Enhancing Medishield: Better Coverage for Singaporeans

As you may have already know by now, MOH is undergoing a major enhancement exercise on the medishield coverage for all Singaporeans. These changes will impact all existing medishield plans members as well as CPF members holding private integrated shield plan coverage from the major 5 insurers namely: NTUC, GE, Prudential, AIA and Aviva.

The new Private Integrated Shield plans will most probably be launched in the month of Mar 2013 and with some standardisation to the types of plans and benefits offered by the different insurers, the public will now have a easier time making comparison between plans and similar plans offered by different insurers.

That being said, most of these changes has been initiated by MOH which makes some long awaited changes to the basic Medishield plan. Do read the abstract from MOH website below or follow the link to get the full article published on MOH website:

"The Ministry of Health (MOH) held a public consultation in July and August to solicit feedback on the proposed MediShield enhancements to improve coverage and make MediShield more inclusive.

2     All the proposed enhancements received strong support from the vast majority of respondents (see Table 1 in Annex A for details). MOH will thus implement all the proposed enhancements.

3     MOH will also consider the extension of coverage to congenital and neonatal conditions as part of a broader review on supporting healthcare costs for children. This will tie in with on-going deliberations on encouraging marriage and parenthood as well as the “Our Singapore Conversation” (OSC) taking place to shape a consensus on the future of Singapore. For example, Prime Minister suggested earlier that a Medisave account could be set up for newborns and the Government could consider providing a start-up amount for childhood medical expenses. These ideas, including the proposed extension to cover congenital and neonatal conditions under MediShield will be surfaced for discussion at various OSC platforms.

4     Members of public also shared many additional ideas for further improvements to the MediShield scheme, some of which will be adopted for implementation in this round of review (see Table 2 in Annex A for details). Among them, MOH will be increasing the Medisave withdrawal limits for premiums, to fully cover basic MediShield premiums at all ages. MOH will also be removing the maximum entry age of 75 to help more uninsured but healthy elderly obtain insurance coverage. Other suggestions, such as for MediShield to cover outpatient treatment will require further detailed study as it is a major shift in MediShield’s focus and could have significant impact on the premiums.

MediShield Enhancements Effective From 1 March 2013

5     In summary, MOH, in consultation with the public, will make the following enhancements and changes to MediShield from 1 March 2013:

Proposed by MOH

a. Increase the maximum coverage age to 90;

b. Extend coverage to inpatient psychiatric treatment at $100 per day up to 35 days per year;

c. Increase the policy year and lifetime limits from $50,000 to $70,000 and from $200,000 to $300,000 respectively;

d. Extend coverage to short-stay wards in Emergency Departments; and

e. Increase the Class B2/C deductibles moderately by $500 for those aged 80 and below¹.

Additional changes arising from public feedback

a. Increase the Medisave withdrawal limits for MediShield and Integrated Shield Plans premiums from $800 to $1,000 for those aged 76 to 80 and from $1,150 to $1,200 for those above age 80; and

 b. Remove the MediShield maximum entry age of 75 to enable healthy uninsured elderly to obtain coverage.

Update of Premiums : read the full article here.

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Getting the Fats Right!

sources: http://www.hpb.gov.sg

You probably know that you should not consume too much fat. But is fat all bad? What else should you know about this nutrient? Read on to find out.

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Fat plays an important role in our body, functioning as an energy store, a cushion for vital organs and a transport system for fat-soluble vitamins. That is why we require some fat in our diet. However, as fat is a concentrated source of calories (9kcal/g compared to 4kcal/g for carbohydrate and protein), eating too much may lead to weight gain and obesity.

So how much fat should I have?

Fat should make up about 25-30% of our total energy intake. Based on a typical 2000kcal diet, the total fat allowance is about 55 to 65g a day. It’s easy to exceed this allowance if one is not mindful. For example, if you have a curry puff for breakfast, a bowl of laksa for lunch and a plate of chicken rice for dinner, you would have already consumed 70g of fat.

Are there different types of fat?

Yes, there are 4 types of fat:

• Saturated fat
• Monounsaturated fat
• Polyunsaturated fat
• Trans fat

Fats and oils in food are a mixture of saturated and unsaturated fats. There is usually a higher proportion of a particular type of fat in the mixture. Fats or oils that contain mostly saturated fat are often termed "saturated fat"; likewise, those that contain mostly unsaturated fat of either type are termed "monounsaturated fat" or "polyunsaturated fat".

Did you know that different types of fat can affect your health differently?

The “bad” fats

• Trans fat

Trans fat is formed when vegetable oils undergo hydrogenation, an industrial process that hardens liquid oil to produce fats like hard margarine and shortening. Trans fat raises LDL (‘bad’) cholesterol and lowers HDL (‘good’) cholesterol levels, thus increasing the risk of heart disease. The main sources of trans fat in our diet are pastries, cakes, cookies, biscuits, commercially deep-fried food as well as products containing vegetable shortening and hydrogenated or partially hydrogenated oils.

