Aaron Ng

Comments from my last entry on means testing have prompted me to think about what criteria would be a fair (or at least, less unfair) way to determine whether a person should be given more subsidy.

The basic yardsticks are usually income and housing type. Generally, if you have a high income and live in private property/high end public housing, you are quite likely to be able to afford higher medical bills. However, these two criteria, in my opinion, can lead to a misleading picture of whether a person is able to afford expensive medical bills.

Consider a hypothetical scenario of person A who is earning $8,000 a month and living in an executive condominium. Consider another hypothetical scenario of Person B who is earning $4,000 a month and living in a 4 room HDB flat. If we were to merely use the two yardsticks mentioned earlier to evaluate the two situations, the logical conclusion is that Person A should be subsidised less than person B should he/she be hospitalised.

However, what if Person A has to support three children of schooling age, two aged and sickly parents and a homemaker spouse who is not working to take care of the family, while Person B has to support a homemaker spouse and one child who’s of schooling age? Can we still say that Person A is still able to afford higher medical bills relative to Person B?

The point I’m trying to make is that while income and salary are useful basic indicators for means test, unfortunately, sometimes, they don’t give a complete assessment of a person’s ability to pay medical bills. I believe that a fairer means test should also factor in the number of dependents in the family. The greater the number of dependents, the greater the amount of subsidy the person should be entitled to. Of course, there are other criteria that would make for an even fairer means test but I believe that incorporating the number of dependents as part of the first level of assessment would help greatly reduce the number of legitimate cases who are unfairly excluded from receiving greater subsidies.

Of course, my discussion is based on a hypothetical scenario. If you want a real example, read this comment from a reader who posted her plight in my earlier entry.

It appears that few are disagreeing with the means testing proposal by MOH to determine the level of subsidy Singaporeans should receive in the event of hospitalisation. The main concern, as usual, is whether the middle-class folks will be heavily burdened as a result.

Actually, I think the middle-class folks are unduly worried. Sure, hospitalisation can be expensive business but it need not be if one takes up private medical insurance. And, comprehensive private medical insurance for hospitalisation isn’t unaffordable for middle-class folks in Singapore, at least not yet.

We already have Medishield for basic hospitalisation coverage. Middle-class folks should ‘upgrade’ their Medishield through the Private Medical Insurance Scheme (PMIS) and take up an additional private plan to complement Medishield. The market is quite competitive (see this PDF document that compares the various products on the market) so premiums are affordable for middle class folks.

Personally, I’ve signed myself on PruShield Premier plus PruShield Extra. It currently costs me about $450 a year, with about one-third of it coming out of my Medisave account. It’s a small price to pay for a peace of mind. PruShield Premier allows me to go to a private hospital and the benefits are as charged, meaning there’s no cap. With Prushield Premier alone, I’ll have to co-pay a small portion of the expenses (deductibles and co-insurance) so I added PruShield Extra which takes care of that. So, in the event that I’m hospitalised (which I have not experienced and I hope not to experience), my insurance takes care of every single cent of my hospital bill.

There are many other similar products out there on the market (see this link for a list of insurers) and it’s perhaps a good time for middle-class folks who are not yet covered to start reviewing their coverage. Means testing will not be a problem for middle-class folks if they know how to cover themselves with private medical insurance. Since Medisave can be used to pay for private medical insurance, it makes even greater sense to get one.

Means testing simply means that we have to be more proactive in ensuring adequate personal medical coverage. I heard over the radio today that the Life Insurance Association is going to engage the health ministry in talks to discuss the impact of means testing on insurers, as well as to explore ways to encourage Singaporeans to take up private medical insurance. Since means testing have grabbed the attention of Singaporeans, I think now is the best time to broadcast the importance of private medical insurance.

The Straits Times recently published a news story saying that three-quarters of Singaporean teachers now have degrees. It’s a good development to read about but I have a problem with the story. The story, at least from my perspective, conflates teaching qualification with teaching quality.

I quote the following paragraph from the news story:

NIE director Lee Sing Kong said Singapore should aim to have a high-quality teaching force where teachers have a university or even higher degrees.

He said that Finland, which is touted to have one of the best education systems in the world, requires all its new teachers to have at least a masters degree.

Prof Lee cited a recent report by consultancy firm McKinsey on the world’s best-performing school systems, which showed that ‘the quality of teachers affects student performance more than anything else’.

Studies done in the United States have shown that if you take pupils of average ability and give them to teachers deemed to be in the top fifth percentile of the profession, they end up in the top 10 per cent of student performers.

The reverse is also true – if you give them to teachers from the bottom fifth, they end up at the bottom.

While I do think that university education does help further one’s intellectual development, which in turn can help assist in one’s ability to teach, I do not think that quality teaching is necessarily positively correlated with the level of education. Even if you have a PhD, it doesn’t mean you can teach.

I remember that the best teachers I had in primary school were teachers without a degree. They did not have a degree, but they were dedicated teachers who were able to spark my interest in learning. They built a solid foundation and that helped me advance academically.

During my undergraduate days, I came across professors who couldn’t teach for nuts. I totally switched off during such lectures. They just droned on and on with powerpoint slides that are chock full of text in small font sizes. I don’t think one needs a PhD to know that such teaching makes students completely uninterested to learn.

I think at the end of the day, what is most important for a teacher is whether he/she is able to communicate with students in an engaging fashion. Of course, in the first place, the teacher should have a certain level of expertise in the subject area but beyond that, it is really about pedagogy and communication.

I apologise for the lack of an update for 3 weeks. I’ve been busy with so many things that I’ve not been able to sit down properly to type a blog entry. I’m not done with my busy schedule, though. However, I read an op-ed piece on New York Times that I simply couldn’t resist posting on this blog.

The title of the piece is “The Dictatorship of Talent” by David Brooks. For those who can’t be bothered to read the entire article, basically, the article talks from the point of view of a Chinese national about the “corporacy” in China and how the Chinese system is producing elites for the corporacy. And, Brooks’ description of the system sounds uncannily close to the Singaporean system.

Here’s the part of the article that describes the Chinese system.

As you rise in school, you see that to get into an elite university, you need to ace the exams given at the end of your senior year. Chinese students have been taking exams like this for more than 1,000 years.

The exams don’t reward all mental skills. They reward the ability to work hard and memorize things. Your adolescence is oriented around those exams — the cram seminars, the hours of preparation.

Roughly nine million students take the tests each year. The top 1 percent will go to the elite universities. Some of the others will go to second-tier schools, at best. These unfortunates will find that, while their career prospects aren’t permanently foreclosed, the odds of great success are diminished. Suicide rates at these schools are high, as students come to feel they have failed their parents.

But you succeed. You ace the exams and get into Peking University. You treat your professors like gods and know that if you earn good grades you can join the Communist Party.

Singapore has been called a nanny state, and it seems that China is becoming a nanny state too. Another paragraph from the article reads:

This is a government of talents, you tell your American friends. It rules society the way a wise father rules the family. There is some consultation with citizens, but mostly members of the guardian class decide for themselves what will serve the greater good.

You should be chuckling to yourself by now at the phrases “wise father rules the family” and “consultation with citizens”.

And finally, the article concludes with something I wonder from time to time (the bolded parts) about Singapore Inc:

You feel pride in what the corpocracy has achieved and now expect it to lead China’s next stage of modernization — the transition from a manufacturing economy to a service economy. But in the back of your mind you wonder: Perhaps it’s simply impossible for a top-down memorization-based elite to organize a flexible, innovative information economy, no matter how brilliant its members are.

It looks like China is pretty good at copying almost anything.