Lesson+2+(Singapore+Healthcare+System)

__Singapore HealthCare System__
Singapore's healthcare system comprises public and private healthcare, complemented by rising standards of living, housing, education, medical services, safe water supply and sanitation, and preventive medicine. There are a total of 13 private hospitals, 10 public hospitals and numerous specialist clinics. The general hospitals provide multi-disciplinary acute inpatient and specialist outpatient services and a 24-hour emergency department. The health system has put in place the “3M” framework: Medisave, Medishield, and Medifund. 85% of all Singaporeans are covered by Medisave. Wards in Singaporean hospitals are three types: A, B and C; which are subsidized accordingly. Ward A patients receive the least amount of government subsidies, while C receives the most (80%).

The health care pizza---everyone shares a part---the various roles

 * Role of individuals**: Their role is to promote self-reliance (financially) and maintain good health. Almost all Singaporeans are covered by medisave. It is a saving scheme whereby some money from a worker’s CPF is placed into his medisave account. The account can be used to pay for hospital bills and other medical treatments. Medishield, a national healthcare insurance scheme, also financially supports a Singaporean’s medical bills. It benefits patients with long term hospitalization. Although patients still pay using Medisave, patients can still make claims from medishield to pay long-term medical bills uncovered by Medisave.


 * Role of the community**: Singapore’s community provides numerous healthcare and support services. The government works with various organizations as it is impossible for the government to facilitate all the healthcare services. Through the government, these organizations receive grants to run hospitals and nursing homes open to the public.


 * Role of the government**: The government’s role is to keep healthcare affordable and promote healthy lifestyles. The government provides healthcare through government subsidies, MediFund as well as means testing. Government subsidies are subsidies from taxes that are given to medical centers, ensuring that basic healthcare is available to everyone. Measures such as the heavy subsidizing of Class C wards and the restructuring of hospitals help them to cut costs, allowing patients to pay less. MediFund is a fund of $200 million distributed to Class B/C ward patients, VWOs, and other parties. Means testing is about subsidizes from the government to patients who need it most, and is based on the income levels of the party involved. In summary, the government’s role is to ensure that every citizen’s health is cared for

Promoting healthy lifestyles is important as Singaporeans with good health can save on medical expenses. This also allows Singaporeans to cope with the rising cost of healthcare. Promoting such lifestyles can be achieved through campaigning and public education. Furthermore, schools and workplaces have programmes to encourage the healthy lifestyle of students and workers.

Plus&Minus-the advantages and disadvantaged of the system
Quick look @ MediSave, MediFund and MediShield

 This is the .ppt version.

This is the .pptx version.

Advantages
 A small percentage of GDP needs to be spent on health care  Nurtures Singaporeans to independently save for health; reducing the government’s burden  Gives the most subsidizes to those who really need it.  Adequate distribution of financial resources  MediSave/MediShield targets the poor, ensuring that they benefit the most.  Almost all Singaporeans have access to basic healthcare.  The government, by promoting healthy lifestyles, helps Singaporeans to cope with the rising cost of healthcare. There are mandatory health savings accounts: “Individuals pre-save for medical expenses through mandatory deductions from their paychecks and employer contributions… Only approved categories of medical treatment can be paid for by deducting one’s Medisave account, for oneself, grandparents, parents, spouse or children: consultations with private practitioners for minor ailments must be paid from out-of-pocket cash…” The private healthcare system competes with the public healthcare, which helps contain prices in both directions. Private medical insurance is also available. Private healthcare providers are required to publish price lists to encourage comparison shopping. The government pays for “basic healthcare services… subject to tight expenditure control.” Bottom line: The government pays 80% of “basic public healthcare services.” Government plays a big role with contagious disease, and adds some paternalism on top: “Preventing diseases such as HIV/AIDS, malaria, and tobacco-related illnesses by ensuring good health conditions takes a high priority.” The government provides optional low-cost catatrophic health insurance, plus a safety net “subject to stringent means-testing.” Almost all care is subject to significant co-pays.



Disadvantages:
 Medisave requires those with monthly income to contribute to the account, hence the self-employed or unemployed cannot contribute. The poor may have financial difficulties contributing monthly to the account.  Medishield is dependent on MediSave, hence the poor and unemployed will be affected. The cost of premiums are also rising, affecting the poor.  MediFund does not cover class A/B1 wards, and the eligibility for this fund is decided on a case-by-case basis.  Since most of the schemes of Singapore’s healthcare system target the poor, the rich may feel that it is unfair.

Challenges
One such problem is the problem regarding the ward grading by Singapore’s healthcare system. C or B2 wards are heavily subsidized by the government. As a result, the higher income Singaporeans might prefer to opt for the subsidized wards if they are warded for extended periods to time. This allows them to save costs, all subsidized by the government. However, this would cost overcrowding in B2 and C wards, hence there would a risk of poor patients being unable to have access to the subsidized wards. It has been suggested that if patients were to be warded for extended periods of time, they would be automatically be allowed to downgrade to the subsidized wards if they are in the A or B1 wards. Also, family income restrictions could be placed on wards, whereby only a family income of “XXXX” would be warded in the subsidized wards.

Furthermore, Singapore is currently facing the problem of H1N1. Though the government imposes home quarantine temperature taking at public events and in schools, the number of cases continues to increase and there is community spread. To solve this problem, some schools taken the initiative by having online E-learning instead of going back to schools after the June holidays. Also, stricter temperature checks are held at major events like AYG to hopefully prevent the spread of the virus.

In fact, medical expenses will continue to increase in the near future due to the aging population. An aging population requires far more medical care and service, thus increasing the medical expenditure. There are reports showing that the medisave will not be enough for the aged. Integrity is also an issue now, especially after the sagas of Renci and NKF.

Some videos to illustrate.

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By now, you should have a clear idea of how the singapore health care worked! Do post in the forums if you ahve any questions. thanks!