Not for love of money, but of Humanity. "Greater is he who works for the good of all, then he who works for the good of himself only" ~ Matthew 25:40: "The King will reply, 'I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.'"- (NIV). I live in Singapore where the Emperor must not be disturbed.

Saturday, March 21, 2015

Medishield-life: A Missed Opportunity to Shape Unhealthy/Kiasu Singaporeans up.

Oki, sorry to have now made a majority of Singaporean readers UPSET by reminding them of their Kiasuism flaw, but folks, isn't seeing many kiasu Singaporeans join a queue EVEN WITHOUT KNOWING WHERE THE QUEUE LEADS TO: quite a frequent sight? (Visit to casino/TOTO, Hello Kitty toys from McDonalds, Korean Boy band at Airport, Gold certificate/ Land-banking ponzi schemes, tution classes sufficient to make any kid go berserk?)[reference: Top 10 Things Singaporeans Will Willingly Queue For |].

Amongst all this queueing for what is deemed 'ideal', isn't personal health an important asset too?: both for country and self (as in the context of medishield-life: Singapore's planned compulsory national health insurance plan whereby those who fail to pay premiums could well find themselves in jail (even after paying up hefty fines)): falling sick early could well raise premiums for all: so shouldn't medishield-life incentivise healthy lifestyles: not least disincentivise smoking/ unhealthy lifestyles/ the avoidance of health check-ups (as is the current situation) so as to keep overall premiums/ health care costs low.

A simple heart attack risk calculator available at 10-year CVD Risk Calculator (Risk Assessment Tool for Estimating Your 10-year Risk of Having a Heart Attack) readily proves the point, with a wide age scale (20-99yrs) to allow all to estimate their 10year risk of suffering from a heart attack: for which one could end up unfit for any productive work (that is if one survives the heart attack at all).

The picts below (in sequence) show the 10yr- heart attack risk tool in raw form, of a fit/healthy 40 yr old and the converse if he were sedentary and obese (plausible measurements used (inspired somewhat by my own IPPT FFI screen results as available on portal)).

6 easily obtained input parameters required (Age, Total-Cholesterol, HDL-cholesterol, Smoker status, Systolic Blood Pressure, Presence/absence of hypertensive medication use):

Fit and healthy 40yr old (>150 mins of exercise/week, healthy mediterranean/ paleo-diet, non-smoker etc ):

Unfit 40yr old smoker who does zero exercise, hates vegetables and loves beer with deep-fried-fatty-food:

The healthy 40yr old has a 10yr heart-attack risk of <1 a="" butt="" eat="" has="" his="" lift="" smoking="" stop="" to="" twin="" unhealthy="" unwilling="" whilst="" wisely="">30% risk (his result could actually be worse since the max of the scale is '>30%'): aka: a walking time bomb waiting to blow the national healthcare budget, if not medishield-life premiums, right through the roof.

The best way to promote healthy-living (exercise, healthy diet, non-smoking et. al.) amongst kiasu Singaporeans would thus be to offer Singaporeans who have medical screening results to prove (e.g. those who go for SAF IPPT FFI after age 35) a discount off medishield life premiums based upon their cardiovascular risk strata: since the scheme is a compulsory one (like a form of NS) and incentivising good health amongst all Singaporeans would be essential to keep premiums across the board low (like giving IPPT awards of up to $500 for IPPT gold). Opting into the premium discount scheme for good screening test results will of course be optional, however, with the risk stratum so divergent (>30x difference in the presented example, premium discounts shouldn't be anything less than truly rewarding). Each Singaporean (of either sex) should be entitled to a free IPPT FFI like screening at the polyclinic annually after age 35: with all subsequent assessments covered as they do in SAF (treadmill/ further assessments): those with special exercise restrictions (knee pain, irregular heart-beat etc) shall be sponsored free counselling by dietitians and physio-therapist so that they too will have good opportunity to perform well in the annual '10yr-heart attack risk score'.

A common sight in Singapore: queues for anything rumoured to be good.
Searched Google for 'queue sg', result:

Singaporeans queueing for Krispy Kreme Doughnuts (some=overnight even):
info source: Singapore Seen | Singaporeans queue overnight for Krispy Kreme dougnuts

PS: Top 10 Things Singaporeans Will Willingly Queue For |

Even PM Lee Hsein Loong queued 30 mins for chicken wings at Redhill: Chicken wings even PM would queue for | The Straits Times SoShiok

Me finds it very sad that despite Medishield-life being even more compulsory than NS (even PRs have no way out), good health isn't one of the top 10 things that Singaporeans feel eager to queue for.

Maybe the Singapore gahmen is feeling a bit too rich for their own good, maybe the seeds of failure of Medishield-life have already been sown.

Whatever the case, according to PM Lee HL, fried chicken wings at Red Hill Food Centre sure do taste very good...
[Alt Pict URL]

Projected Singapore State of Public Health, Year 2020:

Source: Cigarette-smoking toddler Aldi Rizal, quits habit but now he's addicted to food | Daily Mail Online

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