1 00:00:00,009 --> 00:00:02,240 Speaker 1: This is AC N A podcast. 2 00:00:05,639 --> 00:00:08,949 Speaker 1: Hello again, I'm Steven CIA and welcome to another episode 3 00:00:08,960 --> 00:00:12,369 Speaker 1: of Heart of The Matter Cancer. It's the one disease. 4 00:00:12,380 --> 00:00:15,470 Speaker 1: Many of us fear and numbers from the Singapore Cancer 5 00:00:15,479 --> 00:00:18,370 Speaker 1: Registry show that one out of four of us may 6 00:00:18,379 --> 00:00:21,520 Speaker 1: develop cancer in our lifetime. Now, that is a very 7 00:00:21,530 --> 00:00:24,930 Speaker 1: scary thought. The good news is that once treated, many 8 00:00:24,940 --> 00:00:27,750 Speaker 1: do recover. But at what financial cost 9 00:00:28,280 --> 00:00:30,440 Speaker 1: in a bid to help curb the cost of cancer, 10 00:00:30,489 --> 00:00:33,319 Speaker 1: the Singapore government recently announced a list of the most 11 00:00:33,330 --> 00:00:36,900 Speaker 1: cost effective cancer drugs which can be claimed using one's 12 00:00:36,909 --> 00:00:40,130 Speaker 1: basic health insurance policy. Medishield life. 13 00:00:40,470 --> 00:00:43,799 Speaker 1: Yet several politicians raised concerns that we are still paying 14 00:00:43,810 --> 00:00:48,129 Speaker 1: too much mostly to insure ourselves. So are we really 15 00:00:48,139 --> 00:00:51,689 Speaker 1: paying too much? Is our insurance coverage adequate for what 16 00:00:51,700 --> 00:00:54,720 Speaker 1: we pay? Should I be covering myself for all types 17 00:00:54,729 --> 00:00:57,689 Speaker 1: of cancer? And what happens if I don't have enough 18 00:00:57,700 --> 00:00:58,560 Speaker 1: insurance 19 00:01:00,009 --> 00:01:03,220 Speaker 1: with me to discuss this topic today are Associate Professor 20 00:01:03,229 --> 00:01:07,940 Speaker 1: Ravindran Kanazawa, a consultant at the National Cancer Center, also 21 00:01:07,949 --> 00:01:11,860 Speaker 1: chairperson of the Cancer Treatment Fund Committee at Singapore Cancer Society. 22 00:01:11,870 --> 00:01:14,400 Speaker 1: Great to be on the show, Stephen, I go She 23 00:01:14,410 --> 00:01:18,639 Speaker 1: is the Deputy CEO and Chief Advisory Officer of Providence, 24 00:01:18,650 --> 00:01:21,599 Speaker 1: a Wealth Advisory firm. Hello, everyone. And Gina Ho, a 25 00:01:21,610 --> 00:01:23,559 Speaker 1: 43 year old general manager, 26 00:01:23,641 --> 00:01:27,162 Speaker 1: mother of three teenagers. And last year she was diagnosed 27 00:01:27,171 --> 00:01:31,272 Speaker 1: with stage two thyroid cancer. Hi, everyone. Nice to meet 28 00:01:31,281 --> 00:01:34,972 Speaker 1: with everyone and discuss this topic together. Ok, everyone. Thanks 29 00:01:34,982 --> 00:01:36,920 Speaker 1: so much for joining us. Now, Gina, if I can 30 00:01:36,931 --> 00:01:39,791 Speaker 1: invite you to start with your story, because last year 31 00:01:39,802 --> 00:01:42,521 Speaker 1: you discovered that you had thyroid cancer, which we're glad 32 00:01:42,531 --> 00:01:45,961 Speaker 1: to hear us in remission now. And while distressed by that, 33 00:01:45,972 --> 00:01:47,191 Speaker 1: you also found it quite difficult, 34 00:01:47,274 --> 00:01:50,473 Speaker 1: difficult to navigate the health care system, right? So if 35 00:01:50,484 --> 00:01:53,744 Speaker 1: I may just start by sharing last year in June, 36 00:01:53,893 --> 00:01:57,892 Speaker 1: I actually had a comprehensive health screening that was compliments 37 00:01:57,903 --> 00:02:02,583 Speaker 1: from my company. I've always passed my thyroid blood test. Well, 38 00:02:02,594 --> 00:02:06,884 Speaker 1: even though my neck was slightly puffy with this health screening, 39 00:02:06,893 --> 00:02:10,014 Speaker 1: I was able to go for a thyroid ultrasound and 40 00:02:10,024 --> 00:02:10,642 Speaker 1: it was at the 41 00:02:10,906 --> 00:02:13,186 Speaker 1: first sound that they started to discover there were some 42 00:02:13,195 --> 00:02:18,376 Speaker 1: microcalcifications and it looked a little suspicious. That's when the 43 00:02:18,386 --> 00:02:21,895 Speaker 1: doctor who was reviewing me actually told me to probe 44 00:02:21,906 --> 00:02:26,856 Speaker 1: this further, go for further investigations immediately. So like any 45 00:02:26,865 --> 00:02:30,466 Speaker 1: people my age, first of all, I was struck with fear. 46 00:02:30,475 --> 00:02:34,454 Speaker 1: I remember crying so much at the M RT station 47 00:02:34,690 --> 00:02:38,250 Speaker 1: when I received the news. Instead of going to a 48 00:02:38,258 --> 00:02:41,918 Speaker 1: doctor straight, I took some time to find out who 49 00:02:41,929 --> 00:02:45,360 Speaker 1: are some of the prominent doctors that I should visit 50 00:02:45,500 --> 00:02:50,050 Speaker 1: because of work schedule, as well as further procrastinated until September. 51 00:02:50,110 --> 00:02:53,910 Speaker 1: When at the recommendation of one of my friends who 52 00:02:53,919 --> 00:02:56,179 Speaker 1: was a GP, probably I should go to N U 53 00:02:56,190 --> 00:02:57,720 Speaker 1: H now. Why 54 00:02:57,800 --> 00:03:00,668 Speaker 1: N U H? Because at that time, I was also 55 00:03:00,679 --> 00:03:03,559 Speaker 1: thinking cancer is something that is long term, I may 56 00:03:03,570 --> 00:03:08,009 Speaker 1: need more support financially in the long run in the 57 00:03:08,020 --> 00:03:11,220 Speaker 1: events that I'm not able to support myself. And that's 58 00:03:11,229 --> 00:03:14,309 Speaker 1: why I have shortlisted this doctor. He did a F 59 00:03:14,320 --> 00:03:19,490 Speaker 1: N AC a fine needle aspiration test as a biopsy. Indeed, 60 00:03:19,500 --> 00:03:20,829 Speaker 1: one week later, it turned out 61 00:03:20,910 --> 00:03:25,119 Speaker 1: to be cancerous, malignant and that's when he said let's 62 00:03:25,130 --> 00:03:28,448 Speaker 1: schedule for the operation. It must have been devastating to 63 00:03:28,460 --> 00:03:30,800 Speaker 1: hear the news at the time or were some of 64 00:03:30,809 --> 00:03:33,080 Speaker 1: the other considerations you mentioned you were a bit concerned 65 00:03:33,089 --> 00:03:36,199 Speaker 1: about the finances too. Yes, because at that point in time, 66 00:03:36,210 --> 00:03:39,119 Speaker 1: it was also quite timely that the government announced that 67 00:03:39,130 --> 00:03:42,559 Speaker 1: they are going to review the medicine list. There were 68 00:03:42,570 --> 00:03:43,940 Speaker 1: a lot of rumors and uncertain 69 00:03:44,199 --> 00:03:48,460 Speaker 1: going along in the entire general population that oh no, 70 00:03:48,470 --> 00:03:52,089 Speaker 1: it means to say that insurance premiums are going to increase. 