Tuesday, January 22, 2008


Medisafe or Medisave ?

I went to a presentation on Health Insurance and Investment in NUS yesterday. The event was organized by Medical Society primary for medical students. The first half was on changes on the Central Provision Fond (CPF) for Healthcare issues, the second half on the basics for investment and was not too interesting.

Because the health care system in Singapore is very different from Germany, it was a good opportunity for me to learn how things work here.

The main difference between the Singapore health care and German health care is that there is NO health care sector in the way we know it.

The government does not believe in public welfare and public health care, because it would make people develop a "buffet mentality".

Instead Singapore knows three different ways to cover your hospital bill:
1. Medifund
2. Medisave
3. Medishield

1. Medifund is a government fund that you can apply for if you can't pay he bill yourself. But that means that you have to be very poor, you don't have ANY money, you don't have a house, car, your account is broke and all your family members, parents, brothers, sisters, too. Then you can hope to get some money from there.

2. Medisave: I always thought that Medisave is spelled "Medisafe" like in safety, but it is "Medisave" like in "save money" :)
Medisave is nothing but a saving account. Every month between 6% and 8.5% of your salary is put into that account. If you get ill you can use that money to pay the hospital bill. But then the government "helps" you not to spend all the money from your Medisave at once, so you are not allowed to use all the money at once and you can only use it for larger bills. And there is a co-payment scheme which means Medisave never pays 100% of the bill, you always have to pay from your own pocket as well.

3. Medishield: Medishield finally is a insurance that covers your against illness, consultation costs, hospital bills etc. And on top of it there are private health insurances that cover you for everything you are willing to pay for (private hospital, A-Ward,etc)

For somebody that comes from a cozy health care system like the German one, this seems pretty tough. On the other hand it is true that the costs of a public health care sector are enormous. I also think that it is true that not having to pay anything for medical consultation makes people go and see the doctor much more often then they would actually have to. Of course this does not apply to everyone but I bet that the dark figure is enormous.
On the other hand, falling sick in Singapore can mean the financial ruin for you and your whole family.

Whatever problems the German health care system may have (and it has a lot), people should sometimes look to other places to see how many benefits they have in a country like Germany.


Ich bin gestern zu einer Präsentation über die Krankenversicherung und Investitionen in der NUS gegangen. Die Veranstaltung wurde von der Medizinischen Gesellschaft primär für Studenten der Medizin organisiert. Die erste Hälfte war ueber Veränderungen des Central Provision Fond (CPF) für die Gesundheitsversorgung, die zweite Hälfte ueber die Investitionsgrundlagen und nicht allzu interessant.

Weil das Gesundheitssystem in Singapur sehr unterschiedlich ist als in Deutschland, war es eine gute Gelegenheit für mich zu lernen, wie die Dinge hier funktionieren.

Der wichtigste Unterschied zwischen der Gesundheitsversorgung und Singapur dem deutschen Gesundheitssystem ist, dass es KEIN Gesundheitswesen in der Art, wie wir es kennen gibt.

Die Regierung glaubt nicht an öffentliche Wohlfahrt und die öffentliche Gesundheitsversorgung, denn es würde die Menschen da bringen eine "Buffet-Mentalität" zu entwickeln.

Stattdessen kennt Singapur drei verschiedene Möglichkeiten, um die Krankenhaus Rechnung zu decken:
1. Medifund
2. Medisave
3. Medishield

1. Medifund ist ein Fonds der Regierung, den man beantragen kann, wenn man die Rechnung nicht selbst bezahlen kann. Aber das bedeutet, dass man sehr arm sein muss, das man GAR KEIN Geld hat, kein Haus, kein Auto, das Konto ist pleite und alle Mitglieder Ihrer Familie, Eltern, Brüder, Schwestern, auch. Dann kann man hoffen, von dort aus etwas Geld zu kriegen.

2. Medisave: Ich habe immer gedacht, dass Medisave schreibt sich "Medisafe" wie in der Sicherheit, aber es ist "Medisave" wie in "Geld sparen":)
Medisave ist nichts anderes als eine Sparkonto. Jeden Monat werden zwischen 6% und 8,5% des Lohns in dieses Konto gezahlt. Wenn man krank ist kann man dieses Geld nutzen um die Krankenhausrechnung zu zahlen. Aber die Regierung "hilft" zu verhindern, dass man das ganze Geld von seinem Medisave auf einmal ausgibt, so darf man nicht alles Geld auf einmal ausgeben und auch nur für größere Rechnungen. Und es ist eine Co-Zahlungs System, was bedeutet, das Medisave nie 100% der Rechnung zahlt, man muss immer einen Teil aus der eigenen Tasche zahlen.

3. Medishield: Medishield schließlich ist eine Versicherung, die gegen Krankheit, Beratungskosten, Krankenhausrechnungen usw. versichert. Und darüber hinaus gibt es private Krankenversicherungen, die einen für alles versichern, fuer das man bereit ist zu zahlen (privates Krankenhaus, A-Ward, etc. )

Für jemanden, der aus einem gemütlichen Gesundheitssystem wie dem deutschen kommt, scheint all dies ziemlich hart. Auf der anderen Seite ist es richtig, dass die Kosten für ein öffentliches Gesundheitswesen enorm sind. Ich glaube auch, dass es wahr ist, dass nichts für die medizinische Beratung zu bezahlen die Menschen dazu bringt mehr zum Arzt zu gehen als wirklich noetig. Natürlich gilt dies nicht für alle, aber ich wette, dass die Dunkelziffer enorm ist.
Auf der anderen Seite kann eine Krankheit in Singapur den finanziellen Ruin bedeuten, für einen selbst und fuer die ganze Familie.

Unabhängig von allen Problemen, die das deutsche Gesundheitssystem haben mag (und es hat eine Menge), sollten die Menschen manchmal an andere Orte blicken, um zu sehen, wie viele Vorteile, die sie in einem Land wie Deutschland haben.

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