housing. It could be workable in London zone 1-3 but not really in other parts of the UK.

Isn't it mainly pretty small flats? That is what I've been told but obv never lived there.

I also thought it was v expensive.

Interested as you obv know way better I'm guessing than most/ all other posters!

I’m not saying U.K. should not treat non vaxed people. Just that things should be should be proportionate to the danger - and there is lots of scope for different opinions. If coronavirus had a mortality of 50% of those infected, then people would tolerate stricter restrictions. People have tolerated stricter restrictions with regard to drugs, smoking and alcohol/speed limits.

WW2 comes up because people make a big deal of it each year in U.K. and respect the sacrifice that came with it. People tolerated restrictions because they believed it was for the greater good.

@CheeseMmmm I don't recall measles overwhelming the health service. Causing lots of absences for essential workers that the country cant function properly. Causing in excess of 100k deaths. A leading scientists has claimed that covid could very well hamper the next 5 Christmases in the UK. Doubtless it would be the same in Singapore too (as they have an even smaller appetite/acceptance of deaths/overwhelmed health service). You can see why governments all over the world will try in their own way to place punitive measures on the unvaxxed to encourage them to get vaxxed (or to use a Singaporean expression 'to wake up their idea'). As posted above, Salzburg and upper Austria is imposing lockdown on its unvaccinated. You are right, the UK probably wouldn't charge the unvaccinated for their healthcare bills but I would be shocked if they didn't attempt to impose more measures that would make it more difficult for an unvaccinated person to live a normal life in the UK

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@CheeseMmmm it is 1000 square feet to 1300 square feet 3 bedroom flats mainly. Yes it is smaller because land is expensive in the UK. Well the condos and the flats in the more central locations are expensive, the suburban flats that a Singaporean citizen couple can buy with their housing grant subsidy less so. I think it is affordable mainly because I am in London (and to be fair as Singapore is a major financial centre it should be compared to London, not Norfolk or Middlesbrough) and my own 2 bed flat in London zone 3 cost £400k in 2019. Most of my cousins in Singapore spent much less and the cousin who spent as much as me got a government condo with a pool, tennis court, spa and karaoke room! I only have a communal garden. But unlike my cousins, I can sell or rent out my flat to whoever I please including to a landlord, my cousins are not allowed to treat their homes like investment objects.