Singapore to start charging patients unvaccinated by choice

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harrysbar
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#1
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#1
A report in today's Guardian informs us that from 8 December, the government in Singapore will “begin charging Covid-19 patients who are unvaccinated by choice”. It says unvaccinated people “make up a sizeable majority of those who require intensive in-patient care and disproportionately contribute to the strain on our healthcare resources”.

The question is will other countries follow their lead? Personally, I could see it happening in many countries across the world, though not in the UK.

People have a range of reasons not to get vaccinated from a genuine fear of vaccination or lack of confidence in the science behind it to a simple aversion against being told what to do. But what do we feel about the possibility of the unvaccinated being told to pay for their own healthcare if they catch covid? If it fair enough?
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Fullofsurprises
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Might be a good idea to do that here. It would focus minds. Also there should be compulsory mask wearing on transport and in health service premises.
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Justvisited
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(Original post by Fullofsurprises)
Might be a good idea to do that here. It would focus minds. Also there should be compulsory mask wearing on transport and in health service premises.
The beneficial effect of wearing masks is feeble. Prof Ferguson put it at 20% or so. Now a factor of 1.2 is nothing compared to the factor of 10-20 by which vaccines cut the risk of serious illness and death, let alone the factor of 1,000 between such risks in teens and octogenarians for example.

A big hall full of maskees makes them look subservient and docile to government herding. Not a good look at all.

Check out the various short videos of people putting on masks on a cold frosty day outdoors with plenty of breath condensation showing escaping from the sides of the mask. Or try the experiment yourself any morning now when it's cold enough, as I did myself the other day and found the same thing. What more evidence do you need?

And all this is to ignore the downsides of wearing masks, both physical and psychological. An often overlooked factor is the difficulty it places on the hard of hearing who are used to reading lips to help them figure out people's speech.

But on the OP's point, I don't suppose the Singapore authorities are going to charge the willfully unvaccinated for all health costs, just those clearly related to Covid. As such, it's a fair evidence-based step to take.

I compare the situation to that of smoking. While smokers obviously have far elevated risk of lung cancer and several other diseases, as a group they pay for the associated extra health costs through the high taxes they pay on the damaging product itself. Since no such mechanism is available in the case of anti-vaxxers, the UK government has attempted to penalise them in kind by removing certain freedoms, e.g. no nightclubs, hassle-free travel and a few bits and pieces like this. Singapore is doing the same basic thing but in strict cash terms, that's all.
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Gaddafi
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(Original post by Fullofsurprises)
Might be a good idea to do that here. It would focus minds. Also there should be compulsory mask wearing on transport and in health service premises.
Agreed. We should have a general opt out of the NHS system, it should have been introduced years ago but I suppose Covid is a good time to start.

Don't get vaccinated and don't get treated, and to make it fair you get a tax reduction + rebate (as you shouldn't be paying for a service you can't use.)
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Gaddafi
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(Original post by Justvisited)
I compare the situation to that of smoking. While smokers obviously have far elevated risk of lung cancer and several other diseases, as a group they pay for the associated extra health costs through the high taxes they pay on the damaging product itself. Since no such mechanism is available in the case of anti-vaxxers, the UK government has attempted to penalise them in kind by removing certain freedoms, e.g. no nightclubs, hassle-free travel and a few bits and pieces like this. Singapore is doing the same basic thing but in strict cash terms, that's all.
The issue with a health crusade/jihad is that people don't know when to stop.

Smokers contribute via the tobacco duty many times more then they cost the NHS. What started off as a simple cost recovery exercise has now turned into blatant profiteering, with smokers actually now subsidising the healthcare of everyone else.

If we implement chargers for the unvaxxed I can very soon see extorinate charges designed to turn large profits and not just recover charges.
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harrysbar
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#6
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(Original post by Fullofsurprises)
Might be a good idea to do that here. It would focus minds.
I agree it would focus minds.

In the UK, Savid Javid has commented how the experience in the social care sector was that the numbers taking up the vaccine "absolutely surged" after it was made compulsory for care staff to be vaccinated.

Governments around the world have tried the carrot of encouraging people to get vaccinated but increasingly they seem to be moving towards the stick. The NHS could certainly do with the extra source of revenue but I can't see it catching on here as we're so used to free healthcare at the point of delivery.

https://www.bbc.co.uk/news/health-59215282
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Fullofsurprises
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#7
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(Original post by Justvisited)
The beneficial effect of wearing masks is feeble. Prof Ferguson put it at 20% or so. Now a factor of 1.2 is nothing compared to the factor of 10-20 by which vaccines cut the risk of serious illness and death, let alone the factor of 1,000 between such risks in teens and octogenarians for example.

A big hall full of maskees makes them look subservient and docile to government herding. Not a good look at all.