• Saturated fat

A diet high in saturated fat raises the level of LDL-cholesterol in our body, which increases the risk of heart disease. Major sources of saturated fat include animal fats (e.g. lard, fatty meat, skin of poultry); high-fat dairy products (e.g. full cream milk, butter, ghee); food prepared with palm-based vegetable oil; as well as dishes containing coconut milk or coconut cream.

The “good” fats

• Polyunsaturated fat

There are two main families of polyunsaturated fat: omega-3 and omega-6.

Omega-3 fat helps reduce blood clotting in the arteries, protects arteries from hardening, and reduces the level of triglycerides in the blood. This in turn lowers the risk of heart disease. Good sources of omega-3 fat include fish e.g. salmon, sardine, longtail shad (terubok) and Spanish mackerel (tenggiri papan); walnuts; canola oil and soybean oil; as well as products enriched or fortified with omega-3 (e.g. bread and eggs).

Omega-6 fat also helps improve heart health by reducing total and LDL-cholesterol levels in the blood. Good sources of omega-6 fat include: vegetable oils (e.g. corn oil, soybean oil and sunflower oil); and seeds (e.g. sunflower seeds and sesame seeds).

• Monounsaturated fat

Monounsaturated fat tends to lower total and LDL-cholesterol (“bad” cholesterol) levels in the body. Food rich in monounsaturated fat include vegetable oils (e.g. olive oil, canola oil and peanut oil); most nuts (e.g. almonds, cashew nuts and hazelnuts); as well as avocados.

So what should I do?

As part of healthy eating, aim to consume fat in moderate amounts. Remember, having too much fat, even the ‘good’ types, will provide excess calories. Limit the intake of saturated fat and trans fat in your diet, and replace them with unsaturated fats. Here are some ways for you to do just that:

At home

• Use less oil in cooking. Choose oils higher in unsaturated fat, and avoid re-using oils more than twice.
• Adopt healthier cooking methods (e.g. steaming, baking) more often. Replace coconut milk or coconut cream in cooking with low fat milk.
• Use fat spreads (e.g. margarine, butter, kaya, peanut butter) sparingly.
• Choose low fat dairy products, lean meats, fish and skinless poultry
• Consume fish at least twice a week. Replace meat in dishes with beans and bean products (e.g. tofu) on some days.

When eating out

• Choose dishes prepared without coconut cream or coconut milk
• Replace fried noodles with soup noodles occasionally
• Limit deep-fried food to no more than twice a week.
• Consume high-fat bakery products (e.g. pastries, cakes and cookies) less often.
• Remove visible fat and skin from meat and poultry.
• Ask for less oil and gravy in food.

When shopping

• Read the ingredient list to identify products that contain hydrogenated or partially hydrogenated fats/oils/shortening. These are likely to be high in saturated and trans fat.
• Read the Nutrition Information Panel on food labels to compare the amount of fat in food products.
• Choose products with the Healthier Choice Symbol as they are lower in total and saturated fat compared to other products in similar categories. These products also have no trans fat or only negligible amounts of it per serving.

What about cholesterol?

Cholesterol is not a type of fat. It has a different chemical structure and has different functions in the body. Our liver makes most of the cholesterol our body needs. For some people, a diet high in cholesterol can increase their blood cholesterol levels. To be safe, limit your cholesterol intake to less than 300mg per day. Avoid consuming organ meat and shellfish more than twice a week, and have no more than 4 egg yolks per week

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estrogen treatment for breast cancer

Source: www.channelnewsasia.com

Study finds promise in estrogen treatment for breast cancer
Posted: 19 August 2009 1345 hrs

WASHINGTON – Low doses of estrogen could help treat some forms of breast cancer, according to a clinical study published on Tuesday.

The findings, published in the Journal of the American Medical Association, could lead to a partial reversal in how metastatic breast cancer is currently treated using medicines to lower estrogen levels.

"When estrogen-lowering drugs no longer control metastatic breast cancer, the opposite strategy might work," said a statement from the Washington University School of Medicine, which carried out the tests.

Matthew Ellis, an oncologist who was the lead author of the study, said around a third of the women who did not respond to standard treatment reacted well to the new regimen.

"Raising estrogen levels benefited 30 percent of women whose metastatic breast cancer no longer responded to standard anti-estrogen treatment," he said.

Side effects from raising estrogen levels could include headaches, bloating, breast tenderness, fluid retention, nausea and vomiting, but Ellis said side effects were limited in comparison to other treatments.

"We found that estrogen treatment stopped disease progression in many patients and was much better tolerated than chemotherapy would have been."