71 00:03:52,100 --> 00:03:54,410 Speaker 1: What if the cancer drugs that we are going to 72 00:03:54,419 --> 00:03:58,550 Speaker 1: be prescribed is not on the list. So first thing first, 73 00:03:58,559 --> 00:04:02,949 Speaker 1: I have three teenagers who will be going to university, 74 00:04:02,960 --> 00:04:05,710 Speaker 1: who will be going to polytechnic and one more who 75 00:04:05,720 --> 00:04:07,050 Speaker 1: is in secondary school. 76 00:04:07,419 --> 00:04:11,630 Speaker 1: So financial wise, it was definitely a challenge for me 77 00:04:11,639 --> 00:04:16,390 Speaker 1: to quickly review what are my existing policies, the coverage 78 00:04:16,399 --> 00:04:20,349 Speaker 1: if I would be able to manage cash upfront to 79 00:04:20,359 --> 00:04:23,359 Speaker 1: pay for the medicine? And at the end of it, 80 00:04:23,369 --> 00:04:26,100 Speaker 1: can you tell us roughly how much did you spend 81 00:04:26,109 --> 00:04:31,000 Speaker 1: on treatment? I would say that the latest radioactive treatment 82 00:04:31,010 --> 00:04:35,390 Speaker 1: that I went for was around 10,000 to $12,000. I'm 83 00:04:35,399 --> 00:04:36,010 Speaker 1: still waiting for 84 00:04:36,079 --> 00:04:40,649 Speaker 1: my bill, but that was the estimated amount that I 85 00:04:40,660 --> 00:04:44,200 Speaker 1: was given and that was just on the treatment. And 86 00:04:44,209 --> 00:04:46,369 Speaker 1: is your insurance going to cover most of that? Yes, 87 00:04:46,380 --> 00:04:49,959 Speaker 1: it will be covered by my insurance provider. And I'm 88 00:04:49,970 --> 00:04:54,209 Speaker 1: grateful I will be sufficiently covered. So you're not alone. 89 00:04:54,220 --> 00:04:56,839 Speaker 1: I'm sure any person, any parent and adult would have 90 00:04:56,850 --> 00:05:00,678 Speaker 1: the same concerns as you. The journey that Gina has 91 00:05:00,690 --> 00:05:03,279 Speaker 1: just mentioned. Is this a typical journey of someone when 92 00:05:03,290 --> 00:05:04,670 Speaker 1: they discover that they have cancer? 93 00:05:04,910 --> 00:05:07,779 Speaker 1: Yes, Stephen and Gina, I'm glad you're much better now. 94 00:05:07,809 --> 00:05:11,000 Speaker 1: You're on your recovery phase right now, which is great 95 00:05:11,010 --> 00:05:14,320 Speaker 1: because you found the cancer early. You rightly mentioned Steven, 96 00:05:14,329 --> 00:05:17,049 Speaker 1: this is quite a common experience for many of my 97 00:05:17,059 --> 00:05:20,769 Speaker 1: cancer patients as well. They go through the whole gamut 98 00:05:20,779 --> 00:05:24,729 Speaker 1: of emotional upheaval and then up to a point when 99 00:05:24,738 --> 00:05:26,769 Speaker 1: eventually they'll come to terms with it and this can 100 00:05:26,779 --> 00:05:29,719 Speaker 1: take weeks and months and that's why sometimes there may 101 00:05:29,730 --> 00:05:30,459 Speaker 1: be some delay 102 00:05:30,640 --> 00:05:34,359 Speaker 1: between the time where the diagnosis may present itself to 103 00:05:34,369 --> 00:05:36,988 Speaker 1: the point where patients get the courage to go and 104 00:05:37,000 --> 00:05:39,709 Speaker 1: get treatment because it's a taboo topic. Like a lot 105 00:05:39,720 --> 00:05:42,670 Speaker 1: of people don't want to discuss cancer, they associate it 106 00:05:42,678 --> 00:05:46,700 Speaker 1: with death and suffering. However, over the course of the 107 00:05:46,709 --> 00:05:50,339 Speaker 1: last maybe two decades, there have been milestones in terms 108 00:05:50,350 --> 00:05:53,420 Speaker 1: of improvement in cancer care. So it's not as what 109 00:05:53,428 --> 00:05:56,089 Speaker 1: people had imagined it from movies of the past 110 00:05:56,170 --> 00:05:59,380 Speaker 1: you lose your hair, you suffer more than benefit from 111 00:05:59,390 --> 00:06:02,320 Speaker 1: the treatment. And as such, people actually have the impression 112 00:06:02,329 --> 00:06:04,899 Speaker 1: that you'll die faster from treatment, which is not true. 113 00:06:04,970 --> 00:06:08,179 Speaker 1: And from Gina's experience herself, she knows that you can 114 00:06:08,190 --> 00:06:13,660 Speaker 1: get cured and potentially lead a relatively normal life thereafter. 115 00:06:13,670 --> 00:06:18,339 Speaker 1: So answering your question, yes, they go through such concerns 116 00:06:18,350 --> 00:06:21,720 Speaker 1: about cost, about side effects, about survival. 117 00:06:21,988 --> 00:06:26,000 Speaker 1: Mortality becomes something very real to them. It almost makes 118 00:06:26,010 --> 00:06:28,488 Speaker 1: you take a second look at your life itself. The 119 00:06:28,500 --> 00:06:31,790 Speaker 1: heart of the matter team also spoke to another patient, Eileen. 120 00:06:32,109 --> 00:06:35,719 Speaker 1: Uh she's 48. She's had cancer twice once when she 121 00:06:35,730 --> 00:06:39,179 Speaker 1: was 25 again, when she was 44 her biggest issue 122 00:06:39,190 --> 00:06:42,070 Speaker 1: was insurance. Now the first time she was too young, 123 00:06:42,079 --> 00:06:44,690 Speaker 1: the second time she had a hard time being insured. 124 00:06:44,700 --> 00:06:46,469 Speaker 1: I just want to share with you a clip of 125 00:06:46,480 --> 00:06:47,328 Speaker 1: her interview. 126 00:06:47,570 --> 00:06:51,089 Speaker 1: Let's listen to this. Ok. If you ask me, definitely 127 00:06:51,100 --> 00:06:54,500 Speaker 1: not because I'm that kind of person that is when 128 00:06:54,510 --> 00:06:57,839 Speaker 1: I was 17 years old, I started working. First thing 129 00:06:57,850 --> 00:07:00,238 Speaker 1: when I come out, I get my pay. I'm the 130 00:07:00,250 --> 00:07:03,049 Speaker 1: one who look for insurance agent, not insurance agent. Look 131 00:07:03,059 --> 00:07:03,480 Speaker 1: for me 132 00:07:04,119 --> 00:07:06,790 Speaker 1: at that time. Of course, my pay is so little. 