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‘I thought I couldn’t go through any more of it’: Cancer patient gets help after insurer says ‘no’ to $33k bill
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‘I thought I couldn’t go through any more of it’: Cancer patient gets help after insurer says ‘no’ to $33k bill

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Good Samaritans have stepped forward to help a cancer patient, who hopes to spend more quality time with her 15-year-old daughter while keeping the disease at bay.

The drug that Ms Koh Ee Miang, 45, needs to control the spread of her cancer is expensive, and her insurance company has refused to pay for it – leaving her with an outstanding bill of more than $33,000 for treatment carried out between November and January.

Hard-pressed to pay for the drug, she stopped the treatment in January and reverted to basic chemotherapy. Her cancer markers jumped 50 per cent and her tumour grew.

Her oncologist, Dr Choo Su Pin of Curie Oncology, put her back on the targeted therapy treatment and offered to let her pay in instalments. Said Dr Choo: “The treatment works. Do I stop her medicine?”

The drug not only slows the spread of the cancer, it also reduces pain and has fewer side effects than chemotherapy.

Both patient and doctor were in a quandary over the high cost of the treatment after insurers rejected the claim.

Ms Koh is a housewife who says she hopes to take her 15-year-old daughter on a holiday to leave her with “happy memories” since the prognosis for her cancer, which is fourth stage, is not good – with only 2 per cent surviving five years.

The story of her plight in The Straits Times has resulted in several offers of help.

The Community Foundation of Singapore, set up in 2008 to encourage and enable philanthropy, reached out to the Emma Yong Fund – named after one of the stars of the musical cabaret group Dim Sum Dollies, who died of stomach cancer at the age of 36 – for help.

The Fund agreed to pay the $33,000 bill that was outstanding.

Fund administrator Selena Tan said though the fund was set up to help theatre practitioners, she was happy to extend the help to Ms Koh.

“Knowing Emma’s legacy and desire to help patients with cancer, it felt right to help cover 100 per cent of Ms Koh’s medical bills so that she can focus on her treatment and recovery, and not feel distressed by her bills,” she said.

Several readers also offered smaller sums to help defray the cost.

And AstraZeneca, the pharmaceutical company that produces the Enhertu drug she now needs, has offered to provide her with it. It costs about $10,000 per treatment. However, this is subject to certain compliance issues, which Dr Choo is hoping to resolve.

A grateful Ms Koh said: “Their kindness helps me feel less alone. And just when I thought I couldn’t go through anymore of it (it has been two years of chemotherapy treatment and its side effects), they help me push on in spite of weariness.”

She would like to thank all the “generous people whom I’ve never met” for their kind offers. She will not be accepting their offers, since help from the Emma Yong Fund and AstraZeneca is enough for her to continue with the treatment.

Ms Koh suffers from a rare cancer – human epidermal growth factor receptor 2 positive (HER2+) bile duct cancer – which afflicts about one in 3,500 cancer patients.

After it was diagnosed in June 2020, Dr Choo first put Ms Koh on standard chemotherapy treatment. When she stopped responding to the treatment, a second choice was used, but this too was not able to stop the spread of the cancer.

Oncologists say there are no standard treatments beyond this.

Dr Choo decided to put her on a drug that targets the HER2 protein, which causes cancers to spread much faster, to try to contain the disease. It worked.

But Great Eastern, the insurer with whom Ms Koh has a private hospital as-charged Integrated Shield Plan (IP), as well as a rider that pays the full cost of her portion of the bill, refused to pay for the new treatment.

GE said the IP contract has a clause saying it covers only drugs that have been approved for specific illnesses. The drug she was put on has only been approved by the Health Sciences Authority for HER+ breast cancer, and not for bile duct cancer.

More than a dozen oncologists The Straits Times spoke to said it is difficult to conduct large scale clinical trials for rare cancers – since patient numbers are low. And all said they do use drugs “off-label” – meaning the drug has been approved here, but not for that specific cancer, especially for the less common cancers.

Drug companies often feel the returns are not worth the cost and work required to seek approvals from regulators for such low numbers.

Dr Choo, who was chief of Gastrointestinal Oncology at National Cancer Centre Singapore before leaving for private practice in 2018, said there are some small-scale studies showing that the drug does work on the type of cancer Ms Koh has.

Insurers offering IP plans, which are integrated with MediShield Life, are divided on coverage of drugs which doctors think might help, but which are not specifically approved by the HSA.

At least three – AIA, Income and AXA – say they would cover such drugs. The Ministry of Health (MOH) said the basic MediShield Life national health insurance would also pay, subject to a monthly cap of $3,000.

This article was originally published in The Straits Times here. Source: The Straits Times © SPH Media Limited. Permission required for reproduction.