Check out the various short videos of people putting on masks on a cold frosty day outdoors with plenty of breath condensation showing escaping from the sides of the mask. Or try the experiment yourself any morning now when it's cold enough, as I did myself the other day and found the same thing. What more evidence do you need?

And all this is to ignore the downsides of wearing masks, both physical and psychological. An often overlooked factor is the difficulty it places on the hard of hearing who are used to reading lips to help them figure out people's speech.

But on the OP's point, I don't suppose the Singapore authorities are going to charge the willfully unvaccinated for all health costs, just those clearly related to Covid. As such, it's a fair evidence-based step to take.

I compare the situation to that of smoking. While smokers obviously have far elevated risk of lung cancer and several other diseases, as a group they pay for the associated extra health costs through the high taxes they pay on the damaging product itself. Since no such mechanism is available in the case of anti-vaxxers, the UK government has attempted to penalise them in kind by removing certain freedoms, e.g. no nightclubs, hassle-free travel and a few bits and pieces like this. Singapore is doing the same basic thing but in strict cash terms, that's all.
Latest research shows that mask wearing is very effective in reducing spread.
https://med.stanford.edu/news/all-ne...-covid-19.html

The "Ferguson says they are only 20% effective" is a deliberate misquote by an anti-mask source from over a year ago.
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Fullofsurprises
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#8
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(Original post by Gaddafi)
The issue with a health crusade/jihad is that people don't know when to stop.

Smokers contribute via the tobacco duty many times more then they cost the NHS. What started off as a simple cost recovery exercise has now turned into blatant profiteering, with smokers actually now subsidising the healthcare of everyone else.

If we implement chargers for the unvaxxed I can very soon see extorinate charges designed to turn large profits and not just recover charges.
I would remind you that smoking is banned almost everywhere now. And that ban policy works.
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harrysbar
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(Original post by Fullofsurprises)
Latest research shows that mask wearing is very effective in reducing spread.
https://med.stanford.edu/news/all-ne...-covid-19.html

The "Ferguson says they are only 20% effective" is a deliberate misquote by an anti-mask source from over a year ago.
I'm still undecided about masks and don't always wear one - maybe I need an incentive to focus my mind?

The study you quoted is referring to surgical masks not the cloth ones I have lying around in the bottom of my bag covered in biscuit crumbs and fluff or the disposal ones you see people drop and then pick up off the floor - not sure they are quite as effective in reducing the spread of viruses as surgical masks
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Gaddafi
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(Original post by Fullofsurprises)
I would remind you that smoking is banned almost everywhere now. And that ban policy works.
Remind me of what, I'm not sure what you mean? I said that smokers now subsidise everyone else rather then paying for just themselves, that's objectively true.
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londonmyst
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Doubt that it will make a significant difference in Singapore.
It seems that amongst their population the levels of covid vaccination takeup, social distancing in public places and wearing of facial covering are all quite high.

I favour a national system where almost all medical treatment and services are either privately funded or via insurance.
I'm no fan of universal free hospital healthcare funded by the state at point of service.
Nor an expansive welfare state that goes any further than providing a very basic safety net for resident citizens with no criminal records or other passports.
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harrysbar
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(Original post by londonmyst)
Doubt that it will make a significant difference in Singapore.
It seems that amongst their population the levels of covid vaccination takeup, social distancing in public places and wearing of facial covering are all quite high.

I favour a national system where almost all medical treatment and services are either privately funded or via insurance.
I'm no fan of universal free hospital healthcare funded by the state at point of service.
Nor an expansive welfare state that goes any further than providing a very basic safety net for resident citizens with no criminal records or other passports.
It's true that Singapore already have a high level of vaccination take up (about 85% of those eligible) yet apparently the government still fears being “overwhelmed” by surging cases to the point where they are trying to get the percentage as close as possible to 100%.

So you favour a system like they have in America? I'm sure lots of people will agree with this who don't like the way the NHS works (or doesn't work in some cases) in the UK. It will be interesting to see what America decides to do to encourage more of their population to get vaccinated. Maybe it will be hard for their citizens to get cheap health care insurance without it :dontknow:
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TCA2b
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(Original post by Gaddafi)
The issue with a health crusade/jihad is that people don't know when to stop.

Smokers contribute via the tobacco duty many times more then they cost the NHS. What started off as a simple cost recovery exercise has now turned into blatant profiteering, with smokers actually now subsidising the healthcare of everyone else.

If we implement chargers for the unvaxxed I can very soon see extorinate charges designed to turn large profits and not just recover charges.
That, plus there is the question of how fair it is to not then begin excluding all those other voluntary activities deemed to increase cost to the NHS. As you say, if they're not going to be treating for COVID-related illnesses, fine, offer a rebate and tax reduction for that.
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Alfissti
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I'm surprised my country of origin has been so slow to implement this.

