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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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Home Resources News ‘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

John Doe

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.

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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.

Related Topics For You: DIRECT AID, DONOR STORIES, DONOR-ADVISED FUND, HEALTH, NEWS, STORIES OF IMPACT

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Opinion

Accessing Quality Education: Three Areas Where Donors Can Make A Difference

John Doe

Students without means often do not enjoy the same opportunities as their well-to-do peers. Some are forced to give up their studies to support themselves and their families. Others struggle throughout school without realising they have a learning disability. Some younger children are less school-ready, leading them to fall behind academically. With grants from CFS donors, at-risk students can get the right support to access quality education, one of five focal outcome-centred causes that CFS champions.

We firmly believe education can boost a person’s employability, and promote inclusivity and integration within society. However, we recognise that not every child has an equal shot at obtaining the education they need. With targeted philanthropy, we bridge critical gaps and improve social mobility for our most vulnerable young.

Leaving a Legacy for Future Generations

Our Annual Report 2023 is now available for download

Four people in green shirts working on soil in a gardening project.

Four critical gaps in improving employability for all

CFS curates evidence-backed programmes that stretch from pre-school to tertiary level. In this article, we focus on three essential areas where, together with our donors, we continue to make a tangible impact. These are financial assistance for living expenses, helping children with learning differences and building skills for primary-level pupils.

Letting Students Focus on Learning Through Financial Assistance

At the Institute of Technical Education (ITE), students gain diplomas and valuable skills in a variety of industries, from food science to nursing to IT. The majority of ITE students, however, come from challenging backgrounds: 46% are from families with a per capita income of under $1,000, more than twice the national average. Many then have to work part-time, leaving less time for their studies.

ITE lends a helping hand to these youths through the Monthly Financial Assistance Scheme (MFAS). Beneficiaries receive $150 per month for six months to help with their food and transport costs.

ITE is only able to help some of their students with MFAS and relies on donor support to ensure greater coverage. This would help even more students on their quest to graduate and find gainful employment.

Similar financial assistance schemes are also offered by AMKFSC Community Services Ltd, Nanyang Polytechnic, Ngee Ann Polytechnic, Republic Polytechnic and Temasek Polytechnic. Numerous students with limited family support stand to benefit from your generosity.

Support for Dyslexia Assessments

Children with learning differences often have difficulties keeping up in school. This can severely impact their academic life and hurt their career opportunities. Some have dyslexia without knowing it: global incidence rates suggest that up to 10% of the school-going population may suffer from dyslexia.

In Singapore, the Dyslexia Association of Singapore (DAS) conducts close to 1,000 psycho-educational assessments each year, based on referrals by teachers and parents. These assessments are important in identifying the needs of struggling learners to make appropriate recommendations for learning support. However, about 35% of these children come from low-income families, who will not be able to afford the costly assessment fees.

Donor support from CFS directly funds psycho-educational assessments by trained psychologists at DAS. Once diagnosed, the children will be able to receive support tailored to their learning abilities. Through early intervention, donors are helping disadvantaged children overcome their learning differences, allowing them to fulfil their potential.

After-School Enrichment Builds Skills and Confidence

Each child starts at a different point in primary school based on their socio-economic background. Those from families facing challenges may have weaker literacy or numeracy skills and thus be less prepared for school. Being placed into lower-performing classes may demoralise and frustrate these children, leading to disinterest and reduced academic motivation.

KidsExcel works closely with primary schools to reach out to students from families with a gross household income below $2,750 or per capita income below $690. It runs regular enrichment sessions which address learning gaps as well as activities centred on sports and life skills. This includes drama, public speaking and robotics. The programme boosts resilience and character-building while helping the kids academically. It also empowers parents to participate in their children’s educational journey.

In 2022, KidsExcel served 350 primary school children across 11 centres. An encouraging number of children were able to improve their grades, while 87% of Primary 6 pupils passed their PSLE. Through KidsExcel, donors are helping to level the playing field for underprivileged children in primary schools.

We could spark change with far-reaching effects by funding a programme that improves access to quality education. Drawing on our experience working with charities and partners over the years, CFS is here to offer advisory and administrative support so that you can focus on the transformative power of your giving to educational causes.

Learn how CFS can help you support access to quality education at https://www.cf.org.sg/giving/ways-to-give/.

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John Doe

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”。

Related Topics For You: DIRECT AID, DONOR STORIES, DONOR-ADVISED FUND, HEALTH, NEWS, STORIES OF IMPACT

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Stories Of Impact

Shining a light on early childhood literacy

John Doe

Our donors have long been a pillar of support for the charity SHINE Children and Youth Services, especially their Reading Odyssey. This programme builds reading skills and confidence in disadvantaged children. 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.

While most children in Singapore are able to read when they start primary school, some have very limited literacy skills. This could be due to challenging personal circumstances or undiagnosed learning difficulties in their earlier years. The problem is that this limitation immediately sets them back from their peers academically.

