1 00:00:03,759 --> 00:00:05,989 Speaker 1: You're listening to a CNA podcast. 2 00:00:10,590 --> 00:00:14,939 Speaker 2: Cancer is the leading cause of death here in Singapore. Now, 3 00:00:15,109 --> 00:00:18,939 Speaker 2: it's quite possibly the worst thing to happen to someone. 4 00:00:19,090 --> 00:00:23,309 Speaker 2: It exacts a heavy physical and emotional toll, but we 5 00:00:23,309 --> 00:00:26,700 Speaker 2: don't talk enough about the financial costs that tends to 6 00:00:26,700 --> 00:00:31,850 Speaker 2: blindside patients and their families. I'm Andrea Heng, and today 7 00:00:31,850 --> 00:00:35,509 Speaker 2: on the Money Talks podcast, we are confronting this harsh 8 00:00:35,509 --> 00:00:36,989 Speaker 2: reality head on. 9 00:00:37,418 --> 00:00:41,130 Speaker 2: I'm joined today by Dr. Dennis Chia. He is Group 10 00:00:41,130 --> 00:00:45,830 Speaker 2: director for clinical services at the Singapore Cancer Society. And together, 11 00:00:45,880 --> 00:00:49,720 Speaker 2: we will unpack for you the real costs, the support 12 00:00:49,720 --> 00:00:53,880 Speaker 2: structures in place, and the crucial conversations that we all 13 00:00:53,880 --> 00:00:56,759 Speaker 2: need to have. Hi, Dr. Chia. Hi, Andrea. All right, 14 00:00:56,919 --> 00:00:58,840 Speaker 2: good to have you here with us. Now, I would 15 00:00:58,840 --> 00:01:00,159 Speaker 2: imagine that the first thing 16 00:01:00,213 --> 00:01:02,932 Speaker 2: Someone thinks of when they get diagnosed with cancer, Dr. 17 00:01:03,042 --> 00:01:07,601 Speaker 2: Chia is their mortality. When does money come into the 18 00:01:07,602 --> 00:01:11,672 Speaker 2: picture and what's the first thing that patients ask about it? 19 00:01:11,883 --> 00:01:15,961 Speaker 2: The money starts to kicking from screening to diagnosis. So 20 00:01:15,962 --> 00:01:19,112 Speaker 2: screening does not give us the absolute diagnosis on whether 21 00:01:19,112 --> 00:01:21,722 Speaker 2: you have or not have cancer. That's just the first 22 00:01:21,722 --> 00:01:22,922 Speaker 2: layer of checks. That's right. 23 00:01:23,206 --> 00:01:26,115 Speaker 2: Yeah. So for example, if you have a fit kit 24 00:01:26,286 --> 00:01:30,346 Speaker 2: that's for testing colorectal cancer screening, if it's positive, you 25 00:01:30,346 --> 00:01:33,115 Speaker 2: need to take the next step to do a colonoscopy, 26 00:01:33,236 --> 00:01:35,846 Speaker 2: and that will be a cost. So that will be 27 00:01:35,846 --> 00:01:39,815 Speaker 2: what I call the pre-diagnosis stage. There will be costs involved. 28 00:01:40,084 --> 00:01:43,925 Speaker 2: And while it seems huge at this juncture, when you 29 00:01:43,926 --> 00:01:45,685 Speaker 2: think of going for a colonoscopy, 30 00:01:46,129 --> 00:01:49,889 Speaker 2: Not just in terms of finances, but the logistics and 31 00:01:49,889 --> 00:01:51,849 Speaker 2: the whole I need to take time away from work 32 00:01:51,849 --> 00:01:54,650 Speaker 2: kind of thing that comes at a cost. Yes, that's 33 00:01:54,650 --> 00:01:57,970 Speaker 2: an indirect cost. And if you think about it that way, 34 00:01:58,050 --> 00:02:01,680 Speaker 2: it seems huge, but if you actually find out early, 35 00:02:01,930 --> 00:02:06,489 Speaker 2: you might be saving costs downstream. When you speak with 36 00:02:06,489 --> 00:02:09,728 Speaker 2: patients that get diagnosed with cancer, at what point in 37 00:02:09,729 --> 00:02:09,869 Speaker 2: their 38 00:02:09,927 --> 00:02:13,905 Speaker 2: The journey, do they start asking you questions about money? 39 00:02:14,156 --> 00:02:18,036 Speaker 2: I would say quite early and everyone is different. We 40 00:02:18,037 --> 00:02:22,126 Speaker 2: go through this process of grief, even at the first 41 00:02:22,126 --> 00:02:24,796 Speaker 2: instance of diagnosis, if the patient says, no, I'm OK, 42 00:02:25,117 --> 00:02:27,957 Speaker 2: but perhaps they need time to process. We are generally 43 00:02:27,957 --> 00:02:31,796 Speaker 2: a very literate society, very collected and very rational in 44 00:02:31,796 --> 00:02:33,796 Speaker 2: our thoughts. So sometimes we don't. 45 00:02:33,873 --> 00:02:36,863 Speaker 2: Realize it until emotions set in a bit later, but 46 00:02:36,863 --> 00:02:40,823 Speaker 2: the topic of money do come early because there is 47 00:02:40,824 --> 00:02:45,143 Speaker 2: a huge consideration factor in whether I want to proceed 48 00:02:45,143 --> 00:02:48,384 Speaker 2: with what kind of treatment and the downstream. Is that 49 00:02:48,383 --> 00:02:50,444 Speaker 2: the first thing that they tend to ask how much 50 00:02:50,444 --> 00:02:53,384 Speaker 2: am I expected to pay? Quite often, at the first instance, 51 00:02:53,464 --> 00:02:56,123 Speaker 2: most of them will think about the money and it's 52 00:02:56,123 --> 00:02:57,744 Speaker 2: almost quite common. 