Society: Great, Greater, Greatest
In its financial year 2022, the Great Eastern (GE) Holdings Group made a S$784m profit; in 2023, S$775m; and in 2024, S$995m. When Khor Hock Seng, CEO for nine years, retired last October, the firm thanked him with an extra S$2.1m ex-gratia payment, taking his total remuneration for that partial year alone to over S$3.4m. This exuberant performance, at the largest insurer in Malaysia and Singapore, is partly why OCBC Bank, which owns over 90 percent of GE, wants to acquire it completely. Yet money flows not from compassion, but aggression, as Singaporeans were reminded last month. GE announced that it would no longer issue pre-authorisation certificates for patient admissions to Mount Elizabeth Hospital and Mount Elizabeth Novena Hospital, both operated by IHH Healthcare Singapore (IHH). Those insured can still go there for procedures, but they’ll have to first foot the bill, with no guarantee of reimbursement.
This uncertainty will nudge them (and doctors who want to treat them) towards alternatives. Doctors and others associated with IHH are up in arms, in a move that’s been described by medical experts on CNA as “unprecedented in the decades-long history between healthcare payers and providers.” Ordinary Singaporeans may have little sympathy for any of these groups: “greedy” insurers or “predatory” hospitals, as they’ve been called online, or even the privileged patients who want cushy rooms on Orchard Road’s doorstep. Yet GE’s move, especially if other insurers follow suit, will exacerbate the strain on public healthcare facilities, affecting all. Already more than half of Singaporeans with private hospital integrated shield plans (IPs) choose public for treatment, what with spiralling co-payments and other fees inspiring caution.
Though doctor fee inflation has been moderated in recent years, CNA argued, facility fees haven’t, which is what GE is attacking. IHH defends the higher fees because of the holistic, unique medical services offered at its Mount Elizabeth facilities. The experts, stressing the “clear mutual dependence” between insurers and private healthcare providers, call for stronger consumer protection, possibly through IP portability, and greater transparency and data to aid all stakeholders in decision-making. This week, Ong Ye Kung, health minister, said that the Ministry of Health (MOH) is helping to “untie” the knot that insurers and private hospitals have gotten themselves in.
With every party seemingly pointing their finger at others, patients are left to grapple with financial and medical precarity. Ultimately, with public and private healthcare spending skyrocketing, it’s the neoliberal, market-based order that we must interrogate. It’s one that squeezes the lifeblood not just out of desperate patients, but nurses and other middling workers trapped in unequal hierarchies. Is Singapore’s healthcare system positioned to deliver the best healthcare outcomes for an ageing population? Or, rather, to deliver frothy profits to our financial giants?
Some further reading: The CNA commentary by Sheryl Ha, Jeremy Lim and Taufeeq Wahab is a good primer with useful recommendations. See Ong and MOH’s explanation for the establishment view. For some humour, read “Grape Cistern Insurance Company: Operation Great Pincer”, a satire by hobbitsma, an “unknown doctor in some unknown shire”, who has for years published incisive commentaries on the medical industry while maintaining anonymity.
Society: Watching the watchers
Imagine being on medical leave and forced by your company to share your real-time location if you decide to go out. Even Orwell couldn’t have dreamt up this form of labour surveillance in a 21st century global city. It caused, according to one worker at Certis, a Singapore-headquartered security firm, “immense psychological stress and violated my right to privacy. I complied under fear of reprisal.” Frontline officers on sick leave not found at their registered residence when a manager pays them a surprise, “Get Well Soon” house visit, will have to submit their live GPS location via WhatsApp or jump on a video call. Thankfully, they’ll no longer be required to do so, following a meeting between Certis management and the Union of Security Employees (USE).