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News

CFS welcomes new Chairman Christine Ong, succeeding Laurence Lien

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(From left) Catherine Loh, Christine Ong and Laurence Lien.

The Community Foundation of Singapore (CFS) welcomes new Chairman Christine Ong on 1 April 2019, succeeding outgoing Chairman Laurence Lien. The handover was announced at the CFS Philanthropy Forum 2019 held on 18 March.

Signalling a new phase for CFS as the organisation looks to the future, Christine brings extensive experience spanning 30 years from the banking and finance industry, with key leadership positions in Citibank and UBS. She has long been involved in volunteering and mentoring in community regeneration, education and the arts. At UBS, she started a community affairs programme which raised $3 million to support various causes around the region including educating disadvantaged young people in East Java and saving children from being used as drug mules in the Mekong sub-region.

Christine is a current board member of Focus on the Family. She most recently served as Chairman of Arts House Limited and was previously on the board of The Esplanade Co Ltd (2015–2018).

Said Christine, “It is an honour for me to step into Laurence’s giant shoes at CFS. Laurence has not only built a successful organisation but his inclusive leadership has helped forge strong relationships with donors, partners and stakeholders.I am grateful for the opportunity to lead CFS which, over the years, has transformed how philanthropy is approached. As the organisation evolves to respond to an increasingly complex social landscape, I shall continue to build on the trust and meaningful relationships established between donors and charity partners to inspire even more giving and lead CFS into the next decade.”

Laurence was a founding director of CFS when it was launched in 2009, acting CEO from 2009–2013, and has served as its Chairman since 2013. He has been instrumental in introducing the concept of community philanthropy through donor advised funds to Singapore. He played a significant role in helping CFS grow to achieve 126 funds, raising over $134 million and disbursing over $71 million to over 400 charitable organisations in Singapore.

CFS CEO Catherine Loh remarked, “Under Laurence’s strategic leadership, CFS has grown tremendously and established itself as an organisation well-regarded for its community knowledge, professionalism and strategic approach to giving.”

Reflecting on his ten-year tenure at CFS, Laurence said, “When you start a venture in the non-profit sector, you don’t own anything. The rewards are not material but instead a personal satisfaction that comes from knowing you made a difference.”

He cited CFS’s phenomenal four-fold growth in 2018 as a fitting time for his departure, “CFS is really at an inflection point and it is a good time to leave on a high note. I am confident that with a good board and team already in place, and an experienced hand taking over as Chair, CFS will grow from strength to strength, and become a landmark in Singapore’s giving landscape.”

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The competition was organised by City Harvest Community Services Association and received support from FUN! Fund, a Community Impact Fund jointly established by the Community Foundation of Singapore and the Agency for Integrated Care, with the aim of addressing social isolation among the elderly.

Senior Minister of State, Ministry of Communications and Information & Ministry of National Development Mr Tan Kiat How attended the event. He encouraged the elderly to stay physically and mentally well, as well as urging them to participate in community activities and enjoy their golden years together.

Learn more about FUN! Fund at https://www.cf.org.sg/fun-fund/.

 

The programme provides the children with a non-threatening platform to connect with peers and have positive conversations. In addition, it exposes them to different people who can assist to broaden their perspectives.

L.S., a volunteer with the Reading Odyssey programme @ Spooner Road

中心“常胜将军”胡锦盛:比赛限时反应要快

现年92岁的胡锦盛是最年长的参赛者。自2017年退休后,他几乎每天都到活跃乐龄中心报到,从此爱上了玩拉密,每次可玩上三个小时,在中心是“常胜将军”。

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Opinion

How Donor-Advised Funds (DAFs) present an innovative and structured solution to Singapore’s philanthropic landscape

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A history of giving in Singapore and its philanthropic landscape

Philanthropy has seen an evolution over the years, which saw a corresponding increase in family support services due to the development of more HDBs to house our growing population.

As the philanthropic landscape developed and progressed, there was a more targeted response in the 90s by philanthropists seeking to fill in the gaps in philanthropy and wanting to have more of a say in order to shake up the system.

As a result, CFS was founded to promote philanthropy, seeing as philanthropists were stepping up and starting family foundations, and how Singapore has a very active philanthropy landscape in spite of its size.

To date, the current number of charities in Singapore stands at over 2000. However, it was not only charities that received donations but also social enterprises and ground-up groups, especially during the Covid-19 period.

There are very stringent processes to achieve a charity status, charities in Singapore are generally well managed and of the 2000 charities, 600 have attained an IPC status.