53 00:02:58,011 --> 00:03:00,330 Speaker 2: I wouldn't say it's a majority, but in a recent study, 54 00:03:00,371 --> 00:03:04,011 Speaker 2: we realized that about 40% of them would actually be 55 00:03:04,011 --> 00:03:08,570 Speaker 2: very concerned about costs. So that's quite a huge significant number, 56 00:03:08,690 --> 00:03:12,930 Speaker 2: but not unexpected because we're quite a practical here. And 57 00:03:12,930 --> 00:03:16,330 Speaker 2: in Singapore, people always say it's about costs and you 58 00:03:16,330 --> 00:03:19,410 Speaker 2: cannot afford to be ill. Yeah, that's the thing. I'm 59 00:03:19,410 --> 00:03:21,610 Speaker 2: glad that you said that they cannot afford to be ill. 60 00:03:21,960 --> 00:03:24,789 Speaker 2: And when they get diagnosed with an illness, not just cancer, 61 00:03:24,910 --> 00:03:26,710 Speaker 2: the first thing that comes to their mind is how 62 00:03:26,710 --> 00:03:28,990 Speaker 2: much am I going to have to fork out to 63 00:03:28,990 --> 00:03:31,750 Speaker 2: treat myself. Why is that such a problem? I think 64 00:03:31,750 --> 00:03:35,830 Speaker 2: as a society, our views about money and financing is 65 00:03:35,830 --> 00:03:38,949 Speaker 2: something that in our radar all the time. There is 66 00:03:38,949 --> 00:03:42,710 Speaker 2: a high cost of living in Singapore and by and large, 67 00:03:42,809 --> 00:03:47,070 Speaker 2: when people talk about how am I doing financially, they 68 00:03:47,070 --> 00:03:49,429 Speaker 2: don't really talk about, oh, I need to prepare for 69 00:03:49,429 --> 00:03:50,470 Speaker 2: my cancer. 70 00:03:51,559 --> 00:03:54,880 Speaker 2: No one really thinks about that. So that comes as 71 00:03:54,880 --> 00:03:58,039 Speaker 2: a surprise. So can you imagine if you are living 72 00:03:58,039 --> 00:04:01,000 Speaker 2: day to day or month by month and suddenly you 73 00:04:01,000 --> 00:04:04,119 Speaker 2: have this diagnosis landing on your shoulders. The first thing 74 00:04:04,119 --> 00:04:06,570 Speaker 2: you will think about is that in the terms of proportion, 75 00:04:06,660 --> 00:04:09,199 Speaker 2: how much bigger is that going to cost compared to 76 00:04:09,199 --> 00:04:11,800 Speaker 2: my daily expenses? I think you nailed it right on 77 00:04:11,800 --> 00:04:13,960 Speaker 2: the head there, the fact that it's a shock and 78 00:04:13,960 --> 00:04:15,399 Speaker 2: people don't expect it 79 00:04:15,453 --> 00:04:18,484 Speaker 2: The moment they get that kind of diagnosis, we get 80 00:04:18,484 --> 00:04:20,963 Speaker 2: sent in a panic and that's human to react that way. 81 00:04:21,204 --> 00:04:24,644 Speaker 2: Let's go further. Once a person is diagnosed with cancer, 82 00:04:24,794 --> 00:04:27,003 Speaker 2: we want to talk about the treatment process that falls 83 00:04:27,003 --> 00:04:29,954 Speaker 2: in line after that. What can we expect to pay 84 00:04:30,283 --> 00:04:34,553 Speaker 2: in terms of post diagnosis expenses? So from the time 85 00:04:34,553 --> 00:04:37,963 Speaker 2: of diagnosis, I would maybe divide it into the direct 86 00:04:37,963 --> 00:04:39,963 Speaker 2: cost of the treatment, the healthcare treatment. 87 00:04:40,097 --> 00:04:42,488 Speaker 2: And all those, let's say a patient steps into the 88 00:04:42,488 --> 00:04:44,447 Speaker 2: consult room, the first thing you will know, you have 89 00:04:44,447 --> 00:04:46,768 Speaker 2: to pay a consult fee and then you have a 90 00:04:46,767 --> 00:04:51,347 Speaker 2: discussion about what treatment is appropriate and what your options. 91 00:04:51,778 --> 00:04:54,447 Speaker 2: So treatment come with costs. By and large, we have 92 00:04:54,447 --> 00:04:59,638 Speaker 2: the chemotherapy, the radiotherapy and surgery. So that's the more 93 00:04:59,638 --> 00:05:02,808 Speaker 2: direct scope in a way, and it's highly variable. The 94 00:05:02,808 --> 00:05:04,686 Speaker 2: cost is very variable depending 95 00:05:04,742 --> 00:05:07,811 Speaker 2: On the staging and not just about the disease, it's 96 00:05:07,812 --> 00:05:10,842 Speaker 2: also dependent on your options. Are you going to get 97 00:05:10,842 --> 00:05:13,372 Speaker 2: it at a restructured hospital? Are you going to get 98 00:05:13,372 --> 00:05:16,380 Speaker 2: it at a private hospital? And on top of that, 99 00:05:16,532 --> 00:05:19,721 Speaker 2: let's remember that it's not going to be just one consult. 