We’ll call the worker ‘Byoghu’ in this story. He had worked before in Singapore and quite successfully. But when he returned for a second job, he soon fell ill. In the first two weeks on the job, he had a fever and was given medical leave. The employer decided to cancel his Work Permit on 23 November 2016.

The next day, he was so ill he asked the security guard at the dormitory to help him call an ambulance. When he reached National University Hospital (NUH), he was rushed into intensive care.

We came to know of the case because the medical social worker at NUH called us. Our caseworker rushed to the ward to see Byoghu to get more facts. The diagnosis was quite complicated, but apparently the chief problem was that Byoghu was suffering from hydrocephalus, an accumulation of fluid in the brain.  He was all hooked up to tubes, said our caseworker.

We were also informed that the insurance company was refusing to pay the hospital’s bills. Apparently, the insurer’s argument was that since the Work Permit had been cancelled the day before his hospitalisation, Byoghu was no longer covered.

Singapore law holds employers of foreign workers responsible for their medical expenses, up to the date of their repatriation (not cancellation of permit) and also requires employers to purchase insurance of at least $15,000 to cover this liability. It would be most unusual for a policy issued by a reputable insurance company not to be written in a manner in accordance with this requirement.

We advised the employer of this though we underlined that we had no knowledge as to how exactly the policy that he had bought was worded.

While this was being argued over (between the employer and the insurer) the hospital advised that a new operation was required. They needed to put in a stent to drain the fluid from the brain, but it would cost at least $5,000 more. Only after such an operation was done would the worker be fit to travel. We believe the employer agreed with the doctor’s recommendation. Such a decision would be easy to understand: either pay for the operation so that the worker could be sent home, or pay for a prolonged stay in the intensive care unit.

We thought we would have the chance to visit Byoghu again after surgery so that we might help him with his personal arrangements for going home. But we were too late. He was despatched onto a plane within two days of the brain operation.

We remained in contact with the employer for a little while more. Apparently the total medical cost was over $50,000. We were informed that the insurance company finally agreed to cough up $15,000 — we’re glad that TWC2 could at least help the employer argue his case — but that still left the small construction company with tens of thousands of dollars more in bills.

The employer appealed to us to help them pay the bills. They said they’re a new company without reserves.

TWC2’s Direct Services Subcommittee voted against doing so. Our mission is to assist workers, not employers. In this case, Byoghu received all necessary medical care. There’s nothing left for us to assist with.

No doubt, if the employer is unable to pay the hospital, the hospital will be left with a bad debt, but as Debbie Fordyce, chair of the subcommittee, says, “Hospitals all write off bad debts, perhaps as charity, and this will ultimately be covered by public funds. It’s not for a small charity like TWC2 to assist a government-subsidised medical institution.”

Deputy chair Loh Wei Hung pointed out that this problem being faced by the hospital and the employer is a “direct and straightforward consequence of [the Ministry of Manpower’s] medical insurance policy for migrant workers, enacted in agreement with [Ministry of Health]. For the financial situation that the company and NUH find themselves in, they should bring it up with [both ministries]. It is not for a charity like TWC2 to sustain [Ministry of Manpower’s] policy by providing financial bailouts to construction companies or our public hospitals.

“It is also disingenuous for the company to claim unexpected financial hardship,” Loh adds. “It is understood that the $15k insurance is the mandatory minimum, and it’s up to the company to decide if they should purchase more insurance to protect their business. In purchasing the minimum insurance, they accepted the risk that any higher medical costs will have to come from the company’s revenues.”