Increasingly acknowledged for having achieved excellent healthcare outcomes at modest costs, Singapore’s system seems to be functional compared to a pure national insurance scheme where healthcare is provided for free but creates over consumption and over-servicing.
Medifund - is the government endowment fund set up to aid the indigent. The fund covers citizens who have received treatment from a Medifund-apaffording their medical expenses despite government subsidies, Medisave, and MediShield coverage. In 2013, the government set up Medifund Junior for needy children and extended Medifund to primary care, dental services, prenatal care, and delivery services. The ElderCare fund subsidizes care for low- and middle-income patients in intermediate and long-term care facilities. Private health insurance - A range of private insurers to supplement MediShield coverage. Called Integrated Shield Plans, they are funded from individuals’ Medisave accounts. Singaporeans also have the option of purchasing other types of private insurance, although premiums for these cannot be paid for with Medisave funds. Employers may also provide insurance to emDifferently from most countries, Sinsurance scheme, in which healthcare is funded jointly by insurance through MediShield, plus revenue from taxes, plus savings from Medisave, a system unique in the world, nonetheless achieving similar, or even better, out-
comes to most developed countries with less spending. Singapore spends on average about 4.7% of its GDP annually on healthcare (compared to around 9% of GDP in the UK or 17% in the USA), providing universal coverage with multiple layers of care. Increasingly acknowledged for having achieved excellent healthcare outcomes at modest costs, Singapore’s system seems to be functional compared to a pure national insurance scheme where healthcare is provided for free but creates over consumption and over-servicsecond ranking in the Bloomberg Healthcare Singapore spends the most annually in healthcare on a per capita basis (USD 2,752, 2014 data) and this is expected to rise faster than GDP given the aging population and changes in demographics. The government has numerous ways of keeping the healthcare “demand” in check, includ-
ing co-payments, deductibles, and restrictions on the uses of Medisave and MediShield for consultations, treatments, and procedures. These controls discourage unnecessary doctor visits, tests, and treatments. tering and controlling market competition: the government directly regulates the market when it fails to keep costs down. It can also regulate prices for services provided in the public hospitals, as well as the number of public hospitals and beds. Within this environment, private-sector providers must be careful not to price themselves out of the market. At the same time, the government sets cost-recovery targets for each hospital ward class, thereby indirectly keeping public-sector hospitals from
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es, mental healthcare, dental care, or optometry.
The Central Provident Fund is the umbrella account under which Singaporeans save for retirement, housing costs, and medical care (through the “3Ms”). There have been pe-
Fast-growing Burden of an Ageing Population
Polyclinic Dental Clinics
10
Hospital/Institution Dental Clinics
8
School Dental Clinics
Private Dental Clinics, 2019 Source: U.N. Population Division, International Labour Organization, World Bank, International Monetary Fund, 2017
Total 246
Source: Ministry of Health Singapore
228
Total 851
Infomedix International | 1 2021
Public Dental Clinics, 2019
31