100 00:05:19,891 --> 00:05:22,332 Speaker 2: You're going to have some follow-ups, so there will be 101 00:05:22,332 --> 00:05:25,182 Speaker 2: some consultation fees that will follow up. There will be 102 00:05:25,182 --> 00:05:28,721 Speaker 2: other things that will slowly kick in, for example, transport fees. 103 00:05:28,842 --> 00:05:29,332 Speaker 2: In the first 104 00:05:29,795 --> 00:05:32,895 Speaker 2: you might be still in a way physically and functioning 105 00:05:32,895 --> 00:05:35,895 Speaker 2: quite well. You could take public transport, perhaps, but there 106 00:05:35,895 --> 00:05:38,575 Speaker 2: will be additional costs. We all know simple things like 107 00:05:38,575 --> 00:05:42,335 Speaker 2: parking is expensive in the hospitals, things like that, things 108 00:05:42,335 --> 00:05:45,015 Speaker 2: that we take for granted every day as a well person. 109 00:05:45,096 --> 00:05:47,615 Speaker 2: Things like transport as an expense and it's something that 110 00:05:47,615 --> 00:05:51,316 Speaker 2: we have to factor in. What about longer term care expenses, 111 00:05:51,335 --> 00:05:53,895 Speaker 2: because like you said, there will be multiple consults later on. 112 00:05:54,320 --> 00:05:56,640 Speaker 2: Talk to us about the longer term costs. Yeah, so 113 00:05:56,640 --> 00:05:58,920 Speaker 2: the longer term, just now we mentioned a bit about 114 00:05:58,920 --> 00:06:03,559 Speaker 2: the treatment options. Let's say for chemotherapy, some of you 115 00:06:03,559 --> 00:06:06,200 Speaker 2: may not realize this, but you need to pay to 116 00:06:06,200 --> 00:06:09,988 Speaker 2: sit on the chemo chair. So these are considered as consumables. 117 00:06:10,200 --> 00:06:15,040 Speaker 2: So that's outside of the actual chemotherapy treatments. That's right. 118 00:06:15,279 --> 00:06:18,399 Speaker 2: So it could be packaged together, but there are costs 119 00:06:18,399 --> 00:06:19,279 Speaker 2: involved in that. 120 00:06:19,640 --> 00:06:23,660 Speaker 2: And just now we are speaking about transportation. So just 121 00:06:23,660 --> 00:06:26,510 Speaker 2: now we only touched about public transport and maybe private 122 00:06:26,510 --> 00:06:29,500 Speaker 2: car and car park fees, but the next thing we 123 00:06:29,500 --> 00:06:31,179 Speaker 2: need to think about is what if you need to 124 00:06:31,178 --> 00:06:34,390 Speaker 2: take a taxi because your blood count is low. You 125 00:06:34,390 --> 00:06:37,730 Speaker 2: can't be really taking public transport for your own safety, 126 00:06:38,029 --> 00:06:41,190 Speaker 2: and so that's taxi or private hire. 127 00:06:41,500 --> 00:06:43,599 Speaker 2: And then you have the next stage, which is when 128 00:06:43,600 --> 00:06:47,000 Speaker 2: you're really weak and in a way be bound and 129 00:06:47,000 --> 00:06:50,640 Speaker 2: you need to have treatment in the facilities outside, you 130 00:06:50,640 --> 00:06:54,880 Speaker 2: might even need to get an ambulance. Let's assume people 131 00:06:54,880 --> 00:06:57,790 Speaker 2: have insurance. Most people do have some kind of insurance. 132 00:06:57,920 --> 00:07:01,359 Speaker 2: Are all forms of cancer covered by most insurance plans here? 133 00:07:01,459 --> 00:07:04,928 Speaker 2: Singapore? I would say that there are many products outside 134 00:07:04,928 --> 00:07:08,368 Speaker 2: in terms of insurance products and I will not try 135 00:07:08,369 --> 00:07:12,109 Speaker 2: to be the master of all insurance products there. Uh, 136 00:07:12,209 --> 00:07:17,239 Speaker 2: it's highly variable. It's complicated. I would say buy insurance 137 00:07:17,329 --> 00:07:21,250 Speaker 2: early on, premiums will be much lower. That's number one. 138 00:07:21,750 --> 00:07:24,660 Speaker 2: Number 2, you never know when you get hit with something, 139 00:07:25,100 --> 00:07:28,070 Speaker 2: an illness or something that you discover later on. But 140 00:07:28,070 --> 00:07:31,029 Speaker 2: if you're covered early when you're healthy, premiums are lower 141 00:07:31,029 --> 00:07:34,149 Speaker 2: and you are likely to be covered for everything as 142 00:07:34,149 --> 00:07:37,350 Speaker 2: much as the product covers. And if you only do 143 00:07:37,350 --> 00:07:41,589 Speaker 2: it much later, you might be excluded for certain conditions 144 00:07:41,589 --> 00:07:45,269 Speaker 2: because of pre-existing illnesses or family history and premiums might 145 00:07:45,269 --> 00:07:48,739 Speaker 2: shoot up. Having said that, do declare and you 146 00:07:48,790 --> 00:07:52,260 Speaker 2: might be able to find insurers sometimes where they're willing 147 00:07:52,260 --> 00:07:56,730 Speaker 2: to cover pre-existing conditions, but at a higher premium, for example. 