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.