“Singaporeans have also been extremely generous thus far, and gave a total of 1.9 billion in 2019. This generosity is an important focal point, as there is an onus and more incentives for charities to work directly with philanthropists and givers to come up with new and innovative programmes,” says Catherine, CEO of CFS.

Donor-Advised Funds (DAFs) and CFS’s role as a community foundation in Singapore

CFS’s role as a community foundation in the philanthropic ecosystem is to enable philanthropy, foster giving and promote values such as the Legacy Giving Initiative (LGI). The LGI is a concept that anyone in Singapore, regardless of status and wealth, can leave a legacy by giving to a cause close to their heart.

As philanthropy continues to evolve, donors have become more discerning and want to know how the impact of their philanthropy is measured.

There is also a need for philanthropy in Singapore despite it being a wealthy city state, as there is still relative poverty and thus a need to uplift every segment of the nation. There are key issues that need support and funding in Singapore, three areas of which are our rapidly aging society, social income inequality, and inclusivity and sustainability; where people with disabilities and environmental issues need support.

CFS is also seeing an increase in international donors in Singapore, which could be Singaporeans looking to expand their overseas businesses in Singapore, or foreigners setting up family offices in Singapore.

By partnering with CFS, a donor can establish a named donor-advised fund (DAF), a modern philanthropy tool.

A DAF is a simple and cost-effective way to support a wide range of charities in Singapore. CFS will handle the fund administration and provide philanthropy advice to ensure that our donor’s giving makes a strategic impact to the causes that our donors support. 

With a DAF, donors can enjoy upfront tax deductions in Singapore at the prevailing tax deduction rate1 on eligible donations.

1Subject to IRAS regulations. 

How to get started? 

DAFs can be set up by an individual, a beneficiary of a will, a trust, or by a family office. 

CFS philanthropy advisors will inquire about the donor’s interests and leveraging on deep understanding of local issues and extensive network, CFS has unparalleled insight into Singapore’s charitable landscape and community needs to translate the donor’s interests and goals into a defined plan.

CFS handles all the administration required in managing the DAF, donors will save on legal expenses and enjoy tax deductions upfront. Donors will also receive regular statements tracking incoming donations to the DAF and outgoing disbursements to charities.

CEO Catherine Loh gives a WMI-GFO Circle Impact Masterclass on CFS’s role in philanthropy in Singapore 

CFS’s CEO Catherine Loh was invited as a guest speaker and part of the panel to speak about CFS and philanthropy in a WMI-GFO Circle Impact Masterclass webinar organised by the Wealth Management Institute (WMI) titled ‘Global Giving, Asian Innovation’.

The webinar’s aim is to address how philanthropy can support the greatest issues of our times, including issues stemming from ever-rising income inequality and climate change, to the health of our civil society and the pandemic.

The panel presentation hopes to empower family office principals, representatives and philanthropy advisors to help their clients achieve their philanthropic goals, and offer best practices, tips, and considerations for advisors serving philanthropists and their family offices.

If you would like to begin your giving journey with CFS, get in touch with us.

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Stories Of Impact

KidsExcel – Leaving no child behind

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At a time when after school tuition and enrichment programmes have become the new norm, children from less affluent backgrounds are increasingly disadvantaged by their inability to afford these lessons. This creates an educational landscape that places each child at different starting points by virtue of their socio-economic backgrounds.

KidsExcel is a values-driven, academic and sports enrichment programme that aims to support schools and parents in providing a holistic education for kids. Its mission is to provide a holistic, well-rounded programme that develops healthy minds, healthy bodies and strong character, using sports and academic enrichment to nurture the physical, intellectual and social skills of children.

“KidsExcel seeks to address the prevailing asymmetry in educational opportunities for underprivileged children. The programme aims to develop these children holistically through a structured integration of sports and drama with academic enrichment,” said Victor Pok, Director of Vivakids which runs the programme.

By providing primary school students under the Ministry of Education (MOE)’s Financial Assistance Scheme access to a year-long enrichment programme, KidsExcel hopes to inculcate in students an intrinsic motivation to excel, which will hopefully follow them through their lives.

At a recent site visit to Fuhua Primary School – one of KidsExcel’s school partners – the Community Foundation Singapore (CFS) and its donors bore witness to the work they do. Each week, students spend three hours on academic enrichment and an additional three hours on sports as an added incentive for them to turn up for classes.

At the after school programme, students learn through interactive and engaging lessons that provide effective development opportunities. Math classes saw students engaging in friendly competition to solve problem sums flashed out by their teacher. Speech and drama lessons visibly instilled in them a sense of confidence. Frequent proficiency testing also helped facilitate differentiated lesson plans to suit the varied capabilities of students.