"Overall, we demonstrated clearly that the low dose was better tolerated than the high dose and was just as effective for controlling metastatic disease." - AFP/sh

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Maintain healthy lifestyles

Source: Straits Times Aug 16, 2009

PM'S NATIONAL DAY RALLY SPEECH

Maintain healthy lifestyles

By Judith Tan Community-based programmes such as brisk-walking clubs, or qigong, could influence large segments of the population, especially older people, to take charge of their health. -- ST PHOTO: CHEW SENG KIM

PRIME Minister Lee Hsien Loong has given this simple prescription for Singaporeans to keep health costs down: Keep well and maintain healthy lifestyles.

And this means eating more fruits and vegetables, exercising regularly, keeping weight down and not smoking.

'Such a change in attitude and lifestyle requires discipline and perseverance,' said PM Lee in his National Day Rally speech on Sunday night when addressing healthcare issues confronting Singapore.

He said lectures and speeches will not work.

'The best way is to harness social links and interests to help individuals stick to good habits,' said Mr Lee.

Community-based programmes which combine fitness and social elements, such as brisk-walking clubs, or qigong, could influence large segments of the population, especially older people, to take charge of their health.

He cited Minister Lim Boon Heng's Wellness Programme, which comprises three components - medical check-ups, regular exercise and social networking - as an innovative scheme,

The popular Wellness Programme is available at 12 constituencies.

Mr Lee said he visited the one at Jurong and was most struck by cheerful and happy senior citizens.

'We will progressively expand this to cover the whole island,' he said

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Health inequalities rising

Source: Straits Times Aug 14, 2009

Health inequalities rising

WHO representative in China Hans Troedsson (left) said 'Inequalities in health outcomes and access to care are much greater today than they were in 1978.' --PHOTO: DAILYLIFE.COM

BEIJING - THE world is facing bigger inequalities in health and access to medical care than 30 years ago, the World Health Organisation said in two global reports launched in China on Friday.

A child born in a suburb of Glasgow, Scotland, can expect to live 28 years less than another living just 13 kilometres away, while a girl in Lesotho is likely to live 42 years less than one in Japan, the WHO said at the launch of the reports in Beijing.

This year's World Health Report focused on the way primary health care is organised, financed and delivered in rich and poor countries around the world.

A second report, 'Closing the Gap in a Generation,' documents the results of a three-year investigation into health inequalities between and within countries, the WHO said in a statement.

'Inequalities in health outcomes and access to care are much greater today than they were in 1978,' WHO representative in China Hans Troedsson said.

'Genes do not explain any of this,' the doctor added.'Instead, the differences between - and within - countries result from the social environment where people are born, live, grow, work and age. It also depends on health systems that are put in place to manage illnesses.'

Giving an example, the WHO pointed out that in Sweden, the risk of a woman dying during pregnancy and childbirth is one in 17,400 while for mothers in Afghanistan, the odds are one in eight.

The WHO reports call for better understanding of the root causes of health inequalities and for action to improve daily living conditions. They also urged policy makers to return to basics and focus on prevention.

'Instead of relying on specialist care or biomedical interventions, we should focus more on prevention and strengthen primary level care,' Mr Troedsson said. 'Better use of existing preventive and primary care measures could reduce the global burden of disease significantly.'

China recently announced an ambitious reform plan, drawn up with WHO help, that aims to provide basic medical care for all by 2020. An initial three-year programme will see 850 billion yuan (S$179 billion) invested from 2009 to 2011 to reform the unpopular current system which is seen as costly, badly funded and providing shoddy treatment.

'Everyone - male or female, young or old, rich or poor - should have access to health care that is fair, people-centred, affordable and efficient. 'But health systems will not naturally gravitate towards fairness and efficiency. Deliberate policy actions are needed,' Mr Troedsson said. -- AFP

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100,000 Women in Singapore do not have Medishield

Women need MediShield

By Mavis Toh source: Straits Times 25 July 2009

ABOUT 100,000 women in Singapore do not have MediShield insurance coverage and are at risk of being burdened with big medical bills.

They are mostly housewives with no Medisave savings.

Describing this as a significant number, NTUC deputy secretary-general Halimah Yacob said on Saturday that these women and their families would face a big burden in future.

Women live longer than men and face more years of illnesses towards the end. On average, women live up to 82 years and suffer 11 years of disability. Men on average live up to 77 years and suffer eight years of disability.

'But even as we live longer and need more healthcare, we have lesser means to pay for them,' she said at a forum organised by NTUC Women's Development Secretariat to raise health awareness among non-working women.

She noted that such women are not covered either due to 'pure ignorance' or lapses in continuing coverage with time.

NTUC intends to reach out to this group and has appointed 90 women 'MediShield ambassadors' to encourage the women to sign up.

Pamphlets, posters and a video promoting MediShield coverage through cartoons and simple narration were also launched yesterday at the NTUC Centre to help Singaporeans understand the scheme better.

Madam Halimah and guest-of-honour Health Minister Khaw Boon Wan also urged husbands to pay the MediShield premiums of their non-working wives.

They can top up their wives' Medisave accounts to pay for MediShield or sign them up under MediShield if they are not yet registered.