Having received the 3rd letter (the time lag between the 2nd letter & this one was just 1 wk) requesting us to pay another deposit of 4k, both D and I were rather quiet and didn’t dare broach the topic of “Maybe we should transfer our daughter to KK instead”.
Our daughter’s NICU bill at Thomson Medical Centre (TMC) currently stands at $18.5k without Medisave deductions and we have paid 13k of deposits since her birthday on 1 Aug 2010. Fortunately, the amount of money that D’s mum and brother had given for our lil’ girl had helped with a sizable chunk of the initial bill.
We went ahead to pay after seeing our lil’ one, this time I paid for it. D was quieter than usual, which usually means he is thinking very hard. I saw the worry lines on D’s face and said that I will check with KK about the requirements and costs if we would to move her to the restructured hospital.
Since the NICU at Kandang Kerbau Hospital (KK) is a shared ward and the babies are tagged to the mums’ chosen class ward on admission, it doesn’t matter whether the baby is in an A1 class (private) or C class (heavily subsidised) as the baby will be treated all the same regardless. The same treatment, medical procedure etc required by the baby will cost differently based on the class. Those in the C-class will have the highest subsidies allocated and on the opposite end of the spectrum, babies in the A1 class would be charged the most. It would be a huge savings for us if our lil’ one is in the C-class ward in KK.
I was given a referral to see my gynae’s ex-colleague at KK but popped before the appointment date. My gynae thought that perhaps it was better for me to get registered at KK so that if I had to give birth prematurely, the costs would be much lower than in the private hospital (TMC). Besides I didn’t expect to have a premature birth when my first wasn’t, although he was born 4 wks early. Hence I decided go back to the same gynae and give birth in TMC again.
So I called KK and spoke to different people on two different days. Some transferred my call to this person and that and re-transferred my call to the department that I had called in the beginning. I had a few questions and needed confirmation before we decide if it was worthwhile for us to transfer our lil’ one.
1. Since we are transferring from a private hospital, will our girl be charged private rates in KK?
Ans: We will be considered A1 and at most B1 class (both private rates). Our PD, Dr Ong at TMC, must liase with the PD at KK so that there is a proper transfer of records before the baby moves to KK. Also it depends on whether there is any bed space at KK and of course, wehther our baby’s condition is stabilised before the transfer.
2. Can we opt for the subsidised C-class?
Ans: Only after means testing is done. Information such as combined income, no. of family members that need to be supported etc will be taken into consideration before KK decides if we could “downgrade” to a cheaper class ward.
But there is no guarantee that we could even be downgraded all the way to C-class. Hence there is also the possibility that we could just stay in the private class ward or maybe at most B2, but either way, we would be at the mercy of KK’s means testing.
D didn’t like this at all and we didn’t think they would do the means testing before the transfer anyway for us to make a wise informed decision. The private room rates at KK (A1 and B1) are already more expensive than the costs incurred each day by our lil’ one at TMC (she is already at Class 3, the most expensive of the 3 NICU rates), so it makes no monetary sense to move her. The savings will only come about if our baby is transferred to the C-class ward at KK.
3. Any other ways to go to the C-class ward?
Ans: The first time I called, the person I spoke to told me that I could send my baby to KK’s A&E department via the ambulance service and we could go to the C-class ward.
I found this strange and asked the Dr Ong if he had heard of this arrangement. His reply: This is called “dumping” and he was surprised that the person at KK actually suggested this. Basically there will not be any proper transfer of medical records or discussion between the PDs in the two hospitals regarding the condition of my baby girl. This would not reflect well on Dr Ong’s reputation.
The second time I called, I spoke to an actual supervisor and she was very patient and took the time to explain. For us to go to C-class ward, again, KK makes the decision, not us the parents.
In KK, the first level is the means testing before decision is made by them on the correct class ward that the parents can downgrade to. The 2nd level is for us to incur a bill of 15k (at the private ward class) before KK downgrades us, but again, it is no guarantee that we would be downgraded all the way to C-class.
Either way, D and I were caught in a major fix. We had the growing bill to pay and we think our lil’ girl will stay in there for more than a month. Of course Dr Ong had first told us in the very beginning that it could be at least 2 months, but at the rate that our baby girl is putting on weight, we think she may stay longer than that.
The NICU at TMC is smaller and the ratio between the nurses and young patients are better I think than KK and more importantly, my lil’ one is already comfortable there. I told D by the time her condition is stabilised and able to be moved, we would also have been downgraded to Class 2B and even 2A in TMC, so perhaps it doesn’t make any difference in the costs if we would to transfer her to KK. Besides I really dread the transfer, too many what-ifs even though KK is near TMC.
So D and I have decided our lil’ girl will stay on in TMC and we know that God is in charge, both over our lil’ one and the costs. It is really testing us and our financial planning, any plans we have made are on hold as we channel our savings to keeping our lil’ girl well.
I worry at times over future costs, perhaps her sight and hearing could be affected cos of the early birth, maybe some other medical issues that aren’t obvious now will surface later on. It isn’t just the current bill we have to pay for, it’s the others that may come our way later on.
Lots of people have tried to assure us that she will be fine. Some have given us examples of preemies who have turned out fine. We do believe that to be true, but we have also seen one who didn’t survive and the parents’ pain and anguish will be on our minds for a long time. It’s a dose of reality that things don’t always turn out the way we want it to.
D and I know many people are praying for her every day and we take every good news to be a miracle. But I suppose it is so human to worry and fret. Our lil’ one is way too important right now and that helps us to put things in perspective.
D and I just want her to be home soon, happy, healthy and normal.