133 00:07:06,880 --> 00:07:09,019 Speaker 1: I buy what I can do. So I buy life 134 00:07:09,029 --> 00:07:12,540 Speaker 1: insurance but I did not buy in hospitalization because at 135 00:07:12,549 --> 00:07:14,850 Speaker 1: that time I'm young and a lot of things we 136 00:07:14,859 --> 00:07:17,559 Speaker 1: don't know if I thought that, oh, I have Medisave, 137 00:07:17,570 --> 00:07:21,019 Speaker 1: I don't need to buy any hospitalization. So even I'm 138 00:07:21,029 --> 00:07:23,079 Speaker 1: going to put this question to you because many young 139 00:07:23,089 --> 00:07:25,769 Speaker 1: people do think like her, I'm young, I'm healthy. Nothing 140 00:07:25,779 --> 00:07:28,470 Speaker 1: much to worry about. And I don't have much money 141 00:07:28,480 --> 00:07:30,940 Speaker 1: to spend on insurance or rather I'd rather not at 142 00:07:30,950 --> 00:07:32,549 Speaker 1: this point, right? You think you don't need it? 143 00:07:32,989 --> 00:07:35,850 Speaker 1: So when something hits, it really hits hard for this 144 00:07:35,859 --> 00:07:41,000 Speaker 1: group of people, what could eileen sort of have done differently? Well, unfortunately, 145 00:07:41,010 --> 00:07:43,359 Speaker 1: you know, insurance are a lot of times being sold 146 00:07:43,369 --> 00:07:46,899 Speaker 1: rather than bought. People tend to not want to kind 147 00:07:46,910 --> 00:07:49,029 Speaker 1: of like, oh, I want to buy insurance. Our first 148 00:07:49,040 --> 00:07:51,440 Speaker 1: policies tend to be sold to us right? By either 149 00:07:51,450 --> 00:07:53,720 Speaker 1: a friend who has gone into the insurance industry or 150 00:07:53,730 --> 00:07:54,600 Speaker 1: someone we know 151 00:07:54,869 --> 00:07:57,149 Speaker 1: and in her case, like she mentioned, she bought whole 152 00:07:57,160 --> 00:08:01,489 Speaker 1: life insurance rather than medical insurance, which 21 years ago 153 00:08:01,500 --> 00:08:03,980 Speaker 1: when we first started, that's the plan that we tell 154 00:08:03,989 --> 00:08:07,040 Speaker 1: young people, if there's only one plan you need to buy, 155 00:08:07,049 --> 00:08:10,100 Speaker 1: it's a medical insurance. If there's a plan that parents 156 00:08:10,109 --> 00:08:13,179 Speaker 1: need to buy for their Children, it's a medical insurance 157 00:08:13,190 --> 00:08:15,790 Speaker 1: because that's the plan that you need to have for 158 00:08:15,799 --> 00:08:20,470 Speaker 1: life in that sense because the medical expenses, medical incidents 159 00:08:20,480 --> 00:08:22,920 Speaker 1: can happen, whether you're young, you're old. 160 00:08:23,126 --> 00:08:26,235 Speaker 1: So that's really the most important plan I would say 161 00:08:26,246 --> 00:08:28,346 Speaker 1: for all listeners out there, if you do not have 162 00:08:28,355 --> 00:08:31,216 Speaker 1: a medical insurance, that is really the one plan that 163 00:08:31,226 --> 00:08:33,535 Speaker 1: you want to ensure that you have. So, is that 164 00:08:33,546 --> 00:08:35,935 Speaker 1: still the same today? If a young person came to you, 165 00:08:35,945 --> 00:08:38,056 Speaker 1: that would be your advice? Yes. Which one to get first, 166 00:08:38,065 --> 00:08:40,745 Speaker 1: whether young or old must have a medical insurance. But 167 00:08:40,755 --> 00:08:43,616 Speaker 1: then many Singaporeans may say, but I have my Medishield life, 168 00:08:43,625 --> 00:08:45,585 Speaker 1: which is sort of given to all of us. Isn't 169 00:08:45,596 --> 00:08:48,244 Speaker 1: that enough? Whether that's enough or not? It's really a 170 00:08:48,255 --> 00:08:51,315 Speaker 1: function of what's your healthcare expectation? 171 00:08:51,682 --> 00:08:54,381 Speaker 1: If you're happy going to uh see what at a 172 00:08:54,392 --> 00:08:58,541 Speaker 1: restructured hospital? No Air Con, no TV, you know, shared 173 00:08:58,552 --> 00:09:01,372 Speaker 1: bathrooms and all that, then that's fine. But if you 174 00:09:01,381 --> 00:09:04,381 Speaker 1: want something that is more conducive for yourself, you want 175 00:09:04,392 --> 00:09:07,920 Speaker 1: to have Air Con, you want to perhaps choose your doctor, 176 00:09:07,932 --> 00:09:10,742 Speaker 1: then I would say you will need to upgrade, you 177 00:09:10,752 --> 00:09:14,151 Speaker 1: have to buy additional insurance right beyond just the Medishield 178 00:09:14,160 --> 00:09:18,471 Speaker 1: Life and Gina, when you were considering options and doctors 179 00:09:18,481 --> 00:09:19,572 Speaker 1: and medical care 180 00:09:19,950 --> 00:09:23,218 Speaker 1: was cost an issue. Did you filter out some options? 181 00:09:23,229 --> 00:09:26,858 Speaker 1: Because you felt they were too expensive as a general Singaporean. 182 00:09:26,869 --> 00:09:30,580 Speaker 1: Also a bit auntie, I go around asking my friends 183 00:09:30,590 --> 00:09:33,919 Speaker 1: who are fellow mummies. First of all, to tap on 184 00:09:33,929 --> 00:09:37,880 Speaker 1: their knowledge. Number two, I consulted friends of my age 185 00:09:37,890 --> 00:09:43,079 Speaker 1: who are cancer patients. Unfortunately, after making a comparison, I 186 00:09:43,090 --> 00:09:44,439 Speaker 1: thought to myself 187 00:09:44,710 --> 00:09:47,280 Speaker 1: end of the day, I want to be able to 188 00:09:47,289 --> 00:09:52,409 Speaker 1: afford the treatment in a comfortable setting. So I already 189 00:09:52,419 --> 00:09:56,159 Speaker 1: have a P plus plan from my insurance provider. So 190 00:09:56,169 --> 00:09:59,549 Speaker 1: that would cater for me for a private hospital. 191 00:09:59,750 --> 00:10:03,619 Speaker 1: However, if I'm not able to have a secure income 192 00:10:03,630 --> 00:10:05,690 Speaker 1: at the end of the day, if there are any 193 00:10:05,700 --> 00:10:08,869 Speaker 1: financial challenges that comes along the way, would I be 194 00:10:08,880 --> 00:10:12,690 Speaker 1: able to afford private class? So that was definitely one 195 00:10:12,700 --> 00:10:14,699 Speaker 1: key consideration that I had 196 00:10:15,140 --> 00:10:18,450 Speaker 1: when I was considering which doctor that I will ultimately 197 00:10:18,460 --> 00:10:22,099 Speaker 1: go to which hospital I should entrust my care upon 198 00:10:22,109 --> 00:10:23,780 Speaker 1: when you say P plus, you mean you have a 199 00:10:23,789 --> 00:10:27,348 Speaker 1: rider over and above your basic policy. Is that right? 