In the second instalment of my ‘Healthcare Systems…’ series I’m looking at Singapore. I had the privilege of working as a researcher at the Singapore National Eye Centre for six weeks a couple of years back and remember encountering a very modern, cutting edge service.
It seemed too good to be true. But it was true. Though everything wasn’t quite perfection.
In the WHO Ranking of Healthcare Systems in 2000, Singapore’s system ranked 6th. They have what can only be described as a government mandated and controlled union of public and private sector healthcare provision. The Ministry of Health aims to provide universal healthcare through a national insurance system called Medisave.
As with many global systems it’s comprised of compulsory payroll deductions as well as voluntary contributions. These are used to create subsidised services along with negotiations with the private sector to control price at the point of care.
The upside is that healthcare can for the most part be considered relatively affordable as people accumulate vast healthcare funds which they can use to look after their families and not just themselves. The system itself gives each patient the ability to select from three tiers of subsidised care which at one of the end scale involves no subsidisation of care to the other end where a significant amount of care is subsidised.
Here’s the catch.
The government will never completely cover all your costs. Supposedly, this is meant to discourage an unsustainable burden being placed on the system. Yet, that can leave patients with drained funds and significant unmanageable costs.
You can’t argue with the facts though. Singapore consistently ranks amongst the best when it comes to a whole range of ratings such infant mortality and life expectancy. The union between private and public sector means that both sides can provide state of the art technology as well as training for its staff which leads to improved care.
The prevalence of a national insurance scheme and affordable private insurance plans, particularly through employers, creates an essentially, universally accessible system. There are also more advanced government insurance schemes to offer protection against the costs of long term chronic illness (Medishield etc).
Above all. Patients still have choice and can opt to enter any hospital or clinic for their care. The onus is on the citizen to use the tools provided by the government to take an active stake in the management of their healthcare. In return the government aims to provide a sustainable and as flawless a service as possible.
Singapore does not have a perfect system by any means but they have as happy a marriage as you can get between government and corporation. The protection of the public system combined with the innovation of private system has really allowed Singapore to become a centre of excellence in Asia.
Maybe we could learn something over here?
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Dr Saif F Abed
AbedGraham Healthcare Strategies Ltd