Tuesday, November 28, 2006

Subsidised Rates For Subsidised Healthcare

Both my grandfathers are having problems with their health and had recently, or now being in hospitals. Previously, my late paternal grandmother also had problems with her health and was in and out of the hospital. Seeing those old ones going in and out of hospitals, and myself visiting the hospitals more regularly, I've come to see how sad our healthcare system is like in Singapore. I'm not saying it's wrong, or right, but it's pretty sad.

Basically, one pays for better healthcare. It's almost as if healthcare is a private good under the mechanisms of demand and supply rather than being a public good which allows everyone to enjoy the full benefits fairly.

Let me talk about the background of my grandfathers. My paternal grandfather has three children including my dad. Followers of this blog would know that my family is living off quite comfortably. We're not rich or even close to being rich, but we get enough to eat and occasionally to splurge. My two aunts and their families are quite similiar to my family. My elder aunt and her family live in a condo, my younger aunt and her family a terrace house. My grandfather himself has his own property which I don't quite fully know everything. He lives by himself in a three room shophouse but the shop is rented out, so it's only the three room living space that he occupies. Both my aunts have maids and their maids routinely check on my grandfather and does the chores. After the recent hospital spate my dad's sponsored a maid for him but she's not here yet.

Yea... So it's obvious that my paternal side is willing and has the means to pay for better healthcare for my grandfather.

My maternal side is a bit more complicated. My mum's the eldest daughter, followed by a brother and four younger sisters, two not married. I'm only closer to the three younger aunts. I don't quite know my uncle fully, but I think he is quite comfortable, from what I think, his family's staying in a mansionette. I'm estranged from the next aunt, she's a piece of crap basically. She's unmarried, bought a HDB three room flat but left it vacant and moved back to live off my grandparents. I mean, if she at least rented out the flat or something it's still not that crap, but well. The next aunt is divorced, financially a bit struggling now since she has to bring up two sons and it was only because of the separation with her ex-husband that forced her back to the workforce, and that she's not very young already. The second youngest aunt is probably the most successful of all the children, yea, my mum's not, the only credit I have for my mum is that she married my dad and my dad's good. This aunt is a career woman, worked hard for her keeps, regularly achieves top sales in her department. But her daughter's young, and I guess, is her top priority. The youngest aunt is unmarried and just bought a three room HDB pad for herself, so I guess she is not in surplus financially. By right, the two old folks should be living alone in their old three room HDB flat, but because of that estranged aunt, well, she's with them.

Also because of the mindset of my grandmother, healthcare to them is that they keep it to the bare minimum. She doesn't want the children to spend too much on people who are about to die.

So, my paternal grandfather was admitted to Mount Elizabeth, and my maternal grandfather was being admitted to Singapore General Hospital.

I remember when my late paternal grandmother was admitted into Mount Elizabeth and I went to visit her, I didn't know where she was warded to. I gave her name to the concierge and was given a written description of her ward by them. Also maybe it was because Mount Elizabeth was small, it wasn't difficult to look for my grandmother. Yesterday, when my maternal grandfather was admitted, it took me a hell lot of time to get to his ward. My aunt who didn't have the ward number asked the reception and was given wrong information.

Mount ELizabeth, when I went to visit my paternal grandfather, looked to be adequately staff. The staff was polite and well spoken. They looked very matronly. But sometimes might be a bit more customer service oriented for liking. I don't know if it's a one off incident or prevalent, but yesterday when I was at SGH, it looked to be horribly understaffed. My maternal grandfather wanted to shit and asked for a bedpan, it took like over 45min before he got it. Basically a couple of nurses, including one male nurse told use wait a while, but that while never came. In the end the nurse manager came and started barking orders around before the bed pan finally came, then he asked for a commode, then he started ordering the cleaners to clean up the water on the ground. To be very fair, I think the nurse manager was good, very helpful and friendly and did his job well. Okay, the nurses were not bad, just that because they were so understaffed, they were a bit inefficient. And on the average, they were about ten years younger than the nurses in Mount E.

I don't know how is it like regarding the nurses, but the nurses I came across in Mount E spoke Hokkien, and were able to communicate with my paternal grandfather. The nurse tending to my maternal grandfather was Malay, so she spoke English. There was another nurse somewhere who seemed more comfortable speaking Mandarin (no dialect though).

It wasn't just the nurses, the doctors too. If politicians have to learn all the dialects, I think it should be the same for doctors too. Just as how politicians have to connect with their constitency residents, doctors need the same connection with their patients, to understand their condition. Doctors need to learn the language of their patients to better tend to them. Right now it seems like only the older doctors who are able to speak in dialect, the younger ones are all those jiak-kentangs.

My paternal grandfather has his designated doctor, like most private patients. It's good in a way that one has already build up a certain rapport with the doctor and are able to communicate with each other. The problem yesterday with my maternal grandfather was crap. He went into the hospital early in the afternoon, but didn't get to see any doctor until about 8+pm. And the doctor who came was a ginna-kia with a trainee doctor in tow, two ginna-kias. One of them had his handphone switched to ringing mode and he answered his phone twice.

At the end of their diagnosis, they recommended that my maternal grandfather be sent to do a scope. But later in the night a senior doctor would come to check on him. He was supposed to be off food and water and all medication, including a medication that would thin his blood. The scope would then be done in the morning. I left shortly after and hence did not see the senior doctor. From what I understood this afternoon, the scope was still not yet done. My mum was saying that the doctors said that his blood was too thick to do the scope, he needs to take that blood thinning medication again. And my grandfather was still off food and water and very hungry. Even though he was on the drip, he wanted to eat and drink. Well, I reiterated to my mother, since he's paying subsidised rates, he has to suffer this sort of subsidised healthcare service.

A scope is not a difficult process. I can say that because I did it before. I was told to do it the night before, I did it in the morning, by the evening I was back at home already. Simple as that. Okay, I didn't have any problems with my blood, though I did suffered from some side effects of drug allergy that prompted my scope. What I'm saying is that, it isn't something troublesome or would take up a lot of time.

But well, we need to take in consideration, my maternal grandfather was in SGH. My scope was done by my GP who was positioned with the Parkway Medical Group. And I did it in Eastshore Hospital.

Altogether, other than my delivery years ago, I was admitted into hospital three times, other than that day doing the scope, I was admitted to stay overnight in the hospital twice, both when I was 6. Once was for measles, the other for pneumonia. I think the measles one I was in Mount Alvernia, also the place where I was born. I can't really remember much about that experience, except that I was alone in this room and was crying half the time, and my whole body was in red spots. The time when I had pneumonia, I think I was in NUH, or might be Mount Alvernia again, I can't remember, though I think it was in NUH because I at first couldn't get into A ward and ended up with this bunch of kids in a communal room. It was later when i managed to change to an A ward. Can't really remember much only that I had this thing attached onto my arm. It didn't really strike me as a good or bad experience. Maybe because I was in a kids' ward.

Staying in the hospital is nowhere a very fun thing to do. I'd at least hope that there's proper healthcare service. The experience in Eastshore Hospital was a comforting one. I was still suffering some side effects of drug allergy and the nurse there was very comforting and gave me sedatives to calm me.

But I think it all boils down, how much one pays will beget how much return one gets in healthcare service. sigh... If I'm poor, I sure do not want to fall sick and be admitted into hospital. I'd probably die there.

My mum was still jesting that my paternal grandfather was still complaining that the food in Mount E sucks when she saw the food that was being served in SGH. Honestly, if I were ever being admitted to SGH, I would never touch the food there. It's a big turn off. *mental note to self: Don't fall sick!*

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