Singapore is famous for its exemplary health care standard. It is positioned amongst the best systems in Asia. Both private and public sector services are available to citizens; however, expats often talk about the benefits of each. Still, it is safe to say that both sectors are functioning very well in terms of professionalism and efficiency. Usually, citizens use private entities for basic care and public hospitals for complex and emergency care. As usual, public health care is more affordable than the private sector; still, a lot of people are happy to pay more in exchange of more comfort and shorter waiting time. Let’s discuss the pros and cons of the Singapore healthcare system.
Singapore Healthcare System
The Ministry of Health believes in ensuring quality and affordable basic medical services for all.
At the same time, the Ministry promotes healthy living and preventive health programmes as well as maintains high standards of living, clean water and hygiene to achieve better health for all.
It is broken down into 4 AREAS:
#1 – Structure and Budget
Singapore’s healthcare system is designed to ensure that everyone has access to different levels of healthcare in a timely, cost-effective and seamless manner.
#2 – Healthcare Services and Facilities
Healthcare services are accessible through a wide network of primary, acute and step-down care providers.
#3 – Healthcare Regulation
The Ministry of Health and its statutory boards regulate both the public and private providers of healthcare in Singapore.
#4 – Quality and Innovation
To ensure that patients are treated safely with good healthcare standards, the Ministry strives to promote better quality and innovation through various initiatives.
Public health care
Public hospitals as well as outpatient clinics are the most respected and reputed institutions in Singapore. They receive complicated cases from neighboring countries too. However, these facilities as well as the subsidized care are mainly designed to serve permanent residence holders. Expatriates with work permit are not aware of these subsidies; that is why, there is not a big difference in cost between private and public care.
Government health insurance
Singapore citizens and permanent residents are entitled to subsidized healthcare services provided through government healthcare facilities. Depending on various factors, the amount of subsidy can roughly range from 50% to 80%. Further help in co-paying the balance of the medical bill is enabled through a compulsory savings scheme called Central Providence Fund (CPF). Depending on factors such as age and income, a percentage of the monthly salary of an employee is contributed to the CPF. Note that the CPF is not nationally redistributive in that whatever amount you contribute will be for your own or dependents’ use only, it will not be used to subsidize the benefits for another employee who may have earned less than you. Part of the CPF contributions goes towards medical insurance schemes namely Medisave, Medishield, ElderShield and Medifund that collectively can handle major part of the co-pay amounts.
To illustrate an example, Mr. X who is a Singapore citizen earns S$4,167 a month. He is then hospitalised where he chooses to stay in a Class C ward. Below is a breakdown of what he can expect to pay and what he can expect to be subsidised under two different scenarios:
Medisave Bill Subsidy (source: Ministry of Health)
To know more about subsidized healthcare system for Singaporeans, refer to Ministry of Health website.
Private health care
Mostly, expats choose private health care due to affordability and better service levels. There is no doubt that the Singapore healthcare model is much better than the US one. There are tons of private hospitals, individual clinics, medical centers, in the city state. You just need to decide which one is better for you or suits your needs. You don’t even need a health insurance to get benefits of private facilities because the basic healthcare expenses are extremely affordable. In spite of this, health insurance is more crucial when it comes to expenses associated with more complex disease or emergency.
(You can see the element where healthcare is still taken cared of largely by the government to ensure everyone gets an equal opportunity to be treated. Private healthcare is often seen having increased patient volumes from other S.E.A Countries like Indonesia, Thailand etc)
a) Insurance Coverage
If you are a foreigner working in Singapore, you are exempted from CPF contributions but this also means that you do not have access to the government’s subsidized health insurance scheme as above. The good news is that day-to-day healthcare services are quite affordable in Singapore even if you don’t have any health insurance. However you must think about your health insurance options to handle any critical illnesses for you and your family.