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Reading Odyssey to the rescue

SHINE Children and Youth Services bridges this gap through a volunteer-supported reading programme called Reading Odyssey. The programme struck a chord with us at the Community Foundation of Singapore (CFS) and with several of our donors keen to support educational causes. It goes beyond nurturing skills like word recognition. It also builds confidence and hope for these children, who tend to suffer from low self-esteem.

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

“Through CFS’s strategic efforts in garnering support from funders, the programme was able to partner with more community groups and agencies to expand its reach from four to seven communities in 2018,” notes Geraldine Low, Director of SHINE’s Educational Psychology Service.

By 2022, this empowering initiative had grown to cover 13 communities, benefitting over 800 primary school students. It amassed a formidable pool of over 800 volunteers, who patiently guide the children with their reading, widen their exposure to genres and topics, and spur them to become lifelong learners. Reading Odyssey also draws on learning support experts to provide specialised guidance to children who may have conditions like dyslexia.

A partnership that works

It can be a challenge to seek support for children in the community with learning or reading difficulties that are ‘hidden’ and whose needs are easily misunderstood. We appreciate CFS who has been open and committed to journey alongside the team to seek clarity on needs and programme intervention, provide feedback, and actively position the programme to relevant funders.

Geraldine Low, Director of Educational Psychology service, SHINE

CFS’s partnership with SHINE dates back to 2010, during our formative years as the nation’s first community foundation. The charity, founded in 1976, provides an array of services including educational psychology, school-based social work, therapy and mental health. To date, a total of 105 contributions amounting to over $5.5 million have been made by generous CFS donors.

“The donations from CFS have provided a stable and reliable source of funding. This has allowed SHINE to continue operating and delivering vital services to children and youth without interruption,” says Geraldine, adding that the money has also helped SHINE develop new initiatives and explore innovative approaches to their programmes.

A common vision

The powerful work done by SHINE falls under one of our five focal areas for grant making: Accessing Quality Education. We believe holistic, quality education can help break the poverty cycle for low-income families and improve social mobility. We partner with a wide range of charities and educational institutions to help every child receive a good, well-rounded education.

For donors who want to make a difference in early childhood education, we introduce them to programmes like Reading Odyssey, which advances child literacy as well as social inclusivity in Singapore.

“By pooling knowledge and experiences, initiatives that are evidence-based, culturally sensitive and tailored to the unique needs of the beneficiaries can be designed and implemented,” says Geraldine.

That is why SHINE hopes to continue working closely with CFS and to explore long-term funding strategies with CFS, so it can make even more of a lasting impact.

We are proud of our long-term relationship with SHINE and are committed to working with like-minded charities to create a greater impact on the lives of children in underserved communities under the CFS cause Accessing Quality Education.

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/

Related Topics For You: DIRECT AID, DONOR STORIES, DONOR-ADVISED FUND, HEALTH, NEWS, STORIES OF IMPACT

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Opinion

5 Critical gaps in caring for vulnerable seniors in Singapore

John Doe

Singapore is fast reaching superaged status. Life expectancy is going up while the birth rate is heading south. By 2030 – not many years from where we are today – one in four Singaporeans will be 65 years or older. More worryingly, a fifth of that cohort will be over 80 (Population in Brief 2021).

Ageing well and quality of life are huge concerns for our elderly. The biggest challenges centre on health: physical frailty or disability, sensory impairment such as hearing loss, or chronic conditions such as dementia or diabetes. However, ageing is not just a matter of biophysical health. It is also about bolstering psychological, emotional and community support.

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Mental wellness issues, such as depression and loneliness, are a real threat to the older demographic. On top of this, many older Singaporeans worry about financial security, due to escalating care costs, inadequate retirement income and limited earning opportunities.

Many people prefer to age at home but that too has its challenges. In this article, we highlight the critical gaps in caring for vulnerable seniors and what can be done to support them so that ageing can be enabling, empowering and meaningful.

#1 Funding rising healthcare needs

Singapore’s healthcare expenses could jump tenfold between 2016 and 2030 to over $66 billion¹. Family is typically the first line of support but families are getting smaller and relationships may be estranged. Income caps also mean not everyone qualifies for government aid.

Even when fees are subsidized, low-income seniors may struggle with costs. Women, in particular, face more financial insecurity as they tend to have interrupted employment or be in low-wage or unpaid care work. Women also tend to outlive men and are more likely to be single, widowed or divorced in old age.

The burden lands on welfare organisations to meet the shortfall. However, causes that help the elderly don’t attract as much funding as say, education, which in Singapore receives the lion’s share of donations: in 2019, they accounted for 52.9% of total receipts of $20.8 billion (Commissioner of Charities 2020).

#2 Access to home care and assisted living

Letting people age at home or in the community and delaying institutional care is a universal goal. But as the number of seniors with mobility issues or age-related ailments increases, demand for home nursing, home therapy, meal deliveries, assistive devices and home safety and modification services (to prevent falls) will rise. There will also be a much bigger role for centre-based eldercare, such as day care, and initiatives for assisted living.

#3 Depression and suicide

Aside from physical ill health, many seniors grapple with loneliness, loss of loved ones or dependence on others. The number of elderly living alone doubled to 63,800 in 2020 from a decade ago and is set to hit 83,000 by 2030 (Singapore Department of Statistics).

