Discussion Forum - Archives

The fundamental issue undergirding the rationale for healthcare subsidies is essentially one of resource distribution. It is no doubt that PRs settle down in Singapore and contribute to the economy of Singapore. However, to discount the economic contributions made by citizens of Singapore and thereafter manifest a "non-discriminatory" approach to provide subsidies in healthcare is akin to downplaying the significance and value of being a citizen of Singapore. There will come a point whereby PRs will be posed with a choice on whether to convert their residence status to citizenship status. It is then appropriate to 'reward' those with a genuine attitude to take root in this land as a citizen with more benefits, so that citizenship becomes a special privilege.

I think this is a unfortunate and populist move to assuage the concerns of a few parochial people while giving no real benefit to the Singaporean community at large.  If anything, it actually detracts from the and attractiveness of Singapore as a place to come and work and live.  

There is an economic opportunity cost foregone by PRs and/or their Singapore citizen families by PRs being deterred from seeking medical care or delaying seeking medical care, potentially leading to more costly and expensive treatment down the road (and consequently greater total AMOUNT of subsidy the state has to pay, notwithstanding the reduced percentage).

Needless to say, potential delays in seeking treatment because of this short sighted policy may result in a more unhealthy population overall, economic cost to employers, and social costs to families, including Singapore citizen families.

Further, in cases of potential infectious or communicable diseases, there may be unintended effects where patients delay seeking treatment or refuse further diagnostic tests due to the higher cost, and when it is not clear what the disease is, there is often no grounds to detain the patient under public health legislation or regulations.  Thus, a PR patient may subsequently leave hospital and inadvertently spread disease among the population, worsening the overall public health and causing significant economic loss and subsequent healthcare cost.

Finally, this would lead to a further sense of discrimination and make Singapore a less attractive place for citizens from relatively more developed places like Australia, USA, Europe, Canada, Japan etc. from moving here since the opportunity cost of them foregoing their own citizenship is far higher than those from less developed countries.  This is turn robs Singapore of their talent and abilities, potentially making us lose out on economic growth and development and losing some dynamism.  It may also cause us to lose some of our upwardly mobile and bright Singaporeans who would be inclined to move to another place more welcoming of them and/or their spouses, and these Singaporeans who have the ability and means to do so would have fewer qualms about moving to countries with comparable standards of living where (by and large) they do not actively discriminate against permanent residents compared to citizens, while conversely, Singaporeans with partners from less developed places would still take their spouses to Singapore and have little disincentive to naturalise them.

In summary, such a policy, while superficially appealing to demagogues in a dog-whistle sort of way, does very little actual good for most Singaporeans and Singapore in general, and indeed could potentially do significant harm.  As such, I hope the government and opposition will recognise the futility and inherent populism of such a policy and come to a bipartisan agreement to abolish it in the future without cheap political point scoring.