HE had said that he would err on the side of generosity when carrying out means testing for hospitalisation.

So when Mr Khaw Boon Wan met union leaders at a dialogue on means testing last night, he was urged: Make more errors.

It was their witty way of reminding the minister not to be too stringent with means testing.

Mr Khaw graciously took this point but pointed out: 'Whatever mistake I do, it's at the taxpayer's expense.'

And with the Goods and Services Tax, everybody is a taxpayer, he said.

'I have to do my duty well to make sure that tax money is properly spent,' said Mr Khaw.

That means no or very little wastage.

He pointed out that in the United States, the amount of GDP spent on healthcare there is 16 per cent, compared to 4 per cent here.

'But our infant mortality rate is better than the US. That means that a lot of the 16 per cent that the US spends is wasted. Healthcare wastage is very real and we have to be mindful,' he said.

The lively two-and-a-half hour session at NTUC Centre saw many people coming forward with their own life stories and experiences.

Mr Philip Soh, 59, who works for NTUC Income, related how a 56-year-old toilet cleaner he had met by chance one day asked to borrow $100 from him.

'He was going around asking people for money because Singapore General Hospital required him to pay cash for his hepatitis medicine,' said Mr Soh.

The man was previously covered by Medifund when he was hospitalised.

But as an out-patient, after hospitalisation, he had to pay cash for his follow-up check-ups and medication.

'We have many people in that situation,' he said.

Mr Soh also related how even C-class patients do not get subsidies when they need non-standard drugs.

'They may need it through no fault of their own, such as when they are allergic to the standard drugs,' he said.

Mr Freddy Lim, president of the Singapore Urban Redevelopment Authority Workers' Union, also sought help for lower-income patients who needed non-standard drugs as 'some people are going to Johor Baru to buy drugs because it's cheaper'.

He also related how he was asked for a deposit before receiving any treatment as an A-class patient at Alexandra Hospital.

He hoped that those in the lower-income group would not have to go through the same experience.

Mr Khaw assured that in cases of a medical emergency, no hospital staff will ask for paperwork to be done first.

He added that no deposits are required for those in B2 and C class wards.

Another union leader, Mr P Chandran, asked that those born in the 1940s be assessed differently even if they are living in private property.

'Previously, it cost $25,000 to $40,000 to buy a house. If you were a teacher at that time, you can afford to buy a house. But today, those people are not rich,' said Mr Chandran.

He went on to say that his two children are doctors but he did not want to depend on them.

'I do not want to take a cent from my children. I have my dignity,' he said.

Mr Khaw said he did not want to look only at age.

'There are the rich elderly, just as there are many young who are poor. I would rather look at income,' he said.

To Mr Chandran, he said: 'Many of us have children who earn less than your children. You are saying pass the burden to us. Is that fair?'

The evening ended with an anecdote from labour chief Lim Swee Say about living in New York City in 1991 when he and his family were posted there.

He recounted how he had to rush to a public hospital when his two-year-old son hit his head on the edge of a table. After two hours, they still had not seen a nurse nor a doctor.

When he found out he was entitled to private healthcare because he had insurance, a plastic surgeon stitched up the little cut on his son's head.

'That cost US$1,000 ($1,400),' he said.

His point - judge a health minister by the quality of healthcare for the bottom 50 per cent of income-earners.

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Why means testing

It is to ensure that those who can afford private care will not crowd out poorer patients, especially as public healthcare services improve.

What has been suggested so far:

- Patients allowed to choose any class ward they want

- Rich will pay more than the poor in B2 or C class wards

- Means testing will be sensitive to the needs of the elderly and the unemployed

- Ability to pay based on income for those who are working, and on housing type for those who are not

- The difference in subsidies will be graduated, perhaps with as little as a one percentage point difference between levels

- The subsidy in a C class ward will range from at least 65 per cent to 80 per cent

- Avenues for appeal will be set up to make the system flexible

- Bottom 50 per cent of population unaffected by means testing