The cost drivers, as cited by Willis Towers Watson's survey, are familiar. The biggest factor is the overuse of care - or, medical practitioners recommending too many services. The second also qualifies as overuse - the over-consumption of healthcare by members. These same factors were earlier blamed for the poor underwriting results of IP providers.
Singapore's low birth rate suggests its portfolio is an ageing one, and likely increasingly unhealthy. As a national scheme, its mandate isn't profit generating, but it does need to retain a level of surplus to ensure that it can meet claims. Ultimately, it must be sustainable in the long run. Greater transparency in MediShield Life's portfolio of risks may help Singaporeans understand why premium adjustments are necessary. So far, the Council has disclosed that between 2016 and 2020, the scheme paid out S$3.5 billion for 2.3 million claims. Fifteen per cent of the payouts were for around 350,000 claims from those previously uninsured.