While the sports component was conceived to encourage students’ attendance, it plays a pivotal role in developing them holistically. A range of carefully designed and modified games provides opportunities for the students to learn values – such as teamwork and self-confidence – that are beneficial for their intrinsic development.

And the overall results are encouraging. The programme at Fuhua has seen full attendance since its inception. Through timely and consistent tracking of exam results, statistics from KidsExcel’s school partnerships reflect overall improvements in students’ literacy and numeracy levels.

In a spirited sharing of the school’s experience, Fuhua’s co-ordinating teacher-in-charge praised it as an affordable programme that provides sustainable value-add to students. “I have seen an improvement in many of the students and they really enjoy the time they spend with their friends during the programme. Many of them often come to my office just to ask me if the programme is on this week, the following week, or even in the following year. It really speaks to how the programme has given them something constructive to look forward to. Otherwise they will probably be doing nothing at home or gallivanting at the malls.”

“The support of CFS and its donors has been crucial in realising our aims, providing the platform to engage even more in the future.” said Victor.

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Stories Of Impact

Championing inclusive employment for youths with special needs

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For more than 10 years, CFS donors have supported the Metta Welfare Association and its trailblazing Metta Café through the Work Readiness Programme, which equips youths with special needs with the vocational and soft skills they need for the workplace. CFS is commemorating 15 years of giving and this story is one of a three-part series that highlights the strong relationships CFS has fostered with charities over the years.

I am grateful to my trainers for guiding me along patiently. I’ve learnt many things here and I hope to become a baker one day.

Toh Ming Yi hopes to become a baker one day. The 26-year-old is an apprentice at Metta Café. Under the guidance of patient teachers, he is learning to make cookies, muffins and other baked goods. He is also picking up valuable and complementary life skills like managing money and communicating with customers, which will help him in the working world. 

Like the other Metta School graduates with mild intellectual disability and/or autism who work at this inclusive café, cheerful Ming Yi has the right support to help make his dreams come true.

Building a long and fulfilling relationship

Metta Café is part of Metta Welfare Association (MWA), a charity set up in 1992 which has uplifted countless lives of those with special needs. The Community Foundation of Singapore (CFS) has had a long and valuable relationship with MWA since 2011. To date, CFS donors have generously contributed over $736,000 to MWA and have been a pillar of support for Metta Café’s Work Readiness Programme.  

CFS’ continued support has enabled us to continue empowering more individuals in need. Besides equipping our youths with life skills that will better facilitate their integration into society, we were also able to fund programmes that develop social and communication skills to increase their employment opportunities.

Felicia Wee, Deputy Executive Director

Creating employment opportunities through the Work Readiness Programme

The Work Readiness Programme provides apprenticeship opportunities, on-the-job training, job attachments, life-skills training, internship training and open employment to young adults with special needs to prepare them to contribute to the workforce. 

Initially offered solely to Metta School graduates, the programme has delivered such positive outcomes that students with special educational needs from other institutes such as the Institution of Higher Learning and the Institute of Technical Education also seek out internships at Metta Café. 

In 2020, the café became a WSQ In-house Approved Organisation to conduct the Food Safety Level 1 certification. This enables a wider range of participants to upgrade their skills, creating greater inclusiveness and opportunities for them in society. 

Metta Café’s Work Readiness Programme resonates with CFS as it is designed to improve employability, one of our key focal areas for grant making. We look for causes that empower marginalised job seekers to become contributing members of society. This can be through education, exposure to career pathways or advocating for more inclusivity.

CFS has been giving out grants to the programme since it began in 2016 and this enduring support has enabled Metta Café to increase its apprenticeship numbers.

“We value CFS as our long-term partner,” says Felicia Wee, Deputy Executive Director of MWA. “Their donors’ contributions to MWA have been significant. With their collective support, we have been able to help more youths with special needs maximise their potential.”

Encouraging long-term support through legacy giving

More recently, CFS and Metta have been working closely to encourage more legacy giving. Legacy gifts are planned future gifts such as bequests of assets or memorial funds, which offer a more sustainable and reliable source of fundraising for charities. It also opens up ways for donors to create an impact well beyond their lifetime.

With guidance from CFS, Metta has been actively engaging donors on its long-term plans and accepting all forms of legacy gifts including CPF and insurance nominations.

We are proud to maintain a long-term relationship with Metta and are committed to working with other like-minded charities to bring greater impact to youth with special needs under the CFS cause Improving Employability.

CFS is celebrating our anniversary throughout 2023—15 years of empowering donors to make a meaningful impact. Since our inception in 2008, we have received over S$292 million in donations in Singapore and disbursed over S$157 million in grants to over 400 charity partners.  

To discover how you can make a difference, please visit www.cf.org.sg/contact-us/get-in-touch/. 

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