AI and genetic screening, flexible use of MediSave to help super-aged S’pore stay healthy

(Photo credit: ST Photo/Kua Chee Siong)

Source: The Straits Times

With Singapore becoming a super-aged nation, helping people stay healthy is more critical than ever.

So, the nation is raising the bar in preventive medicine.

Health Minister Ong Ye Kung brought up three new initiatives to support the changes in healthcare as Singapore readies itself for the future: The use of artificial intelligence in strengthening healthcare delivery; genetic testing for preventive care; and making MediSave flexible to help patients better meet their chronic and preventive care needs.

“Ageing does not arrive with a bang. Neither is it a whimper. It progresses quietly, with a real and profound impact,” he said. As of 2026, 21 per cent or more of Singapore’s population is aged 65 and above.

Speaking at the debate on his ministry’s budget on March 5, Mr Ong, who is also Coordinating Minister for Social Policies, said that Singapore had acted early, having foreseen this demographic transition years ago.

It did so by raising the goods and services tax to strengthen fiscal position; increasing retirement and re-employment ages; building more age-friendly streets and two-room flexi flats; and bolstering financial security for seniors through Silver Support, CPF Life and MediShield Life.

He assured members of the House that preventive care and population health remain the “overarching strategic thrust of what we are doing”, anchored by Healthier SG and Age Well SG.

Harnessing AI to identify high-risk patients, screening for prevention

As with other sectors, MOH also has plans to deploy AI. But Mr Ong said when it comes to healthcare, it should be AI-enhanced, not AI-decided, and clinicians should remain in the loop, with healthcare remaining a profoundly human endeavour.

“We take a practical, use case-driven approach. AI should not be a solution looking for a problem. We deploy AI only where it demonstrably improves patient outcomes or the delivery of care, and does so cost-effectively,” he said.

One such use is for strengthening health screening. Like many other countries, Singapore has developed an AI model to predict if a well person is likely to develop severe diseases in future by reviewing his current health status.

The Assisted Chronic Disease Explanation using AI, or ACE-AI tool, developed by national healthtech agency Synapxe, will standardise the way primary care providers identify individuals with high risk of developing diabetes or high cholesterol within the next three years, Mr Ong said.

Those flagged as high risk by the tool to have more than a 75 per cent chance of being diagnosed with diabetes and/or hyperlipidaemia (high cholesterol) within the next three years will undergo annual cardiovascular disease (CVD) risk screening, stepped up from every three years.

“This AI risk assessment tool will be rolled out to doctors for all Healthier SG enrollees from early 2027. If the tool flags a patient as high risk, the doctor may recommend more significant lifestyle adjustments and annual instead of three-yearly screenings,” Mr Ong said. The additional screenings will continue to be subsidised under Healthier SG, he added.

As at February, there are about 1,100 Healthier SG clinics.

Genetic screening to manage hereditary breast, ovarian cancers

It is estimated that one in 150 individuals carry a mutation in genes such as BRCA1 or 2 that are associated with hereditary breast and ovarian cancer (HBOC). Such a mutation substantially increases a woman’s lifetime risk of developing breast and ovarian cancer.

To enhance preventive care measures to support better health outcomes for Singaporeans, MOH is extending subsidised genetic testing to HBOC from December.

Women with the hereditary condition face a lifetime risk of up to about 60 per cent for breast cancer and up to about 50 per cent for ovarian cancer, compared with up to 13 per cent and up to 2 per cent, respectively, in the general female population.

Mr Ong said these women will undergo genetic counselling before and after the test.

“If they test positive, we will also offer the test to their immediate family members. We expect over 2,000 individuals to be eligible for the test annually,” he added.

Up to 70 per cent of the costs of specific, approved genetic tests will be subsidised for eligible Singapore citizens and permanent residents, who can also tap their MediSave to offset the remaining cost.

At present, when a woman is identified to have hereditary mutation(s) in HBOC-associated genes through genetic testing, she is recommended for more frequent mammograms for those at risk for hereditary breast cancer or other risk-reducing measures such as surgery.

Doctors will also recommend that family members also undergo the same genetic test so that they also benefit from early intervention if they test positive.

Since preventive intervention for high-risk individuals is being viewed increasingly as medically necessary to prevent more intensive treatment, financing coverage for risk-reducing surgery will also be strengthened.

Mr Ong said while he has come across women in Singapore who chose to undergo preventive mastectomy to reduce their risk of breast cancer, they lamented that they cannot claim insurance for such operations.