200 00:10:27,359 --> 00:10:29,710 Speaker 1: I mean to say that I have the coverage to 201 00:10:29,719 --> 00:10:33,579 Speaker 1: cover me up to a private class. So unfortunately, at 202 00:10:33,590 --> 00:10:36,289 Speaker 1: that point in time, I didn't have the foresight to 203 00:10:36,299 --> 00:10:41,679 Speaker 1: buy riders. So that was where the 10% of copayment 204 00:10:41,770 --> 00:10:44,709 Speaker 1: actually comes in, but it worked out well because at 205 00:10:44,721 --> 00:10:47,320 Speaker 1: the end of the day, I'm still able to cover 206 00:10:47,330 --> 00:10:52,200 Speaker 1: that 10% cost by myself. And with the hospitalization plan 207 00:10:52,210 --> 00:10:56,361 Speaker 1: which was very comprehensive, I would say that the cash 208 00:10:56,370 --> 00:10:59,760 Speaker 1: upfront is actually a comfortable sum. Even though I'm going 209 00:10:59,770 --> 00:11:04,080 Speaker 1: for a private class in a restructured hospital, it managed 210 00:11:04,091 --> 00:11:07,000 Speaker 1: to cover a large portion of the cost that you 211 00:11:07,010 --> 00:11:08,221 Speaker 1: were required to pay. 212 00:11:08,492 --> 00:11:10,851 Speaker 1: Ravi. I mean, you hit the Cancer Treatment Fund Committee 213 00:11:10,861 --> 00:11:14,160 Speaker 1: at Singapore Cancer Society. Give us some idea what is 214 00:11:14,171 --> 00:11:17,161 Speaker 1: the current landscape when it comes to costs? Are most 215 00:11:17,171 --> 00:11:20,822 Speaker 1: people covered like Gina or are many in a situation 216 00:11:20,831 --> 00:11:24,731 Speaker 1: where they end up needing extra help prior to September 1st, 217 00:11:24,742 --> 00:11:28,021 Speaker 1: last year, when the cancer drug list first came into 218 00:11:28,030 --> 00:11:31,651 Speaker 1: the picture, there were many gaps. A lot of drugs 219 00:11:31,660 --> 00:11:35,111 Speaker 1: did not get reimbursement from the government. The government reimburse 220 00:11:35,213 --> 00:11:39,192 Speaker 1: was fixed at 3000 per month for Medishield life and 221 00:11:39,203 --> 00:11:44,023 Speaker 1: 1002 from your Medisave. So if drugs cost more than 4000, 222 00:11:44,033 --> 00:11:46,882 Speaker 1: 200 patients had to fork it out of their pocket 223 00:11:46,893 --> 00:11:50,453 Speaker 1: unless they had integrated plans with or without riders that 224 00:11:50,463 --> 00:11:53,163 Speaker 1: will cover the balance. So your co-pay will depend on 225 00:11:53,242 --> 00:11:57,093 Speaker 1: whether you have a rider or not. Now, after September 1st, 226 00:11:57,102 --> 00:12:01,833 Speaker 1: the government negotiated prices with pharmaceutical companies to bring 227 00:12:01,934 --> 00:12:07,033 Speaker 1: down cancer drug costs substantially. You're talking about drug cost 228 00:12:07,044 --> 00:12:12,243 Speaker 1: reduction from 30 to 60% 65% for some of the drugs. 229 00:12:12,393 --> 00:12:15,833 Speaker 1: Are you saying 65% less than what it used to be? 230 00:12:16,653 --> 00:12:20,262 Speaker 1: So with that savings, the government has now channeled the 231 00:12:20,273 --> 00:12:25,643 Speaker 1: savings to fund drugs that they didn't fund in the past. 232 00:12:25,653 --> 00:12:28,544 Speaker 1: So meaning to say, if you do not have 233 00:12:28,655 --> 00:12:32,914 Speaker 1: high income and we use the per capita household income 234 00:12:32,924 --> 00:12:37,184 Speaker 1: as the threshold and that threshold is 6500 per capita 235 00:12:37,195 --> 00:12:40,755 Speaker 1: household income, not the individual's income. If you're talking about 236 00:12:40,765 --> 00:12:44,544 Speaker 1: a family of three or four and one person earning 237 00:12:44,554 --> 00:12:49,424 Speaker 1: an income, many people would qualify for ma f medication 238 00:12:49,434 --> 00:12:53,585 Speaker 1: assistance fund support. And when you get medication assistance fund support, 239 00:12:53,594 --> 00:12:55,284 Speaker 1: these drugs are literally 240 00:12:55,375 --> 00:12:58,444 Speaker 1: $0 out of pocket. And we're talking about really expensive 241 00:12:58,455 --> 00:13:02,346 Speaker 1: drugs that are immunotherapies, state of the art drugs just 242 00:13:02,356 --> 00:13:05,596 Speaker 1: to give you some background cancer treatment fund is basically 243 00:13:05,606 --> 00:13:10,645 Speaker 1: for patients who don't have financial support or insufficient financial 244 00:13:10,655 --> 00:13:13,885 Speaker 1: support to pay for their cancer drugs. And we use 245 00:13:13,895 --> 00:13:17,366 Speaker 1: means testing to see whether they are eligible. So basically 246 00:13:17,375 --> 00:13:20,745 Speaker 1: it's for low and low middle income patients who will 247 00:13:20,755 --> 00:13:22,005 Speaker 1: qualify for this fund 248 00:13:22,250 --> 00:13:25,030 Speaker 1: and it used to cover for drugs in excess of 249 00:13:25,039 --> 00:13:29,239 Speaker 1: that 4200 support that the government had provided prior to this. 250 00:13:29,250 --> 00:13:31,960 Speaker 1: So we had many, many applications. Now, many of those 251 00:13:31,969 --> 00:13:36,049 Speaker 1: patients are getting medication assistance fund support. Now they're getting 252 00:13:36,059 --> 00:13:39,940 Speaker 1: subsidized drugs because of how the government has channeled the 253 00:13:39,950 --> 00:13:43,059 Speaker 1: savings to support these patients. So now we don't have 254 00:13:43,070 --> 00:13:46,960 Speaker 1: that many applications for those drugs. So more than 90% 255 00:13:47,039 --> 00:13:50,380 Speaker 1: of drugs that we had used in the past are 256 00:13:50,390 --> 00:13:51,780 Speaker 1: part of the cancer drug list, 257 00:13:52,190 --> 00:13:55,669 Speaker 1: but that leaves a small percentage that is not part 258 00:13:55,679 --> 00:13:58,460 Speaker 1: of the cancer drug list that may be beneficial. So 259 00:13:58,469 --> 00:14:00,979 Speaker 1: it's not just about cost effective care. When the government 260 00:14:00,989 --> 00:14:03,859 Speaker 1: evaluates these things, they look at evidence based as well. 261 00:14:03,869 --> 00:14:07,440 Speaker 1: So it must be effective and cost effective. Those patients 262 00:14:07,450 --> 00:14:10,069 Speaker 1: now have a gap and cancer treatment fund can help. 263 00:14:10,080 --> 00:14:12,510 Speaker 1: So in a way, you're saying the most commonly prescribed 264 00:14:12,520 --> 00:14:15,559 Speaker 1: drugs have become much cheaper and therefore a lot more 265 00:14:15,570 --> 00:14:17,659 Speaker 1: accessible to a larger group of people. But 266 00:14:17,950 --> 00:14:20,179 Speaker 1: if you are unfortunate enough to have one of those 267 00:14:20,190 --> 00:14:24,840 Speaker 1: more rare cancers, then you may not benefit from that. Right. Absolutely. 