Earlier in this blog series, I talked a topic about medical expenses, and this blog issuance is of the continuation. 

When we the family had moved to Singapore more than eight years ago, no foreign family could afford to buy an insurance exclusively for locals, but for private insurance owned and sold by a foreign company. We therefore sought after the one in 2012 and in the next year, when we gave up and decided not to purchase it any more for whole the family. From around 2015, however, while this was totally out of our knowledge, NTUC (National Trade Union Congress), a local semi-governmental and semi-private company in Singapore, expanded its sales restrictions from permanent residents (PR) holders to working visa (EP) holders. The official name of the company is NTUC Income Insurance Co-operative Limited, by the way. 

From the latter half of 2018, immediately after my wife's breast cancer, a total of three people of family (annual premium of less than SGD 8,000) including myself and two children got the policy with the hospitalization benefits. Wife Koko could not as she had become her cancer back in 2018. Any precondition precludes possible buyer from buying it, which is the same as Japan.

(Note, the work visa in Singapore, in general, is divided into multiple categories according to the amount of income earned each month. The category called Employment Pass (EP) is of the highest salary group, and most of the expatriates including Japanese fall into the category. In the case of a S-Pass category, it mainly refers and corresponds to construction workers from neighboring countries around Singapore. S-Pass holders are regarded as "essential workers", such as engaging in condominium construction, that of dams, and river dredging, etc. Although it is extremely important for the country building-up, S-Pass holders were/are squeezed into a group of about 10 people in a single compartment with a bed assigned to each in a rather less luxurious building of 200+ pax, which in the Island are up to more than 40 locations. Unfortunately they contributed greatly to the spread of Covid-19 infection. For details on the classification of work visas, see Singapore's Ministry of Manpower.)

Today, the major point in Singapore private insurance is that foreigners (or so-called EP holders) can enter a private hospital room, and they are mostly funded by their companies such as Toyota, Mitsubishi...The full amount is refunded after you are discharged, no matter how many days you would be in the hospital. A room in a private one is as large as a luxury hotel. But, I was not surprised to hear that those rooms are normally used by highly wealthy people in the region, who fly in Singapore for medical treatment. My doctor for sigmoid cancer was that for a Brunei royal family, for example. Kook's doctor used to do operation to several Indonesians living in Singapore. 

The foreign insurance companies have the ability (human resources) to deal with "fictitious hospitalization" scams. But anyway, no foreign expatriate wants to stay in such a hospital for longer terms than necessary. 

Conversely, it may not be impossible for expats to get hospitalized into a public one such as Singapore General Hospital, but there are very few expats who wish to enter SGH. Even in a normal period, not now with Covid-19 spread, the hospitals would be full of non-insured people lining up for long hours, before their turns come in. People lining up and waiting long queues are also of the reflection of Singapore medical industry (medical doctors). When the doctors are young, they get trained at SGH or a public hospital (so-called polyclinic), then move to a private hospital, climbing up the industry ladder to a prominent doctor. For example, only a handful of doctors reside in Paragon, which faces the main street Orchard Road. It's like just a handful of players remaining in the major league teams in NBA (in US terms at least). The remaining people are targeted under "up or out" by upper echelon of their belonging organization(s) ("if you don't get promoted, then quit") and you would end up your medical doctor's journey as general practitioners nowhere in the city state.

Insurance in Singapore does not cover the costs of so-called outpatients. The dentist is also not covered. This is also different from Japan, which has an insurance system for everyone. Yes, everyone. 

At the same time of my purchase of NTUC in 2018, I also purchased another medical insurance from a US company. It's more like life insurance than non-life insurance (hospitalization coverage), so I didn't have to worry about duplication with NTUC, as told by my agent. However, immediately after I got sigmoid cancer, another problem rose and I quarreled with my counterpart in the US company, who were different from my agent. I was fortunate that the settlement returned a little more than I paid as the premium.

Compared to the simple and clear Singapore system, that of Japan is mysteriously complex. First of all, I had no idea what the "limit application certification" was at the time when I returned to Japan in last July. Based on the system, paying a large amount of medical expenses by individual nations would be limited to particular amounts with respective five categories assigned depending on the certifier's income. The five are also bound by detailed regulations, and lingering to later years. It's the system that has been kind of newly created one and appreciated by people, like me, who have super-expensive medical care, but the calculation is too detailed. With this, the criticism of "bane of applicant" may not be denied.

In my previous writing of "Medical Expenses" in this blog series (Toast to Life 13), I had thought I would give a detailed breakdown of medical expenses incurred to me/my family, and I still keep the A4 white paper at hand, on which I had jotted numbers. I asked my wife if it was okay to post it on my blog, she, after posing a bit, recommended me not to. Her reason was simple: even in Japan, the coverage is different for each person, and our family had private insurance(s) in Singapore until July; when I put it all together, the refunds may be quite different from other Japanese, which makes people feel too unfair; we the family also have had unfair treatment from Japanese government, too. So, I do not disclose it out, and will never. 

(The photo is a guide sheet for the International University of Health and Welfare, Mita Hospital on October 21, 2020. To be continued.)