148 00:07:56,980 --> 00:08:00,769 Speaker 2: So some products, I think from my dad's personal experience, 149 00:08:00,859 --> 00:08:03,899 Speaker 2: they cover a list of more common cancers. So for 150 00:08:03,899 --> 00:08:06,459 Speaker 2: the very rare ones, it might not be covered. I'm 151 00:08:06,459 --> 00:08:09,690 Speaker 2: not too sure, but for the more advanced ones, perhaps 152 00:08:09,690 --> 00:08:13,339 Speaker 2: it will be covered because your other insurance coverage, if 153 00:08:13,339 --> 00:08:15,850 Speaker 2: you do have, probably will cover things like. 154 00:08:16,019 --> 00:08:23,559 Speaker 2: Hospitalization, follow up pre post hospitalization, outpatient treatments and expenses also, yeah. 155 00:08:23,809 --> 00:08:27,000 Speaker 2: I think my financial planner introduced this early critical illness 156 00:08:27,399 --> 00:08:29,290 Speaker 2: plan to me. I found it a bit expensive at 157 00:08:29,290 --> 00:08:31,869 Speaker 2: the time, but maybe it's time for me to reconsider. 158 00:08:31,970 --> 00:08:36,289 Speaker 2: So even for myself, I got insured really early. First 159 00:08:36,289 --> 00:08:40,400 Speaker 2: year at work, I got my financial advisor to really 160 00:08:40,400 --> 00:08:43,169 Speaker 2: insure whatever I could and whatever I could afford. 161 00:08:43,880 --> 00:08:46,239 Speaker 2: Really, I think it's a need to balance. You need 162 00:08:46,239 --> 00:08:48,469 Speaker 2: some coverage, but you need to really look at what 163 00:08:48,469 --> 00:08:51,750 Speaker 2: you can afford and what's the best value. Don't shun 164 00:08:51,750 --> 00:08:55,520 Speaker 2: it completely. So you talked about some of the costs earlier, 165 00:08:55,760 --> 00:08:58,630 Speaker 2: direct and indirect costs. Can we talk about the range? 166 00:08:58,679 --> 00:09:03,880 Speaker 2: So from doctor's appointments to chemotherapy to radiotherapy, etc. and 167 00:09:03,880 --> 00:09:07,319 Speaker 2: follow-ups as well. I understand that they can be provided 168 00:09:07,320 --> 00:09:10,140 Speaker 2: or offered as a package, but perhaps give us a 169 00:09:10,140 --> 00:09:11,000 Speaker 2: ballpark range. 170 00:09:11,357 --> 00:09:13,838 Speaker 2: If you will, so that we just have a clearer 171 00:09:13,838 --> 00:09:18,907 Speaker 2: understanding of the digit. So perhaps before subsidies in a 172 00:09:18,908 --> 00:09:22,367 Speaker 2: restructured hospital, by and large you're talking about ranging up 173 00:09:22,367 --> 00:09:26,018 Speaker 2: to a 5 digit figure for all of the treatment 174 00:09:26,018 --> 00:09:30,018 Speaker 2: and it depends on in total. I need to assure 175 00:09:30,018 --> 00:09:32,367 Speaker 2: you that while I say that it goes up to 5, 176 00:09:32,518 --> 00:09:35,756 Speaker 2: and even for some specific cancer treatments, it goes up 177 00:09:35,756 --> 00:09:38,437 Speaker 2: to 6 digit figures like 200 over 1000. 178 00:09:38,976 --> 00:09:44,546 Speaker 2: It can be as low as a few hundreds to thousands, 179 00:09:44,556 --> 00:09:48,075 Speaker 2: that kind of range, and there are assistant, welfare assistance, 180 00:09:48,315 --> 00:09:51,875 Speaker 2: financial assistance available from the government side all the way 181 00:09:51,875 --> 00:09:55,866 Speaker 2: to even in Singapore Cancer Society. Be assured that there 182 00:09:55,866 --> 00:10:00,755 Speaker 2: are people and there are organizations trying to help everyone 183 00:10:00,755 --> 00:10:05,026 Speaker 2: defray that. Just out of curiosity, what's the most common 184 00:10:05,026 --> 00:10:05,916 Speaker 2: expense that is 185 00:10:05,984 --> 00:10:08,554 Speaker 2: Unexpected, out of pocket. Oh, I didn't know I had 186 00:10:08,554 --> 00:10:11,564 Speaker 2: to pay for this. Is there anything else that perhaps 187 00:10:11,564 --> 00:10:13,693 Speaker 2: may not have crossed our minds? I think we have 188 00:10:13,693 --> 00:10:17,874 Speaker 2: to remember the day to day expenses, for example, milk feeds. 189 00:10:18,593 --> 00:10:21,193 Speaker 2: So when you are getting a bit weaker and you 190 00:10:21,193 --> 00:10:24,734 Speaker 2: can't really consume very much, you need specialized milk feeds 191 00:10:24,994 --> 00:10:28,924 Speaker 2: or temporary or permanently you might require a nasogastric tube, 192 00:10:29,033 --> 00:10:31,914 Speaker 2: the tube that goes down, and those are really ongoing 193 00:10:31,914 --> 00:10:33,314 Speaker 2: costs and you still have things. 