268 00:14:25,510 --> 00:14:27,979 Speaker 1: So that's actually a good thing. Overall, we are making 269 00:14:27,989 --> 00:14:30,840 Speaker 1: it more accessible to more people. Is it the drugs 270 00:14:30,849 --> 00:14:34,039 Speaker 1: that are really expensive? What about the treatment itself too? 271 00:14:34,590 --> 00:14:38,630 Speaker 1: Is cancer treatment, would you say very expensive in Singapore? Basically, 272 00:14:38,640 --> 00:14:43,119 Speaker 1: cancer treatment can be surgery can be systemic therapy, which 273 00:14:43,130 --> 00:14:48,049 Speaker 1: is chemotherapy. Now, we have targeted treatment immunotherapy and it 274 00:14:48,059 --> 00:14:51,090 Speaker 1: can be radiotherapy. Of course, at the tail end, you 275 00:14:51,099 --> 00:14:55,409 Speaker 1: get palliative therapy, supportive care drugs. Overall, the cost of 276 00:14:55,419 --> 00:14:59,539 Speaker 1: surgery in public hospitals in general, it's pretty much well 277 00:14:59,549 --> 00:15:00,530 Speaker 1: controlled in terms 278 00:15:00,604 --> 00:15:04,275 Speaker 1: of pricing and it's relatively affordable because the government controls 279 00:15:04,284 --> 00:15:07,255 Speaker 1: pricing across all public hospitals. So you don't have to 280 00:15:07,265 --> 00:15:10,364 Speaker 1: hospital shop to get the cheapest surgery somewhere as a 281 00:15:10,375 --> 00:15:12,284 Speaker 1: subsidized patient So I'm I'm talking to you from a 282 00:15:12,294 --> 00:15:16,494 Speaker 1: point of a Singaporean. Even APR will get some subsidies 283 00:15:16,505 --> 00:15:19,145 Speaker 1: but mainly from a Singaporeans perspective. You, you actually get 284 00:15:19,155 --> 00:15:22,914 Speaker 1: high quality care at very reasonable cost. So like as 285 00:15:22,924 --> 00:15:25,534 Speaker 1: what Gina mentioned, if you're concerned, you're not sure about 286 00:15:25,544 --> 00:15:26,494 Speaker 1: your insurance coverage 287 00:15:26,619 --> 00:15:29,549 Speaker 1: and you're willing to get C or B two class treatment, 288 00:15:29,559 --> 00:15:33,590 Speaker 1: you get very reasonably priced treatment. Now the elephant in 289 00:15:33,599 --> 00:15:36,409 Speaker 1: the room always has been the systemic therapy part because 290 00:15:36,440 --> 00:15:40,440 Speaker 1: these drugs are controlled by pharmaceutical companies that sell these 291 00:15:40,450 --> 00:15:44,030 Speaker 1: drugs to us. And it's always been priced according to 292 00:15:44,039 --> 00:15:47,549 Speaker 1: the country's GDP. So high income countries pay a lot 293 00:15:47,559 --> 00:15:51,359 Speaker 1: more for these drugs than lower middle income countries. However, 294 00:15:51,369 --> 00:15:52,570 Speaker 1: when the ministry 295 00:15:52,635 --> 00:15:56,414 Speaker 1: health looked at pricing in other high income countries, Singapore 296 00:15:56,424 --> 00:16:00,684 Speaker 1: was paying proportionately higher sum compared to countries like Korea 297 00:16:00,695 --> 00:16:02,505 Speaker 1: and Japan. Of course, you can argue that they had 298 00:16:02,515 --> 00:16:06,244 Speaker 1: larger population compared to Singapore, you know, a smaller market, 299 00:16:06,265 --> 00:16:08,604 Speaker 1: but we are paying significantly higher. And that led to 300 00:16:08,614 --> 00:16:13,065 Speaker 1: these negotiations about cancer drug costs. But your question also 301 00:16:13,265 --> 00:16:16,114 Speaker 1: hits to the point about the value, right? How would 302 00:16:16,125 --> 00:16:18,585 Speaker 1: you value these drugs? They are very expensive but 303 00:16:18,799 --> 00:16:21,890 Speaker 1: you know, to an individual with cancer, you would value 304 00:16:21,900 --> 00:16:24,250 Speaker 1: it highly if it's going to prolong your life even 305 00:16:24,260 --> 00:16:26,650 Speaker 1: by a month or two months. So I think while 306 00:16:26,659 --> 00:16:29,390 Speaker 1: society may value it differently, especially when you don't have 307 00:16:29,400 --> 00:16:33,900 Speaker 1: cancer for their patients, for their families every single day matters. 308 00:16:33,909 --> 00:16:35,549 Speaker 1: So I think wherever we can 309 00:16:35,619 --> 00:16:40,010 Speaker 1: and try to curtail spiraling costs, do these negotiations bring 310 00:16:40,020 --> 00:16:43,200 Speaker 1: down prices and try to get the best value out 311 00:16:43,210 --> 00:16:45,340 Speaker 1: of it? Then I think we are doing good and 312 00:16:45,349 --> 00:16:49,429 Speaker 1: already most definitely, I think nobody ever wants to not 313 00:16:49,440 --> 00:16:52,400 Speaker 1: take up a certain treatment option because they cannot afford it. 314 00:16:52,609 --> 00:16:54,830 Speaker 1: That would be the most sad thing for them. 315 00:16:58,890 --> 00:17:02,090 Speaker 1: Hello, everyone. My name is Christina and I'm Adrian and 316 00:17:02,099 --> 00:17:04,520 Speaker 1: we're the host of a podcast called Work It if 317 00:17:04,530 --> 00:17:06,510 Speaker 1: you never heard of it. Well, it's a good time 318 00:17:06,520 --> 00:17:09,339 Speaker 1: to tap in. In the last three episodes. We've discussed 319 00:17:09,349 --> 00:17:12,479 Speaker 1: topics like how to negotiate for a salary increase or 320 00:17:12,489 --> 00:17:15,089 Speaker 1: how to get along with younger colleagues who have different 321 00:17:15,099 --> 00:17:16,069 Speaker 1: values from you. 322 00:17:16,265 --> 00:17:20,015 Speaker 1: Incidentally is our top performing episode. If work consumes your 323 00:17:20,025 --> 00:17:23,665 Speaker 1: life and you want some perspective on issues like management stress, 324 00:17:23,675 --> 00:17:27,494 Speaker 1: even office romance. This podcast should be on your list. 325 00:17:27,655 --> 00:17:30,555 Speaker 1: A new episode drops every Monday. Catch us on the 326 00:17:30,564 --> 00:17:33,515 Speaker 1: C N A app or wherever you get your podcast 327 00:17:36,040 --> 00:17:38,599 Speaker 1: even. We've also heard of some patients who have this 328 00:17:38,609 --> 00:17:41,060 Speaker 1: Buffet syndrome. You know, they want to like give it 329 00:17:41,069 --> 00:17:43,609 Speaker 1: a chance, try everything, do everything even if it's a 330 00:17:43,619 --> 00:17:46,349 Speaker 1: very small chance of helping and they claim for all 331 00:17:46,359 --> 00:17:49,938 Speaker 1: of it, including what may be deemed a certain unnecessary procedures. 