This issue was brought up by Dr Hamid Razak (West Coast-Jurong West GRC) and Workers’ Party chair Sylvia Lim (Aljunied GRC) during the debate.

Mr Ong added that MediShield Life generally does not cover prevention to keep the coverage focused and premiums affordable, and private insurance takes its cue from MediShield Life.

But if a high-risk individual is unable to undergo preventive mastectomy, she has a high chance of eventually needing cancer treatments, including a curative mastectomy to remove cancerous tissue in her breast, pushing expenses up, he said.

“We will therefore extend MediShield Life and MediSave to cover preventive surgeries for HBOC later this year. I should add that breast reconstruction is also covered, no different from today. This will better support women in harnessing advancements in genomics to take better care of their health,” he told the House.

MOH is working towards implementing MediShield Life coverage for risk-reducing mastectomy by the third quarter of 2026 and for risk-reducing removal of both the fallopian tubes and ovaries by the fourth quarter for patients who test positive for HBOC.

Coverage will be extended to operations with a clear clinical need and minimal risk of abuse, and which are suitable for risk-pooling through insurance and do not financially burden the MediShield Life scheme.

“This is a meaningful policy change ahead of International Women’s Day on March 8,” he added.

Flexible use of MediSave for chronic and preventive care

The third initiative Mr Ong said is to inject more flexibility in the use of MediSave to encourage early intervention and reduce downstream complications.

“To provide more support for preventive and chronic care in the community, we will raise the MediSave limits from $500/$700 to $700/$1,000. This will benefit over 910,000 patients who currently tap on the scheme, roughly 20 per cent of whom have annual bills exceeding the current limits,” he said.

The MediSave 500/700 scheme will be enhanced from January 2027, with its name changed to MediSave Chronic and Preventive Care scheme to better reflect its new purpose to support chronic disease management and preventive care.

Mr Ong said Workers’ Party MP Jamus Lim (Sengkang GRC) was right to describe medical expenses as “lumpy” when it comes to the existing MediSave withdrawals, with large sums to be paid towards the end.

But it will be less so with this new design. He said that after the subsidies, MediShield Life and MediSave, nine in 10 Singaporeans will be paying less than $500 out of pocket for their subsidised inpatient bills.

According to an MOH spokesman, out of these 915,000 patients, about 20 per cent had post-subsidy bills for chronic and/or preventive care that exceeded their withdrawal limit and around 95 per cent made a MediSave withdrawal under the Chronic Disease Management Programme (CDMP).

The remaining had utilised MediSave for preventive care only.

Among chronic patients who tapped MediSave 500/700, around 80 per cent had complex chronic conditions and were eligible to withdraw up to $700 a year.

These are patients who received treatment for either two or more CDMP conditions in a visit; or for at least one CDMP condition with a recognised complication.

The CDMP, which currently covers 23 major chronic conditions, including diabetes mellitus, hypertension, lipid disorders, stroke, and chronic obstructive pulmonary disease (a progressive, irreversible, and inflammatory lung disease that causes obstructed airflow, leading to severe breathing difficulties), will also be expanded to cover thyroid disorders.

Patients diagnosed with hyperthyroidism and hypothyroidism will be able to benefit from the enhanced MediSave Chronic and Preventive limit as well as receive CHAS subsidies for their ongoing treatment and management under CDMP.

This is expected to benefit more than 53,000 patients with thyroid disorders who will be able to use MediSave to pay for their outpatient treatment as well as selected vaccinations and preventive tests at polyclinics, MediSave-accredited general practitioner (GP) clinics and specialist outpatient clinics.

MOH is also looking at including other chronic conditions, such as eczema, in the CDMP, and will provide an update when it is ready.

Mr Ong said the Government health budget is about 2.7 per cent of GDP in 2026, and it is expected to rise to around 3.5 per cent by 2030.

“This 0.8 percentage point increase is very significant – it means increasing the Government’s health budget from about $22.5 billion this year to over $30 billion in 2030,” he said.

In closing, he said Singapore need not fear being a super-aged society.

“We can embrace it and make the best of it. Ultimately, it is not the percentage of Singaporeans above 65 that defines us… What matters is that Singaporeans are not just living for longer; we will strive to enable Singaporeans to live healthier for longer. We are not just a super-aged society; we will do whatever we can to build a super-healthy Singapore.”

Correction note: This story has been updated following a clarification from MOH with regard to the percentage risk for ovarian cancer in the general population.