According to the Samaritans of Singapore, the number of people aged 60 and above who took their own lives reached a high at 154 deaths in 2020. That’s a 26% increase from the year before and is the highest elderly suicide death rate since 1991². There is an urgent need to support charities that connect with seniors, organise social outings or wellness activities for them, offer intergenerational bonding or assist beneficiaries with their healthcare needs such as medical appointments and screenings.

#4 Dementia support

Dementia is our nation’s most prevalent neurodegenerative disease today, affecting one in 10 seniors. By 2030, the number of dementia patients is set to reach 92,000 – a doubling from 2015 (Dementia in the Asia Pacific Region). Dementia additionally imposes a huge burden on caregivers, many of whom are ageing themselves. We need more funding to support early diagnosis and intervention, community dementia care services such as exercise and cognitive activities as well as training and support for caregivers.

#5 End of life care

Discussions about death or end of life remain taboo. There is insufficient advance care planning as well as a lack of healthcare workers and expertise in the palliative care system. Better awareness and improved options for inpatient, home or day care hospice services are needed.

How CFS helps you do more with your giving

If you would like to help seniors who have fallen through the cracks or would like to make ageing more empowering and inclusive, we at CFS can align your giving goals with the needs of this community. We are a cause-neutral organisation that supports grantmaking to a wide range of charitable areas in Singapore. Of the 400-plus charities we evaluate and make grants to, close to 30% work with seniors. We partner with charities that focus on clearly identified problem areas or social gaps that are under-supported. Charities must also demonstrate measurable outcomes and good stewardship of funds.

A simple and cost-effective way to contribute to a variety of causes in Singapore is by setting up a Donor-Advised Fund (DAF). A DAF can be set up by an individual, a beneficiary of a will, a trust, or a family office. CFS will handle all fund administration and leverage our unparalleled insight into Singapore’s charitable landscape to provide philanthropy advice that ensures your giving is targeted, accountable and impactful. CFS strives to ensure that every grant that goes out creates positive change.

As a donor, you will save on legal expenses and enjoy upfront tax deductions at the prevailing rate on eligible donations. Donors will also receive regular statements tracking incoming donations to the DAF and outgoing disbursements to charities. CFS has an established track record when it comes to setting up DAFs and our DAF payout rates outperformed the entire US DAF industry by 12% and their community foundations by 2 times.

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

This article was written by Sunita Sue Leng, a former financial analyst and journalist, who believes that the written word can be a force for good. She hopes to someday write something worth plagiarising.

¹ https://www.asiaone.com/health/elderly-health-costs-rise-tenfold-2030-report

² https://www.sos.org.sg/pressroom/singapore-reported-452-suicide-deaths-in-2020-number-of-elderly-suicide-deaths-highest-recorded-since-1991

Related Topics For You: DIRECT AID, DONOR STORIES, DONOR-ADVISED FUND, HEALTH, NEWS, STORIES OF IMPACT

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Events

Impact lives through savvy giving

John Doe

Make savvy giving a legacy in your life: that was the clarion call to around 100 donors, charities and partners at the Community Foundation of Singapore’s (CFS) Lunar New Year lunch held in February.

“Being savvy in giving is about going beyond the usual traditions of supporting general fundraising campaigns, to deliberately taking charge of generosity,” shared Christine Ong, Chairman of CFS in her opening speech, “It’s about planning and thinking deeply about how to create a powerful effective result, to improve things and impact lives.”

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Children dressed in bright costumes holding props while performing on stage

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Bright moon illuminating serene city park.

The Funding Network (TFN)

Signaling a new phase for CFS in her first year as Chairman, Christine outlined CFS’s ambition to nurture “a nation of savvy givers” to create a more caring Singapore.

“The signature of a savvy giver or philanthropist, is to be bold and informed, curious and committed, and enthusiastic about putting into practice their beliefs and hopes for a better world,” she explained.

To this end, Christine highlighted that CFS would work on championing new giving by reaching out to donors and making giving easy and meaningful. Moving forward, CFS would also continue to drive collaboration for change, provide professional learning opportunities to the local sector and develop CFS’s organisational culture and capacity.

The lunch also saw the announcement by CFS for a new nationwide Legacy Giving Initiative – an ambitious project to help donors making savvy giving a legacy in their lives.

CFS wants to make legacy gifts a social norm in Singapore, and for donors to consider giving at every stage of their life journey.

The three-year initiative will be launched in the latter half of 2020. It aims to reach out to three audiences: donors, professional advisors and charities by promoting awareness, building and sharing knowledge and supporting action.

As Singapore’s only community foundation, CFS is fortunate to build on over 11 years of experience, to bring donors, charities and other stakeholders together.

Rounding off the lunch, CEO Catherine Loh thanked CFS’s donors, Board, partners and charity partners for their support as CFS turned a new page in its history. “We will be embarking on new initiatives and pursuing innovations as we build towards the future. Our Legacy Giving Initiative will further strengthen CFS’s position as the go-to philanthropy resource in Singapore, benefitting donors and charities alike,” she shared.

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John Doe

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