194 00:10:33,401 --> 00:10:39,030 Speaker 2: Like perhaps diapers, stoma bags. So there are such consumables 195 00:10:39,030 --> 00:10:43,392 Speaker 2: that are high volumes or price per item, but they 196 00:10:43,392 --> 00:10:46,872 Speaker 2: eat into your expenses and a caregiver as well if 197 00:10:46,872 --> 00:10:49,671 Speaker 2: it's so needed. Yeah, that's right. Since we're touching a 198 00:10:49,671 --> 00:10:54,021 Speaker 2: little bit more about the indirect costs involved, family caregiving, 199 00:10:54,151 --> 00:10:58,692 Speaker 2: besides the emotional costs, there is a financial cost of caregiving, 200 00:10:59,011 --> 00:11:00,711 Speaker 2: instance of absenteeism. 201 00:11:01,010 --> 00:11:04,500 Speaker 2: And if let's say you're working on an hourly wage, 202 00:11:04,599 --> 00:11:07,760 Speaker 2: for example, or project based, you can't do certain work, 203 00:11:07,950 --> 00:11:11,479 Speaker 2: you're losing income. It's not just the usual, I take 204 00:11:11,479 --> 00:11:14,890 Speaker 2: leave or take family care leave and I'm I'm OK. 205 00:11:15,119 --> 00:11:17,760 Speaker 2: And if I talk a little bit more about the 206 00:11:17,760 --> 00:11:23,000 Speaker 2: kind of family impact and longer term impact, we also 207 00:11:23,000 --> 00:11:23,479 Speaker 2: have to consider. 208 00:11:23,562 --> 00:11:27,660 Speaker 2: The children, the children who sometimes may have to pause 209 00:11:27,910 --> 00:11:31,471 Speaker 2: their tertiary education because they need to do caregiving duties, 210 00:11:31,552 --> 00:11:35,511 Speaker 2: that's an impact later on on their own career and 211 00:11:35,511 --> 00:11:38,911 Speaker 2: their own income. Of course, not forgetting their own personal 212 00:11:38,910 --> 00:11:42,831 Speaker 2: loss of income. We do have a lot to survive 213 00:11:42,831 --> 00:11:45,981 Speaker 2: the cancers, very gladly that they are in remission. 214 00:11:46,114 --> 00:11:48,463 Speaker 2: And they return back to work. So we do try 215 00:11:48,463 --> 00:11:51,093 Speaker 2: to support all of these things to make up for 216 00:11:51,304 --> 00:11:55,023 Speaker 2: the financial issues that they have. Anecdotally, there are cases 217 00:11:55,023 --> 00:11:57,823 Speaker 2: in which cancer patients have been able to tap on 218 00:11:57,823 --> 00:12:01,583 Speaker 2: company insurance for some of these costs. I have a 219 00:12:01,583 --> 00:12:04,463 Speaker 2: friend who did just that and it was quite a 220 00:12:04,463 --> 00:12:08,414 Speaker 2: unique situation for her because she had just gotten this job. 221 00:12:08,666 --> 00:12:11,056 Speaker 2: And she got her cancer diagnosis maybe a month or 222 00:12:11,056 --> 00:12:14,976 Speaker 2: two into it and that company was very kind. They said, 223 00:12:15,015 --> 00:12:16,856 Speaker 2: you know what, go and take the time that you 224 00:12:16,856 --> 00:12:19,625 Speaker 2: need to go and recover. You can tap on our 225 00:12:19,625 --> 00:12:22,535 Speaker 2: company insurance and I've been told that's actually a better 226 00:12:22,535 --> 00:12:27,175 Speaker 2: route to tap on company insurance before your personal insurance 227 00:12:27,176 --> 00:12:30,155 Speaker 2: because in that story I just told you, she was 228 00:12:30,155 --> 00:12:31,175 Speaker 2: able to 229 00:12:31,729 --> 00:12:35,969 Speaker 2: Undergo more specialized, more expensive treatments so that she can 230 00:12:35,969 --> 00:12:39,760 Speaker 2: recover better. What do you say about that? By and large, 231 00:12:40,010 --> 00:12:40,809 Speaker 2: I would say that. 232 00:12:41,130 --> 00:12:45,840 Speaker 2: The company insurance, just like personal insurance, really varies with 233 00:12:45,840 --> 00:12:49,520 Speaker 2: the product and the coverage, and I would say that 234 00:12:49,520 --> 00:12:52,080 Speaker 2: if let's say you are diagnosed with cancer and you 235 00:12:52,080 --> 00:12:55,760 Speaker 2: have a discussion about treatment options, yes, by all means 236 00:12:55,760 --> 00:12:58,880 Speaker 2: do check in with your company, whether it's HR or 237 00:12:58,880 --> 00:13:01,559 Speaker 2: who is responsible, to check if you can actually tap 238 00:13:01,559 --> 00:13:04,559 Speaker 2: on company insurance. And I think that discussion is very 239 00:13:04,559 --> 00:13:07,890 Speaker 2: much on the discretion of the company and in this case, 240 00:13:07,945 --> 00:13:11,375 Speaker 2: She's very fortunate and it's wonderful to hear that we 241 00:13:11,375 --> 00:13:13,974 Speaker 2: have companies that actually do that. I think it's exemplary, 242 00:13:14,135 --> 00:13:18,255 Speaker 2: but however, we understand the resource limitations. Not all companies 243 00:13:18,255 --> 00:13:21,974 Speaker 2: can afford that kind of premiums and the other economics 