Singapore’s health care system has been praised for its efficiency and effectiveness. The country has achieved universal health coverage through a mixed financing system, and its public statutory insurance system, MediShield Life, is a key component of this system. Singapore’s health care financing system is underpinned by the belief that all stakeholders share responsibility for attaining sustainable universal health coverage. In this article, we will explore the key features, challenges, and shifts in Singapore’s health care system and draw lessons that other countries can learn from.
Multipayer Health Care Financing Framework
Singapore has a multipayer health care financing framework, where a single treatment episode might be covered by multiple schemes and payers, often overlapping. The system, known as the 3Ms, comprises the following programs:
- MediSave: A national medical savings scheme that helps individuals save for their future personal or immediate family’s hospitalization, day surgery, and certain outpatient expenses.
- MediShield Life: A national health insurance scheme that provides lifelong protection against large hospital bills and selected costly outpatient treatments, such as dialysis and chemotherapy.
- MediFund: A safety net for needy Singaporeans who face difficulties paying for their medical expenses, even after receiving government subsidies and drawing on other means of payment, including MediSave and MediShield Life.
Strong Government Control and Oversight
The hallmark of Singapore’s health care market has been strong government control and oversight. Demand- and supply-side controls encourage patients and providers to be judicious and cost-conscious in their use of health care services. In addition, the public sector’s role as the dominant health care provider sets the benchmark for the private sector, as well as the entire health system’s ethos of deemphasizing profit maximization.
Emphasis on Primary Health Care
Singapore’s multi-year strategy, Healthier SG, aims to transform primary health care by nurturing an ecosystem that supports better health by leveraging the primary health care system and community partners. Family doctors participating in Healthier SG are required to join a Primary Care Network to facilitate more team-based care and must also participate in a national electronic health records system, which will require IT improvements for many practitioners. This is a priority especially as the population ages and the government seeks to provide more integrated, home- and community-based care.
Public-Private Partnership
Singapore’s mix of a public and private health system shares some similarities with that of the United States, but the way the system is split looks very different. Eighty percent of primary care is delivered through the private sector, while 80 percent of all acute care and 100 percent of hospital ownership is public. Prominent international healthcare and research organizations such as Duke University, Healthcare Information and Management Systems Society, and Joint Commission International have established a presence in Singapore.
Challenges and Shifts in Singapore’s Health Care System
Aging Population
Singapore has one of the fastest aging populations in Asia, which will translate to a greater demand for specialized elderly care amid rising costs. Healthcare demand and spending will increase due to an aging population, heavier chronic disease burdens, advances in technology, and a more well-informed and perceptive population. Combined with medical facility constraints, Singapore will likely see a rebalance of its healthcare system towards more home-based care. There will be opportunities to introduce telecare initiatives as the healthcare system gradually evolves towards being more patient-centric.
Rising Health Care Costs
Singapore’s health care costs have been rising, and the government has been taking steps to address this issue. For example, the government has introduced measures to encourage the appropriate use of health care services, such as the introduction of co-payment for medical services and the implementation of a fee benchmarking system for medical procedures. The government has also been investing in technology to improve the efficiency and effectiveness of the health care system, such as the implementation of a national electronic health records system.
Lessons for Other Countries
Singapore’s health care system offers several lessons for other countries:
- Universal Health Coverage: Singapore’s mixed financing system has enabled the country to achieve universal health coverage. Other countries can learn from Singapore’s approach to financing health care.
- Primary Health Care: Singapore’s emphasis on primary health care and the use of technology to improve the efficiency and effectiveness of the health care system can serve as a model for other countries.
- Public-Private Partnership: Singapore’s public-private partnership in health care can offer insights for other countries seeking to balance the roles of the public and private sectors in health care.
- Strong Government Control and Oversight: Singapore’s strong government control and oversight of the health care market can offer lessons for other countries seeking to control health care costs and improve the quality of care.
Singapore’s health care system has achieved universal health coverage through a mixed financing system, with a strong emphasis on primary health care and public-private partnership. The country’s health care system faces challenges such as an aging population and rising health care costs, but the government has been taking steps to address these issues. Other countries can learn from Singapore’s approach to financing health care, emphasis on primary health care, public-private partnership, and strong government control and oversight of the health care market.
Key Features of Singapore’s Healthcare System
Singapore’s healthcare system is often held up as an example of excellence, and for good reason. The country has achieved universal health coverage through a mixed financing system, with approximately 70-80% of Singaporeans obtaining their medical care within the public health system. The government’s share of health expenditures has increased in recent years, with the aim of reducing out-of-pocket costs for citizens.
Singapore’s healthcare system is also known for its low costs and high-quality care. The country’s delivery system is geared towards raising up all its citizens, rather than achieving excellence in a few high-profile areas. Primary care is provided mostly by the private sector, with about 80% of Singaporeans receiving care from general practitioners.
In addition to its healthcare system, Singapore is also home to many world-class medical facilities and healthcare professionals. The country’s healthcare industry is constantly evolving, with the role of technology becoming increasingly important.
Overall, Singapore is an excellent place to seek medical treatment. Its healthcare system is efficient, affordable, and of high quality. With its focus on promoting healthy living and preventing disease, Singapore is a model for the world in terms of healthcare.
Sources:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293982/
- https://en.wikipedia.org/wiki/Healthcare_in_Singapore
- https://www.nytimes.com/2019/04/22/upshot/singapore-health-system-lessons.html
- https://www.commonwealthfund.org/international-health-policy-center/countries/singapore
- https://www.vox.com/policy-and-politics/2017/4/25/15356118/singapore-health-care-system-explained
- https://www.weforum.org/agenda/2020/10/how-to-build-a-better-health-system/