If your Singapore employer is a medium to large size company, it’s likely that the company will provide a health insurance policy that covers you and your family. You should check health insurance benefits with your potential employer if you are in the process of relocating to Singapore. If you have your own business or are considering providing health benefits to your employees, you should seriously consider taking up a private health insurance policy to cover for at least critical illnesses. There is a variety of choices and healthy competition among internationally recognized health insurance companies who can offer you a policy that suits your needs. Depending on your age, lifestyle habits, and the type of policy, the monthly cost of a critical illness private health insurance may range from S$75 to S$400 per insured. Below is a list of some of the established private insurers in Singapore:
Finding the right medical insurance policy can be a very time-consuming task and prone to error as the insurance companies usually have many exclusions and exceptions in their coverage policies. It’s very important to read the fine print to be sure you know what you are getting in the policy. A good alternative is to engage an independent insurance broker who has in-depth knowledge of policies from various insurance companies and can recommend you a policy that’s best suited to your particular requirements.
Primary healthcare costs
Day-to-day healthcare services are relativey affordable in Singapore. A routine check-up with a General Practicioner plus (generic) medicine will likely cost you around S$20-S$30 while blood-work and x-ray will cost you around S$50-S$80. Roughly 20% of primary health care is provided through the government polyclinics, while the remaining 80% is provided through some 2,000 private medical clinics. Specialist consultation in a private clinic might cost you between S$75 -S$125.
Hospitalization charges vary depending on the type of ward choosen. Wards in Singapore vary from open wards with no air-con in place to a private medical suite that resembles a royal suite at a 5-star hotel. Accordingly the daily charges for a ward can vary from S$30 to S$3000. Charges between government and private hospitals for non-subsidized patients are very similar. For more details on charges by various Singapore hospitals, refer to MOH web page.
Recently, PM of Singapore, Lee Hsien said “providing good and advanced healthcare is too hard”. Despite the fact that people of Singapore have spent a lot of their hard earned money on taxes to get medical schemes like Medisave and Medishield; the health care expenses are so raised that you still need to spend money on private insurance coverage schemes to get fully covered. The problems as well as the disadvantages of the Singapore healthcare model include over dependency on market pricing, no world class system, poor pricing properties, wastefulness of resources on medical tourism, and a few more.
How Singapore healthcare is better that US healthcare?
Here’s what Singapore’s conservative admirers get right: Singapore really is the only truly universal health insurance system in the world based on the idea that patients, not insurers, should bear the costs of routine care.
Why are conservatives so taken with Singapore? The American Enterprise Institute’s glowing write-up explains it well:
What’s the reason for Singapore’s success? It’s not government spending. The state, using taxes, funds only about one-fourth of Singapore’s total health costs. Individuals and their employers pay for the rest. In fact, the latest figures show that Singapore’s government spends only $381 (all dollars in this article are U.S.) per capita on health—or one-seventh what the U.S. government spends.
Singapore’s system requires individuals to take responsibility for their own health, and for much of their own spending on medical care.
But Singapore isn’t a free market utopia. Quite the opposite, really. It’s a largely state-run health care system where the government designed the insurance products with a healthy appreciation for free market principles — the kind of policy Milton Friedman might have crafted if he’d been a socialist.
Unlike in America, where the government’s main role is in managing insurance programs, Singapore’s government controls and pays for much of the medical system itself — hospitals are overwhelmingly public, a large portion of doctors work directly for the state, patients can only use their Medisave accounts to purchase preapproved drugs, and the government subsidizes many medical bills directly.
What Singapore shows is that unusual fusions of conservative and liberal ideas in health care really are possible. Singapore is a place where the government acts to keep costs low and then uses those low costs to make a market-driven insurance system possible. One thing you quickly realize when studying their system is it would be a disaster if you tried to impose it in a country with America’s out-of-control medical prices.
That speaks to the more depressing lesson of Singapore. As soon as you begin seriously comparing where they are, and how their system works, to where the US is, and how our system works, it becomes painfully clear how far America is from having the institutions or preconditions for truly radical health care reform.
The Singapore health care system focuses on preventative care as well as disposing of abuse of medical care, and that is why their system is very effective and successful even with a few flaws. The citizens are highly educated on making healthy choices and maintaining health standards to prevent health care requirements. The government of Singapore likewise ensures that the medical care (basic) is accessible and available to everyone. They have successfully implemented great programs for child immunisations such as like measles, tetanus, and tuberculosis, and screening programs for complex conditions such as cancer and heart disease. Apart from this, dental care is also encouraged by the government, which is almost impossible in the states unless it is a traumatic condition. They use simple and effective strategies and give priority to the healthcare. This is why, their healthcare system is better from many economically strong nations.
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