244 00:13:21,974 --> 00:13:24,895 Speaker 2: that runs behind the scenes. So smaller companies may not 245 00:13:24,895 --> 00:13:27,294 Speaker 2: have that kind of insurance, and if a lot of 246 00:13:27,294 --> 00:13:30,934 Speaker 2: their staff actually have claims, it may affect premiums and 247 00:13:30,934 --> 00:13:33,135 Speaker 2: all of those. So there's a lot of such considerations 248 00:13:33,135 --> 00:13:34,614 Speaker 2: down the road, but as a patient, 249 00:13:35,010 --> 00:13:37,619 Speaker 2: You would want to take that step to tap on 250 00:13:37,619 --> 00:13:41,659 Speaker 2: the company insurance, because any way to defray the costs 251 00:13:41,659 --> 00:13:45,020 Speaker 2: will matter down the road. Now Dr. Chia, we all 252 00:13:45,020 --> 00:13:48,098 Speaker 2: hope to optimize our finances during this time. So before 253 00:13:48,099 --> 00:13:50,619 Speaker 2: we need to tap on insurance, perhaps let's take a 254 00:13:50,619 --> 00:13:52,699 Speaker 2: look at what is subsidized now. So 255 00:13:52,940 --> 00:13:55,609 Speaker 2: Can you tell us about subsidies in the area of 256 00:13:55,609 --> 00:14:01,159 Speaker 2: cancer expenses? The general framework of subsidies for Singapore healthcare 257 00:14:01,409 --> 00:14:04,799 Speaker 2: in a restructured hospital would include the basic subsidies that 258 00:14:04,799 --> 00:14:08,809 Speaker 2: we receive, whether you're Singaporean or Singapore PR, so that's 259 00:14:08,809 --> 00:14:10,770 Speaker 2: up to 80% or 50%. 260 00:14:11,109 --> 00:14:14,570 Speaker 2: And then you can tap on the MediShield Life and 261 00:14:14,570 --> 00:14:17,719 Speaker 2: you have another safety net, which is the MediFund for 262 00:14:17,719 --> 00:14:21,159 Speaker 2: those who are really needy and not forgetting MediSave that 263 00:14:21,159 --> 00:14:24,239 Speaker 2: you have from your CPF, that's your own personal savings 264 00:14:24,239 --> 00:14:26,469 Speaker 2: in a way. And on top of that, that's when 265 00:14:26,469 --> 00:14:30,549 Speaker 2: we actually would find we need to have other help 266 00:14:30,840 --> 00:14:34,630 Speaker 2: from whether it's a personal insurance, whether it's company insurance, 267 00:14:34,840 --> 00:14:35,690 Speaker 2: or some 268 00:14:35,734 --> 00:14:39,205 Speaker 2: For other assistance, like in Singapore Cancer Society, we also 269 00:14:39,205 --> 00:14:44,585 Speaker 2: provide additional welfare or financial assistance to patients who after 270 00:14:44,585 --> 00:14:48,005 Speaker 2: tapping on all these big items, they find that they 271 00:14:48,005 --> 00:14:50,684 Speaker 2: still can't cope with the cost. And it is a 272 00:14:50,684 --> 00:14:53,405 Speaker 2: heavy cost as well. Just a segue here, Dr. Chia. 273 00:14:53,565 --> 00:14:57,674 Speaker 2: I know of an ALS patient who is undergoing trial 274 00:14:57,674 --> 00:15:00,195 Speaker 2: right now for a new kind of treatment for ALS. 275 00:15:00,640 --> 00:15:03,979 Speaker 2: And it's heavily subsidized. Do we have this in the 276 00:15:03,979 --> 00:15:06,820 Speaker 2: field of oncology? And if so, is this an option 277 00:15:06,820 --> 00:15:10,789 Speaker 2: that we should consider, especially when we are trying to 278 00:15:11,260 --> 00:15:14,750 Speaker 2: manage our finances a bit better. Quick answer is that yes, 279 00:15:14,780 --> 00:15:19,400 Speaker 2: you can consider. Again, it's case by case, depending on 280 00:15:19,400 --> 00:15:22,820 Speaker 2: the trial, and by and large, they will cover things 281 00:15:22,820 --> 00:15:27,260 Speaker 2: like the new treatment options, the follow-up consults that are 282 00:15:27,260 --> 00:15:30,859 Speaker 2: related to the new treatment options, and be assured also 283 00:15:30,859 --> 00:15:33,890 Speaker 2: that um they always fall back on the gold standard 284 00:15:33,890 --> 00:15:37,090 Speaker 2: current in case anything differs from there. 285 00:15:37,400 --> 00:15:39,669 Speaker 2: Uh, for example, the treatment outcomes are not as ideal. 286 00:15:39,780 --> 00:15:42,580 Speaker 2: They always fall back on what is the current best 287 00:15:42,580 --> 00:15:45,739 Speaker 2: gold standard in that sense. But it could differ again 288 00:15:45,739 --> 00:15:49,219 Speaker 2: for new trials depending on the scope and also it 289 00:15:49,219 --> 00:15:53,719 Speaker 2: depends on your own wishes as a patient, on understanding 290 00:15:53,719 --> 00:15:56,859 Speaker 2: really whether there is a risk, what's the risk involved, 291 00:15:56,979 --> 00:15:58,260 Speaker 2: what's your risk appetite. 