332 00:17:50,260 --> 00:17:53,969 Speaker 1: Do they then drive up insurance premiums? Definitely, that is 333 00:17:53,979 --> 00:17:54,949 Speaker 1: what we have seen. Right 334 00:17:55,020 --> 00:17:58,310 Speaker 1: in the past decade or so, essentially, it's the Medishield 335 00:17:58,319 --> 00:18:01,520 Speaker 1: Life Integrated Shield plans. That's the main tool to finance 336 00:18:01,530 --> 00:18:06,129 Speaker 1: hospitalization expenses and expensive outpatient treatments such as that for 337 00:18:06,140 --> 00:18:09,300 Speaker 1: cancer treatments. So like uh what Gina has mentioned, this 338 00:18:09,310 --> 00:18:12,708 Speaker 1: main plans actually can finance up to 90% of the 339 00:18:12,719 --> 00:18:13,929 Speaker 1: medical cost. And 340 00:18:14,209 --> 00:18:17,760 Speaker 1: if people have a rider, this bill can be entirely 341 00:18:17,770 --> 00:18:20,250 Speaker 1: paid by the plans that they have. But because of 342 00:18:20,260 --> 00:18:23,699 Speaker 1: this kind of buffet as charged feature of such plans, 343 00:18:23,859 --> 00:18:28,599 Speaker 1: the claims experience of the insurance companies has increased exponentially 344 00:18:28,609 --> 00:18:31,429 Speaker 1: that led on to big jumps in the premiums, which 345 00:18:31,439 --> 00:18:33,339 Speaker 1: then led on to all these concerns about, you know, 346 00:18:33,349 --> 00:18:34,800 Speaker 1: whether premiums can be sustained 347 00:18:35,239 --> 00:18:38,780 Speaker 1: over the long term, especially as one grows older. And 348 00:18:38,790 --> 00:18:41,859 Speaker 1: that's where all these changes that we see in this 349 00:18:41,869 --> 00:18:45,909 Speaker 1: recent years come in to help to curb the escalating cost. 350 00:18:45,920 --> 00:18:49,449 Speaker 1: Is there a big difference between public and private hospitals 351 00:18:49,459 --> 00:18:51,170 Speaker 1: and Gina when you were looking at it, you, you 352 00:18:51,180 --> 00:18:53,639 Speaker 1: were fortunate enough to have enough coverage to allow you 353 00:18:53,650 --> 00:18:56,510 Speaker 1: to visit a private hospital. But much of what we're 354 00:18:56,520 --> 00:18:58,780 Speaker 1: talking about, the limits have been set and these are 355 00:18:58,790 --> 00:19:01,369 Speaker 1: based on subsidized prices at public hospitals. 356 00:19:01,599 --> 00:19:04,790 Speaker 1: So does that mean that typical patient does not have 357 00:19:04,800 --> 00:19:07,280 Speaker 1: the option to go to a private hospital? Yes, you're 358 00:19:07,290 --> 00:19:10,760 Speaker 1: absolutely right. These limits have been set based on cost 359 00:19:10,770 --> 00:19:13,780 Speaker 1: of drugs to public hospitals and a lot of the 360 00:19:13,790 --> 00:19:18,109 Speaker 1: price negotiations surround getting the best prices for public hospitals. 361 00:19:18,119 --> 00:19:21,650 Speaker 1: So private oncologist get drugs at higher prices and it's 362 00:19:21,660 --> 00:19:23,630 Speaker 1: up to them, they can negotiate with Pharma to bring 363 00:19:23,640 --> 00:19:27,969 Speaker 1: these drugs down. That is a separate process to answer 364 00:19:27,979 --> 00:19:28,468 Speaker 1: your question 365 00:19:28,535 --> 00:19:31,864 Speaker 1: with regards to coverage if you have a rider and, 366 00:19:31,875 --> 00:19:35,525 Speaker 1: and you can see since April 1st insurers now have 367 00:19:35,535 --> 00:19:38,754 Speaker 1: to cover drugs only on the cancer drug list. Unless 368 00:19:38,765 --> 00:19:41,915 Speaker 1: you have a rider, then you get coverage outside to 369 00:19:41,925 --> 00:19:44,515 Speaker 1: a certain amount, right? But if you don't have a 370 00:19:44,525 --> 00:19:47,375 Speaker 1: rider and you just have an integrated plan, these insurance 371 00:19:47,385 --> 00:19:51,954 Speaker 1: companies have coverages of 2 to 5 times above the 372 00:19:51,964 --> 00:19:55,405 Speaker 1: medishield life coverage. So now with that amount 373 00:19:55,469 --> 00:19:58,800 Speaker 1: of coverage, potentially, you may be able to still avail 374 00:19:58,810 --> 00:20:02,159 Speaker 1: yourself to the cost of drugs in private practice as well. 375 00:20:02,170 --> 00:20:05,879 Speaker 1: So those avenues are still there. The question is, will 376 00:20:05,890 --> 00:20:09,410 Speaker 1: this bring down the cost of cancer care in private 377 00:20:09,449 --> 00:20:14,149 Speaker 1: and overall help health care in Singapore, you know, curtail 378 00:20:14,219 --> 00:20:17,698 Speaker 1: the spiraling cost? And I think the answer may be yes. 379 00:20:18,020 --> 00:20:20,189 Speaker 1: And what do you think Gina, when you were looking 380 00:20:20,199 --> 00:20:21,979 Speaker 1: at the options that were available to you, 381 00:20:22,405 --> 00:20:25,094 Speaker 1: coverage was sufficient for me to go to a private, 382 00:20:25,104 --> 00:20:28,994 Speaker 1: but I didn't choose that route because for long term, 383 00:20:29,165 --> 00:20:32,875 Speaker 1: I believe that I would need something that's more sustainable. 384 00:20:32,885 --> 00:20:35,274 Speaker 1: And that's why I went for a public hospital care. 385 00:20:35,285 --> 00:20:38,994 Speaker 1: There is actually a thyroid cancer support group on Facebook 386 00:20:39,005 --> 00:20:42,844 Speaker 1: and I have been exchanging information with the other members. 387 00:20:43,125 --> 00:20:46,415 Speaker 1: If I'm now to go to Raffles Hospital, for example, 388 00:20:46,425 --> 00:20:49,274 Speaker 1: to receive my radioactive ID R treatment, 389 00:20:49,750 --> 00:20:53,180 Speaker 1: I think it would have been a different cost that 390 00:20:53,189 --> 00:20:55,290 Speaker 1: may be out of this world for me at this 391 00:20:55,300 --> 00:20:59,500 Speaker 1: point in time. And even if let's say the insurance 392 00:20:59,510 --> 00:21:05,829 Speaker 1: does cover for this occurrence of cancer, but if future treatments, 393 00:21:05,839 --> 00:21:08,839 Speaker 1: I can't afford it anymore. So that has always been 394 00:21:08,849 --> 00:21:11,750 Speaker 1: a nagging point for me and that's why public health 395 00:21:11,760 --> 00:21:15,329 Speaker 1: care was my first choice all along. So even what 396 00:21:15,339 --> 00:21:17,569 Speaker 1: would you tell people like, you know, who, who are 397 00:21:17,579 --> 00:21:18,459 Speaker 1: concerned about this 398 00:21:18,555 --> 00:21:21,724 Speaker 1: sustainability in the long term cost? Because it's true, it 399 00:21:21,734 --> 00:21:25,214 Speaker 1: could come back again and do certain companies sort of 400 00:21:25,224 --> 00:21:27,704 Speaker 1: say it's a one off thing and in that sense, 401 00:21:27,714 --> 00:21:31,544 Speaker 1: should all of us then be maxing out our insurance, 402 00:21:31,555 --> 00:21:33,685 Speaker 1: getting a rider, making sure we have the full coverage 