This should definitely be the norm and I foresee 99.9% of those that haven't yet been vaccinated would very quickly get jabbed especially when they find out how much it cost to get treated in an ICU ward or to be on a mechanical ventilator.
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londonmyst
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(Original post by harrysbar)
So you favour a system like they have in America? I'm sure lots of people will agree with this who don't like the way the NHS works (or doesn't work in some cases) in the UK. It will be interesting to see what America decides to do to encourage more of their population to get vaccinated. Maybe it will be hard for their citizens to get cheap health care insurance without it :dontknow:
I do support very firm social encouragement of all adult citizens & larger businesses to have private insurance policies and personal savings available to fund their household/workforce healthcare needs, without making it compulsory to do so by law.
But the american system taken as a whole is chaotic and too open to serious abuse by all manner of unscrupulous characters.
With an enormous amount of divergence between different states, insurance providers and local regions which sometimes leads to very odd judicial traditions in divorce or civil cases.

I find the mandatory insurance systems in Japan, Switzerland and The Netherlands very interesting.
The Japanese healthcare system is a fascinating one but involves medical fees strictly regulated by the government and hospitals run as non-profit operations to ensure that the costs remain affordable to almost every working adult.
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harrysbar
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(Original post by londonmyst)
I do support very firm social encouragement of all adult citizens & larger businesses to have private insurance policies and personal savings available to fund their household/workforce healthcare needs, without making it compulsory to do so by law.
But the american system taken as a whole is chaotic and too open to serious abuse by all manner of unscrupulous characters.
With an enormous amount of divergence between different states, insurance providers and local regions which sometimes leads to very odd judicial traditions in divorce or civil cases.

I find the mandatory insurance systems in Japan, Switzerland and The Netherlands very interesting.
The Japanese healthcare system is a fascinating one but involves medical fees strictly regulated by the government and hospitals run as non-profit operations to ensure that the costs remain affordable to almost every working adult.
That does sound interesting... I will read up on it especially the Japanese healthcare system
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TCA2b
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(Original post by londonmyst)
I do support very firm social encouragement of all adult citizens & larger businesses to have private insurance policies and personal savings available to fund their household/workforce healthcare needs, without making it compulsory to do so by law.
But the american system taken as a whole is chaotic and too open to serious abuse by all manner of unscrupulous characters.
With an enormous amount of divergence between different states, insurance providers and local regions which sometimes leads to very odd judicial traditions in divorce or civil cases.

I find the mandatory insurance systems in Japan, Switzerland and The Netherlands very interesting.
The Japanese healthcare system is a fascinating one but involves medical fees strictly regulated by the government and hospitals run as non-profit operations to ensure that the costs remain affordable to almost every working adult.
Part of the issue with the US system is it has lots of restrictions on who can carry a policy or how (e.g. cannot buy across state lines), plus policies tend to be tied to an employer and have to cover conditions which may not even be relevant to the policy holder. People tend to mistake the US for a free market bastion, but instead it simply outsources some state activities to private providers, which is a different thing entirely.
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londonmyst
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(Original post by TCA2b)
Part of the issue with the US system is it has lots of restrictions on who can carry a policy or how (e.g. cannot buy across state lines), plus policies tend to be tied to an employer and have to cover conditions which may not even be relevant to the policy holder. People tend to mistake the US for a free market bastion, but instead it simply outsources some state activities to private providers, which is a different thing entirely.
PRSOM.
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Napp
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I can think of worse ideas. Then again its a rather bad precedent to make people start paying for self inflicted injuries'. Be it smoking, drinking mental health, broken limbs etc. etc. Overall it might make us feel better that we're not subsidizing over peoples idiocy but the precedent it sets would undoubtedly come back to bite everyone, not to mention it would undermine our own healthcare system, if not the Singaporeans.
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harrysbar
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(Original post by Napp)
I can think of worse ideas. Then again its a rather bad precedent to make people start paying for self inflicted injuries'. Be it smoking, drinking mental health, broken limbs etc. etc. Overall it might make us feel better that we're not subsidizing over peoples idiocy but the precedent it sets would undoubtedly come back to bite everyone, not to mention it would undermine our own healthcare system, if not the Singaporeans.
I could never imagine it happening in the UK (apart from possibly people paying higher premiums for private healthcare if they choose not to get vaccinated) but as it has already been introduced in Singapore,it is easy to see that other countries with a mainly private system of healthcare could follow. In the UK though we tend not to judge people's lifestyle choices (obesity, smoking, alcohol/drug abuse, refusal to get vaccinated) in healthcare settings as the NHS values are more along the lines of "everyone counts" and working for the benefit of the whole community, not just for people who follow a certain approved lifestyle.
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