292 00:15:58,539 --> 00:16:02,659 Speaker 2: So that's very much dependent on your discussion. Be assured 293 00:16:02,659 --> 00:16:06,580 Speaker 2: that all these trials go through ethics, go through a 294 00:16:06,580 --> 00:16:10,049 Speaker 2: lot of rigorous testing before that. So the safety profile 295 00:16:10,049 --> 00:16:13,059 Speaker 2: is not completely established, but it's safe enough for us 296 00:16:13,059 --> 00:16:16,419 Speaker 2: to conduct human trials. That's the kind of assurance that 297 00:16:16,419 --> 00:16:18,989 Speaker 2: we give you. But really, at the end of the day, 298 00:16:19,039 --> 00:16:20,140 Speaker 2: I can tell you all these 299 00:16:20,440 --> 00:16:22,929 Speaker 2: But when I'm sitting on a chair as a patient, 300 00:16:23,099 --> 00:16:27,340 Speaker 2: deciding really make that decision together with our loved ones 301 00:16:27,340 --> 00:16:31,419 Speaker 2: and be very well informed about what you're getting yourself into. Yeah, absolutely. 302 00:16:31,619 --> 00:16:34,450 Speaker 2: I think that was a really good piece of advice there. 303 00:16:34,700 --> 00:16:37,419 Speaker 2: We can say everything and provide you with all the 304 00:16:37,419 --> 00:16:39,780 Speaker 2: information there is out there, but ultimately you're the one 305 00:16:39,780 --> 00:16:41,710 Speaker 2: that is, like you said, sitting in that chair. 306 00:16:42,020 --> 00:16:45,530 Speaker 2: Getting the treatment, what will be covered or subsidized if 307 00:16:45,530 --> 00:16:48,419 Speaker 2: the cancer comes back? So by and large, government subsidies 308 00:16:48,419 --> 00:16:52,330 Speaker 2: will still apply because that's a cross board. But however, 309 00:16:52,619 --> 00:16:57,739 Speaker 2: in terms of company insurance or personal insurance, it really depends. 310 00:16:58,059 --> 00:17:00,609 Speaker 2: When you describe such a scenario, people will think about 311 00:17:00,609 --> 00:17:05,510 Speaker 2: the multipay critical illness coverage. So that's the kind of 312 00:17:05,510 --> 00:17:10,410 Speaker 2: protect individuals from a relapse or a second critical condition. 313 00:17:10,640 --> 00:17:13,400 Speaker 2: And they will have their payouts according to the products 314 00:17:13,400 --> 00:17:15,119 Speaker 2: that you bought. What about 315 00:17:16,030 --> 00:17:21,380 Speaker 2: Medical complications that arise from having cancer, are those covered 316 00:17:21,630 --> 00:17:25,270 Speaker 2: by subsidies and insurance plans as well? So things like 317 00:17:25,270 --> 00:17:31,500 Speaker 2: mental health illnesses, depression, anxiety, and whether it's rehabilitation needs, 318 00:17:31,790 --> 00:17:35,780 Speaker 2: these are generally subsidized if you go by the subsidized 319 00:17:35,780 --> 00:17:38,988 Speaker 2: route at the restructured hospitals, but if you're going by 320 00:17:38,989 --> 00:17:42,280 Speaker 2: the private way, then it's not subsidized unfortunately. 321 00:17:42,625 --> 00:17:44,675 Speaker 2: And you still have to tap on your insurance depending 322 00:17:44,675 --> 00:17:48,114 Speaker 2: on your products. Usually most of the products out there, 323 00:17:48,275 --> 00:17:52,135 Speaker 2: if they're not multipay critical illness, it's one time and 324 00:17:52,135 --> 00:17:56,224 Speaker 2: your policy kind of terminates and ends. Have you heard 325 00:17:56,224 --> 00:18:00,395 Speaker 2: of patients toggling between private and public during their cancer 326 00:18:00,395 --> 00:18:04,994 Speaker 2: treatment just to maximize and optimize their financial positions? Have 327 00:18:04,994 --> 00:18:07,114 Speaker 2: you seen such scenarios because it suddenly came to my 328 00:18:07,114 --> 00:18:07,564 Speaker 2: mind that 329 00:18:07,829 --> 00:18:09,989 Speaker 2: I would do that if I could. So it's not 330 00:18:09,989 --> 00:18:13,609 Speaker 2: uncommon if someone says that I heard that this doctor 331 00:18:13,609 --> 00:18:17,050 Speaker 2: is really good, but he's in private practice. So I 332 00:18:17,050 --> 00:18:19,930 Speaker 2: will go to the private side to see him and 333 00:18:19,930 --> 00:18:22,050 Speaker 2: have part of the treatment there and then I'll go 334 00:18:22,050 --> 00:18:23,770 Speaker 2: subsidize for part of another treatment. 335 00:18:24,020 --> 00:18:26,579 Speaker 2: So that's also whether it's going to be covered by 336 00:18:26,579 --> 00:18:29,780 Speaker 2: subsidy and are you allowed to do that. It's highly variable. 