403 00:21:33,694 --> 00:21:36,885 Speaker 1: for everything just in case it's really about what is 404 00:21:36,895 --> 00:21:40,625 Speaker 1: your need versus your affordability. First thing first is what's 405 00:21:40,635 --> 00:21:43,954 Speaker 1: the healthcare expectations? Especially when you're younger, you may feel 406 00:21:43,964 --> 00:21:45,353 Speaker 1: that oh, I want to have the option to go 407 00:21:45,364 --> 00:21:47,264 Speaker 1: to a private hospital because the premiums 408 00:21:47,359 --> 00:21:51,109 Speaker 1: be more affordable. It's easier to downgrade than to upgrade 409 00:21:51,119 --> 00:21:53,550 Speaker 1: because uh shield plan is a medical plan. So it's 410 00:21:53,560 --> 00:21:56,849 Speaker 1: a function of what's your health, your insurability, what's your 411 00:21:56,859 --> 00:22:00,369 Speaker 1: health condition, whether you have any pre-existing conditions? So from 412 00:22:00,380 --> 00:22:02,510 Speaker 1: that standpoint, we think in terms of like do want 413 00:22:02,520 --> 00:22:05,349 Speaker 1: to have want to have options to choose doctors because 414 00:22:05,359 --> 00:22:07,790 Speaker 1: if you are at sea and B two, right? I 415 00:22:07,800 --> 00:22:10,280 Speaker 1: don't think you can choose your doctors even in restructured 416 00:22:10,290 --> 00:22:13,619 Speaker 1: hospitals only I think. Award and B one, I think. Yeah, 417 00:22:13,630 --> 00:22:15,949 Speaker 1: a one. Right. Then you can choose when you're in 418 00:22:15,959 --> 00:22:15,989 Speaker 1: that 419 00:22:16,165 --> 00:22:18,734 Speaker 1: situation, may be talking to friends, support group and all that. 420 00:22:18,744 --> 00:22:21,214 Speaker 1: And then you kind of get referrals or introduction of 421 00:22:21,224 --> 00:22:23,604 Speaker 1: certain doctors. You want to choose those doctors, then if 422 00:22:23,614 --> 00:22:25,484 Speaker 1: you want to have that option or like I said, 423 00:22:25,494 --> 00:22:27,935 Speaker 1: you want to have that privacy or your own room, 424 00:22:27,944 --> 00:22:30,574 Speaker 1: then that's award. And then you said, ok, I may 425 00:22:30,584 --> 00:22:33,155 Speaker 1: want to again also have the option to go to 426 00:22:33,204 --> 00:22:36,284 Speaker 1: doctors that in private practice. Then there was no choice. 427 00:22:36,295 --> 00:22:38,454 Speaker 1: You really have to kind of like go for a 428 00:22:38,464 --> 00:22:41,435 Speaker 1: private plan. That sounds a bit of a luxury to 429 00:22:41,444 --> 00:22:44,334 Speaker 1: a certain extent. So if we talk about the basic needs, 430 00:22:44,344 --> 00:22:44,915 Speaker 1: then 431 00:22:45,790 --> 00:22:49,180 Speaker 1: would you say what we have is adequate to cover 432 00:22:49,189 --> 00:22:52,599 Speaker 1: most of us? Definitely, if you're looking for restructured hospital, 433 00:22:52,609 --> 00:22:54,208 Speaker 1: I mean, all your CD L and all that is 434 00:22:54,219 --> 00:22:58,040 Speaker 1: all covered in that sense, whatever your IP plans and 435 00:22:58,050 --> 00:23:01,079 Speaker 1: your Medishield life, it will be adequate. If let's say 436 00:23:01,089 --> 00:23:04,569 Speaker 1: the patient is just going for a sea and restructured hospital, 437 00:23:04,579 --> 00:23:07,489 Speaker 1: whatever cancer treatment that they go through there will be 438 00:23:07,500 --> 00:23:07,859 Speaker 1: likely 439 00:23:07,949 --> 00:23:11,310 Speaker 1: fully covered. So other than that 10% but the bulk 440 00:23:11,319 --> 00:23:14,550 Speaker 1: of it will be covered. So in terms of affordability, 441 00:23:14,680 --> 00:23:17,280 Speaker 1: we have it, the restructured hospital is very good. It's 442 00:23:17,290 --> 00:23:19,429 Speaker 1: just for people who wants to have the options and 443 00:23:19,439 --> 00:23:21,909 Speaker 1: all that you want to choose doctors. Yeah, then they 444 00:23:21,920 --> 00:23:23,439 Speaker 1: have to pay for it. So if I was to 445 00:23:23,449 --> 00:23:25,650 Speaker 1: put this question to all of you, do you feel 446 00:23:25,660 --> 00:23:30,000 Speaker 1: that what we have the pricing in our current hospital system? 447 00:23:30,260 --> 00:23:32,750 Speaker 1: the insurance that we have, the support that we have, 448 00:23:32,760 --> 00:23:35,879 Speaker 1: is there enough to adequately care for us? Do you 449 00:23:35,890 --> 00:23:37,939 Speaker 1: feel that it's too expensive? Do you feel that it's 450 00:23:37,949 --> 00:23:40,319 Speaker 1: enough for what we're paying in that sense? I'm getting 451 00:23:40,329 --> 00:23:42,650 Speaker 1: what I need to meet my needs at that point 452 00:23:42,660 --> 00:23:45,459 Speaker 1: in time, if you look at it and compare our 453 00:23:45,469 --> 00:23:49,229 Speaker 1: health care system with its current level of coverage with 454 00:23:49,239 --> 00:23:52,609 Speaker 1: other health care systems from OECD high income countries. 455 00:23:52,900 --> 00:23:56,119 Speaker 1: Firstly, in terms of cancer drug list coverage, we have 456 00:23:56,130 --> 00:24:00,819 Speaker 1: one of the best. It's far more than Australia, New Zealand, Canada, 457 00:24:00,829 --> 00:24:04,369 Speaker 1: United Kingdom in terms of reimbursement. So if you are 458 00:24:04,380 --> 00:24:08,169 Speaker 1: a patient in Singapore who has no money to pay 459 00:24:08,180 --> 00:24:13,000 Speaker 1: for shield plans, you are fully covered only by Medishield 460 00:24:13,010 --> 00:24:15,010 Speaker 1: Life and are happy with 461 00:24:15,099 --> 00:24:18,829 Speaker 1: getting C or B two class coverage in terms of admissions, 462 00:24:18,839 --> 00:24:23,800 Speaker 1: inpatient admissions and supportive care investigations. Actually, you will get 463 00:24:23,810 --> 00:24:27,819 Speaker 1: a very high standard of care when compared to similar 464 00:24:27,829 --> 00:24:30,790 Speaker 1: countries elsewhere in the world. And if you can afford 465 00:24:30,800 --> 00:24:34,188 Speaker 1: to pay for integrated plans, which I would highly recommend 466 00:24:34,199 --> 00:24:36,479 Speaker 1: you don't need the rider at least have an IP 467 00:24:36,640 --> 00:24:37,379 Speaker 1: you would get 468 00:24:37,719 --> 00:24:42,010 Speaker 1: an even higher level of coverage and care which will meet, 469 00:24:42,020 --> 00:24:45,119 Speaker 1: you know, your needs and also give you some level 470 00:24:45,130 --> 00:24:48,150 Speaker 1: of comfort. If you talk about a class care in 471 