MEDICAL insurance needs to be extended to cover people beyond the age of 85, especially with the introduction of means testing, Madam Halimah, head of the Government Parliamentary Committee for Health, advocated on Friday.

She said changing the level of subsidy for the middle income group is not something that should be done in isolation. Other pieces also need to be changed so everything fits together.

Among these are raising the insurable age under MediShield, the national medical insurance scheme, and perhaps even making the insurance compulsory for all.

Referring to the debate in Parliament last year on the proposed longevity insurance which would pay an income from the age of 85, she said: 'We were told that half of us will live beyond 85 years. The Government is selling the longevity insurance on that basis. Then the question is, how are we going to finance our healthcare beyond that age?'

Giving the keynote speech at the 2nd International Conference of the Asia Pacific Society for Healthcare Quality, Madam Halimah said means testing will hit uninsured people hardest. Some 750,000 people - largely housewives and children - have no medical insurance now.

Perhaps incentives could be given to encourage them, she said.

Madam Halimah, who is also a union leader, made a plea to the minister, who had earlier opened the session: 'Please think very carefully where to draw the line' for continued full subsidy.

In his opening address to the 670 delegates from 26 countries, Health Minister Khaw Boon Wan said details of how means testing will be implemented will depend on people themselves.

That is why he has been holding many dialogue sessions to get feedback. The consensus so far is that all should continue to get some subsidy, with high-income earners co-paying a larger amount of their bills.

He has indicated that the bottom half of the population will continue enjoying current subsidy rates. The rest will be subsidised on a sliding scale, up to a cap of 35 per cent in C class and 50 per cent in B2. He again explained that means testing is not something that is needed today, but is an important step 'to continue to deliver good and affordable care on a sustainable basis to all Singaporeans'.

This led to another request from Madam Halimah: 'The minister says he has not made up his mind on the cut-off yet. That's very good. We should look carefully at what we mean by middle income.'

Based on the Labour Force Survey, the median income of all workers in June last year was $2,170. Madam Halimah asked if cutting off full subsidy at that income level would 'put a squeeze' if the person is supporting a family of four.

She also urged the minister to be generous with both subsidy and time. After the details are out, people will need time to plan their finances, in preparation to changes in the subsidy they get.

She explained that a five per cent reduction in C class subsidy means a 25 per cent increase in the bill the patient has to pay. In C class, the Government now picks up 80 per cent of the tab.

As he has done several times over the past two weeks, Mr Khaw promised to be generous in defining low-income, and 'always be compassionate' to those with special deserving circumstances.