337 00:18:29,819 --> 00:18:33,180 Speaker 2: You have options, but whether you receive the same subsidies 338 00:18:33,180 --> 00:18:37,260 Speaker 2: and all those, it really varies. Yeah. And I hate 339 00:18:37,260 --> 00:18:39,958 Speaker 2: to paint the worst case scenario, but we have to. 340 00:18:40,339 --> 00:18:44,900 Speaker 2: There are cancer patients who may not be insured. You 341 00:18:44,900 --> 00:18:46,900 Speaker 2: can be of low income but you are insured, but 342 00:18:46,900 --> 00:18:49,140 Speaker 2: what if you have the double whammy? You are not 343 00:18:49,140 --> 00:18:52,510 Speaker 2: insured and you don't have the finances to fund your 344 00:18:52,510 --> 00:18:53,218 Speaker 2: cancer treatment. 345 00:18:53,599 --> 00:18:56,639 Speaker 2: What can they do then? What kind of support is available? 346 00:18:56,750 --> 00:19:00,958 Speaker 2: So by and large, charities will help to support some 347 00:19:00,959 --> 00:19:04,560 Speaker 2: of these, and while I say that statement, I think 348 00:19:04,560 --> 00:19:06,800 Speaker 2: someone who has just a cancer diagnosis will be asking 349 00:19:06,800 --> 00:19:09,800 Speaker 2: me what do I do next? For example, you can 350 00:19:09,800 --> 00:19:14,560 Speaker 2: always come and approach Singapore Cancer Society. We have a hotline, 1-800. 351 00:19:15,030 --> 00:19:19,500 Speaker 2: SES, which stands for 7273333. So you can always share 352 00:19:19,500 --> 00:19:22,030 Speaker 2: with us, whether it's for financial assistance or other kind 353 00:19:22,030 --> 00:19:26,069 Speaker 2: of assistance to find out where else can I get 354 00:19:26,069 --> 00:19:28,699 Speaker 2: help and we try to help you navigate that journey. 355 00:19:29,150 --> 00:19:32,109 Speaker 2: Even my friends who had cancer didn't realize that we 356 00:19:32,109 --> 00:19:38,069 Speaker 2: have this cancer care fund. So if you have a 357 00:19:38,069 --> 00:19:41,199 Speaker 2: diagnosis and within the 6 months and you hold 358 00:19:42,540 --> 00:19:45,599 Speaker 2: a blue card or orange card, you can just approach 359 00:19:45,599 --> 00:19:48,199 Speaker 2: us and let us know and we can give you 360 00:19:48,199 --> 00:19:52,750 Speaker 2: a once-off financial support. Currently, it's for the Blue charge card, 361 00:19:52,760 --> 00:19:56,478 Speaker 2: it's $1000 once off and $500 once off for the 362 00:19:56,479 --> 00:20:01,040 Speaker 2: orange card. Dr. Chia, any parting remarks? I would say 363 00:20:01,040 --> 00:20:04,270 Speaker 2: number one is that having a cancer diagnosis is not 364 00:20:04,270 --> 00:20:07,920 Speaker 2: a death sentence. Do not be afraid to face it. 365 00:20:08,510 --> 00:20:12,270 Speaker 2: Because we are here at Singapore Cancer Society to try 366 00:20:12,270 --> 00:20:17,310 Speaker 2: and support everyone. And #2, do not be afraid about 367 00:20:17,310 --> 00:20:21,540 Speaker 2: the costs. Someone is going to help you and really, 368 00:20:21,630 --> 00:20:23,790 Speaker 2: if you don't know where to approach, give us a 369 00:20:23,790 --> 00:20:26,429 Speaker 2: call and we will try our best to help you 370 00:20:26,430 --> 00:20:27,829 Speaker 2: navigate through the system. 371 00:20:28,410 --> 00:20:31,650 Speaker 2: Do not fear about going for screening and all these 372 00:20:31,650 --> 00:20:36,089 Speaker 2: early prevention, early diagnosis is always the key to a 373 00:20:36,089 --> 00:20:40,290 Speaker 2: very good quality of life, even if you have cancer. Yeah. 374 00:20:40,770 --> 00:20:43,050 Speaker 2: I think the biggest takeaway from that is Dr. Chia, 375 00:20:43,290 --> 00:20:45,550 Speaker 2: all you need to do is reach out for help. Yes, 376 00:20:45,729 --> 00:20:49,209 Speaker 2: and someone will be there. Vital information and valuable advice. 377 00:20:49,329 --> 00:20:51,329 Speaker 2: Thank you so much for sharing them, Dr. Chia. Thank 378 00:20:51,329 --> 00:20:55,050 Speaker 2: you very much, Andrea. Now, if you know a cancer patient, 379 00:20:55,290 --> 00:20:56,130 Speaker 2: send this episode. 380 00:20:56,250 --> 00:21:00,859 Speaker 2: Cross, speak to your medical professional, and as always, reach out, 381 00:21:00,959 --> 00:21:03,239 Speaker 2: someone is going to be there to hold your hand 382 00:21:03,239 --> 00:21:05,399 Speaker 2: and walk you through the process. You can find Money 383 00:21:05,400 --> 00:21:09,359 Speaker 2: Talks on Apple Podcasts, Spotify, YouTube, as well as the 384 00:21:09,359 --> 00:21:13,468 Speaker 2: Me Listen app. Leave us a rating while you are there. 385 00:21:13,560 --> 00:21:16,639 Speaker 2: And a big thank you to Tiffany Ang, Junaini Johari, 386 00:21:16,800 --> 00:21:21,119 Speaker 2: Joanne Chan, Hanida Amin, and Arjun Bala. I'm Andrea Heng, 387 00:21:21,400 --> 00:21:23,589 Speaker 2: and this has been the Money Talks podcast. Thank you 388 00:21:23,589 --> 00:21:24,119 Speaker 2: for listening.