Singaporean Healthcare: Exposed

Singaporeans often remark that it is cheaper to die than get treated, and while it is meant to be taken with a truckload of salt, there is some reality to the statement. Hiding under the ruse of insurance plans, Medisave, or even Medifund, is the big fat cheque you often have to cut after a simple consultation. Singapore markets itself as an economy with healthcare plans available for people of all income levels, and it even attracts lots of foreign nations for what is broadly termed “medical tourism”. The United Nations (UN) also puts Singapore in the first place in a Global Health Ranking conducted in 2017. But while Singapore outshines other nations in terms of low infant mortality rate and high life expectancies, its highly privatized healthcare system doesn’t necessarily make it affordable. 
 

Putting a Price On It 
    In Singapore, only one-third of spending on health care is public, whereas two-thirds are private. As a result, there are both public and private healthcare services and institutions that provide them. There are also several tiers of care offered at public hospitals, which are ranked as five classes: A, B1, B2 and C. As Singapore General Hospital mentions on their website, a person who chooses class A gets a single room with a television, fully automated bed and attached bathroom with toilet, whereas a person choosing class C shares the ward space with 9 other people and doesn’t have access to any other amenities. The main difference between the two is the price that they come with; while picking class A suggests that you bear the burden of the cost by yourself, picking class C ensures that the government pays up to 80 percent of the cost. From this example alone, the message is clear; you can get the best healthcare and treatment with the doctor of your choice if you’re willing to put a price on it. On the contrary, healthcare is a right, and not a product and so consumerism is not always the best approach. Regardless of if you can pay for class C or class A, getting the same fair treatment shouldn’t be a question. 

Constraints 
 

    However, the concept of universal healthcare isn’t new to the Singapore cabinet. In the past, Singapore has introduced competition into the market and allowed hospitals to use the free market mechanism to lower costs. But this led to hospitals trying to gain as many patients as they could through expensive technology, better technology and bonus packages that ended up increasing the costs. Hospitals marketed themselves to nurses and doctors too by agreeing to pay them more in order to out-compete the others in the business. But this too led to the focus shifting to class A wards while patients in class C received sub-par treatment. This failure in the market, spurred by an under-provision of merit goods to the common man, led to the government implementing controls in the market and ensuring that in public hospitals, the tiered system led to them having control over the patient care. More regulations were also implemented so that hospitals focused equally on care provided at all levels and so that even if the private system wanted to challenge the public system, the affordability of public healthcare would play a dominant role. The number of doctors and nurses hired is also monitored and the government regulates their salaries too. 
 

Moreover, despite regulations ensuring that the common man can afford quality services at the government’s expense, certain other things are still outside the ministry’s reach. For instance, doctors in Singapore are conservative by nature because of past experiences with patients suing them for misdiagnosis or failure to recognize ailments. As a result, most doctors recommend several scans, second opinions or alternative treatment methods that can add to medical bills. While this is important and people should take measures to ensure that their diagnosis is right, the high costs of these precautions are not something the government can control. Hence a cautious patient might take the doctor’s advice and pay excessive charges for the extra tests, but another might choose to throw caution to the wind and avoid taking the tests to save up. 
 

Finally, there is no healthcare plan that is subsidized for foreigners. Hence most clinics have a different rate for citizens and permanent residents (PR) but a more exorbitant fee for foreign nationals. The government does not have to concern itself with people that aren’t its own and this is hence not up for much debate. Expats always have the option of taking private health insurance and are more often than not sponsored to take it by their companies. 

As a small economy, Singapore has to maintain its resources and distribute them effectively for long-term sustenance. The government has tried its best to provide optimum healthcare for all, and while it has its pros and cons (the biggest con being its price), its efforts are still commendable. Unlike large countries like Canada or even Australia, Singapore cannot afford to offer free healthcare, and the current system is the best alternative to achieving the same motive. But in the future, with more doctors in the mix, perhaps the healthcare market will see some improvement and become more affordable too.

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