Is Mr Khaw Boon Wan really misunderstood?

During the Parliamentary sittings on 9 and 10 February 2009, Health Minister Khaw Boon Wan caused a storm when he allegedly said that Singaporeans should consider sending their elderly parents to retire in JB nursing homes if they cannot afford Singapore’s nursing homes.

Following the negative response from the ground, Mr Khaw Boon Wan changed tack and claimed that his words were “twisted”.

Did the media misrepresent Mr Khaw or did we misunderstood his intention?

Let us revisit the Parliamentary records of his speech in the two days and the Straits report report a later. We leave you to judge for yourselves:

Mr Khaw Boon Wan, 9 February 2009:

“We discussed earlier about lower cost possibilities in the neighbouring region, especially Johor Bahru. Let me talk about my day trip during the Chinese New Year to Johor Bahru. I visited one site where a Singaporean investor is going to put up 200-bed nursing home. I asked him, “How much would you be spending on your capex (capital expenditure)?” It is mind-boggling, the construction cost and land cost are so low, that my cost of just putting up a polyclinic is probably more than his cost of putting up a 200-bed nursing home. So the cost of keeping a resident in a private nursing home in Singapore can easily pay 2.5 months of nursing home care in JB. If the connection is easy and if there is any urgent problem, you can always ambulance in the elderly to Singapore. The family members can get to visit the elderly on weekends. As this nursing home’s CEO told me, even in Singapore, when they put the elderly in the nursing home, they also only visit them once a week over the weekends. Of course, many visit daily but quite a significant percentage just visit on the weekends. So, what is the difference with putting them in JB?

Source: Hansard

Mr Khaw Boon Wan in response to Ms Sylvia Lim, 10 February 2009 :

On the nursing home in Johor, I mentioned it in passing because I made a trip there. Actually my main purpose was to look at the hospital because Members have asked me to consider the possibility of Medisave to be used for hospitals there. I used the opportunity to look at the Iskandar Malaysia region; I have not been to that part of Johor for many years and wanted to see how the development is shaping up there. It was a very pleasant trip. I went by the Tuas Second Link, then from west to east to Pasir Gudang, ended up with a nice seafood and cheap lunch near Pasir Gudang and came back through the new CIQ Checkpoint to our Causeway. At the Iskandar Malaysia region, I also took a look at the site where I heard they have investment from a medical school from England which is coming to set up. I also went to take a look at the Legoland theme park where the land is being prepared. Sorry, for digressing.

But many Singaporeans, including many residents in my constituency, go to Johor very regularly, top up their car, which many do, and also to have a nice seafood meal at much cheaper prices. I think these are natural activities, and that is part and parcel of globalisation. In fact, this is not even globalisation; this is regionalisation, and there is nothing wrong with that. Consumers are free to choose. I know many go over to the pharmacy there to get cheaper drugs. It is not our fault. The pharmaceutical companies have a way of setting prices: Third World, they set lower prices; First World, like Singapore, they set higher prices. By allowing the flexibility of consumers walking over the Causeway, they benefit. I do not think we should constrain them from doing so. Our cost will always be higher because our wages are different. Nurses are paid very differently here compared to Johor and ditto for doctors; likewise construction cost.

I just want to point out to Singaporeans that there are options like these. In fact, it is already happening. This free flow of patients across borders, so much so that there is a term called “medical tourism”. Singaporeans go to Bangkok, I know, for lasik, and vice versa. Americans come here. Russians come here. Singaporeans go to Penang and Malacca. I think we should allow that. In any case, how can we prevent it? We cannot prevent it. But in fact, by keeping the borders “open”, it puts some competitive pressure on our local providers which eventually will be good for our own consumers. Because if they price themselves too high, the patients will start going across the Causeway and they lose customers.

Source: Hansard

Mr Khaw Boon Wan in response to Mr Low Thia Kiang, 10 February 2009 :

So no, I am not saying that if you are poor, I will put you in an ambulance, send you across the Causeway to Johor nursing home. That is not what I said and please do not twist my words. But what I am saying is for those in the middle-income group, you have choices, you are paying out of your own pocket, you decide. Do you want to have a seafood meal in Singapore or you want to have a family reunion in JB, it is up to you, this is your own choice. Do you want to fill your car tank in Singapore or you want to drive across and have a haircut, that is up to you. You are spending your own money. And I am just sharing with Singaporeans that there are alternatives of that kind. But for low-income Singaporeans, we look after and heavily subsidise them. There is no need for them to walk across, because they enjoy a heavy subsidy here. They have to pay unsubsidised rate in JB. It will be more expensive than what they can receive in Singapore. So that is the way we do our systems and I hope to get the Member’s support for it as well.

Straits Times report, 11 February 2009:

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