00:24:48,160 --> 00:24:51,699 Speaker 1: a restructured hospital. From that perspective, I think we have 472 00:24:51,709 --> 00:24:54,609 Speaker 1: it pretty well covered here. Of course, if you want 473 00:24:54,619 --> 00:24:57,909 Speaker 1: to compare with the ideal situation of having that buffet 474 00:24:57,920 --> 00:25:01,219 Speaker 1: of options and walking into a private hospital and seeing 475 00:25:01,229 --> 00:25:04,339 Speaker 1: whichever doctor you want that will obviously come at a cost. 476 00:25:04,469 --> 00:25:05,790 Speaker 1: But that cost 477 00:25:05,892 --> 00:25:08,321 Speaker 1: will have to come from that individual who has to 478 00:25:08,333 --> 00:25:11,102 Speaker 1: pay for the riders, which will not be subsidized by 479 00:25:11,113 --> 00:25:13,052 Speaker 1: the government. But I think that's fair. I think as 480 00:25:13,061 --> 00:25:16,272 Speaker 1: long as basic level of care is covered and it's 481 00:25:16,282 --> 00:25:19,603 Speaker 1: provided at a very high quality that enables you access 482 00:25:19,613 --> 00:25:21,613 Speaker 1: to drugs that will help you. See there are a 483 00:25:21,623 --> 00:25:23,552 Speaker 1: lot of drugs out there that may not be very 484 00:25:23,561 --> 00:25:27,342 Speaker 1: helpful or useful with marginal benefits and those drugs are 485 00:25:27,353 --> 00:25:30,522 Speaker 1: not covered in this list. And there's good reason for that. 486 00:25:30,532 --> 00:25:33,863 Speaker 1: But you know, when you have cancer, it is a struggle, right? 487 00:25:33,873 --> 00:25:33,963 Speaker 1: Like 488 00:25:34,066 --> 00:25:37,105 Speaker 1: you run out of options, you've used 34 lines, you're 489 00:25:37,115 --> 00:25:39,565 Speaker 1: still young, you're fighting hard and you will try to 490 00:25:39,576 --> 00:25:42,635 Speaker 1: hold on to hope there's nothing wrong with that. But 491 00:25:42,645 --> 00:25:45,556 Speaker 1: there are other means we have clinical trials, we have 492 00:25:45,566 --> 00:25:49,475 Speaker 1: molecular tumor boards that can help you find something suitable 493 00:25:49,484 --> 00:25:51,795 Speaker 1: that won't, you know, burn a hole in your pocket. 494 00:25:51,806 --> 00:25:54,725 Speaker 1: So those options are available in restructured hospitals. It's still 495 00:25:54,734 --> 00:25:58,036 Speaker 1: not a dead end and that is very good news. Indeed, Gina, 496 00:25:58,046 --> 00:26:00,865 Speaker 1: when you look back at your situation, would you have 497 00:26:00,875 --> 00:26:02,176 Speaker 1: any advice for someone 498 00:26:02,540 --> 00:26:07,729 Speaker 1: who might be kind of experiencing what you just went through? Yeah, 499 00:26:07,739 --> 00:26:12,469 Speaker 1: assess your situation and do not limit yourself to just 500 00:26:12,479 --> 00:26:16,780 Speaker 1: private hospital options. So far, there has been challenges along 501 00:26:16,790 --> 00:26:18,989 Speaker 1: the way in the hospital that I'm visiting 502 00:26:19,119 --> 00:26:22,209 Speaker 1: given that it is a public hospital setting. Of course, 503 00:26:22,219 --> 00:26:26,209 Speaker 1: there won't be staffing issues. There may be confusion over 504 00:26:26,219 --> 00:26:29,119 Speaker 1: the schedule to visit the doctors. But at the end 505 00:26:29,130 --> 00:26:32,010 Speaker 1: of the day, I must say that the care and 506 00:26:32,020 --> 00:26:35,609 Speaker 1: medical attention given has been very, very good 507 00:26:35,849 --> 00:26:39,819 Speaker 1: even though it's a public hospital, do not stereotype it 508 00:26:39,829 --> 00:26:44,119 Speaker 1: as something that is secondary and do not think that 509 00:26:44,130 --> 00:26:46,569 Speaker 1: we are not there in terms of the care that 510 00:26:46,579 --> 00:26:49,540 Speaker 1: is given. I would say that my entire experience has 511 00:26:49,550 --> 00:26:52,849 Speaker 1: been so good. I really enjoy going to visit the 512 00:26:52,859 --> 00:26:56,260 Speaker 1: doctor even though that shouldn't be the case. But every 513 00:26:56,270 --> 00:26:59,069 Speaker 1: time that there was a question, the medical team was 514 00:26:59,079 --> 00:27:00,339 Speaker 1: there to help, to answer 515 00:27:00,760 --> 00:27:03,938 Speaker 1: the nurses were there to assist and everybody was all 516 00:27:03,949 --> 00:27:07,329 Speaker 1: hands on board to ensure that the patient was well 517 00:27:07,339 --> 00:27:10,160 Speaker 1: informed or even if not at that point in time 518 00:27:10,170 --> 00:27:13,639 Speaker 1: there were answers to the questions. So I really appreciate 519 00:27:13,650 --> 00:27:18,209 Speaker 1: this and my advice is really yes, get your riders 520 00:27:18,219 --> 00:27:18,989 Speaker 1: look through your 521 00:27:19,084 --> 00:27:22,025 Speaker 1: coverage, make sure that you are able to make a 522 00:27:22,035 --> 00:27:28,194 Speaker 1: choice by having a private class coverage if possible. If not, yes, 523 00:27:28,204 --> 00:27:32,494 Speaker 1: we are already receiving enough care. Well, thank you so much. 524 00:27:32,505 --> 00:27:35,004 Speaker 1: Cancer is a complex disease and one that seems to 525 00:27:35,015 --> 00:27:37,334 Speaker 1: be likely among us for many more years to come. 526 00:27:37,869 --> 00:27:40,669 Speaker 1: And in the unfortunate event that you do fall ill, 527 00:27:40,680 --> 00:27:42,780 Speaker 1: the hope is that you can get the treatment you 528 00:27:42,790 --> 00:27:46,448 Speaker 1: require costs should never be a stumbling block to be 529 00:27:46,459 --> 00:27:48,239 Speaker 1: sick is one thing and to have to choose between 530 00:27:48,250 --> 00:27:51,260 Speaker 1: receiving treatment or putting food on the table for your family. 531 00:27:51,270 --> 00:27:53,310 Speaker 1: That is something none of us ever want to have 532 00:27:53,319 --> 00:27:55,959 Speaker 1: to encounter. We hope this episode has shed a bit 533 00:27:55,969 --> 00:27:57,989 Speaker 1: more light on that and given you a better idea 534 00:27:58,000 --> 00:28:00,800 Speaker 1: of how to manage the journey from a cost perspective. 535 00:28:01,260 --> 00:28:04,139 Speaker 1: And if you have found this episode helpful, please feel 536 00:28:04,150 --> 00:28:06,670 Speaker 1: free to share it with others too. The team behind 537 00:28:06,680 --> 00:28:10,810 Speaker 1: this podcast is Jackson Chan, Joan Chan Tiffany Ang and 538 00:28:10,819 --> 00:28:14,229 Speaker 1: Christina Robert and I'm Steven Chow, signing off.