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Health Minister Ong Ye Kung spoke recently about the financial state of health insurance ( , July 12). Doctors and other readers have also voiced their opinions in Forum letters. Let me add my voice as one of the insured people, whose health is managed by the Ministry of Health (MOH) and the healthcare industry. Constantly changing national healthcare policies, and the associated reactions of the insurance companies, can be confusing and distressing. Issues such as the need to control general healthcare costs, classification of panel versus non-panel doctors, and new Cancer Drug List (CDL) restrictions are constantly raised. Patients do not have a stable environment in which to make treatment decisions. I am a cancer patient undergoing immunotherapy treatment. I started this treatment before the CDL was adopted. My immunotherapy drug, while an approved one under the CDL, now has a two-year limitation of use. Before the CDL was introduced, there was no limitation of use and no limitation of insurance coverage for my immunotherapy drug. I assumed that national policies are not retrospectively applied, and therefore my treatment would be covered by insurance for two years after the CDL was applied to my policy. But Income Insurance was unsure, and preferred to err on the side of caution and apply the limitation of use from the start of my treatment, before the CDL had been introduced. I wrote to MOH, and received an e-mail response that the two-year limitation of use applies from the start of treatment, even if it had been before the CDL was adopted. In other words, MOH intends for CDL limitations to be retrospectively applied. The outcome now is that I have to pay Income back for recent treatment claims which are no longer covered under the CDL. And I will have to stop my immunotherapy treatment due to costs. No patient would want to face such a distressing situation, in which patients are penalised financially due simply to changes to national policy, and the actions taken by insurance companies in response to them. Hence, I urge an all-encompassing approach to the national healthcare system that addresses and meets the needs of all stakeholders, including and especially patients. We want clarity and stability.