PAYING FOR HEALTH CARE IN SINGAPORE : THE STUDY OF A POLICY ISSUE
TAN YONG NIEN
TAN YONG NIEN
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Health care is an issue that is of great concern for the governments in the developed countries. The rising cost of health care, methods of financing health care and access to health care are but a few of the issues and problems that these governments must face. Health care has become an important political issue in countries like Canada, Germany, Sweden, New Zealand, Britain and the United States of America (USA). The problems in health care faced by these countries, (several of which are predominantly welfare states) have been given ample coverage in the local press. Singapore is no exception. Over the last few years, health care, especially rising health costs, has become a matter of increasing public concern and a central policy question for the government. The purpose of this academic exercise is to examine the various aspects of this policy question, especially the issue of rising costs, and why it has led to public concern. The first chapter will first examine the system of health care in Singapore and the restructuring programme for the government hospitals. The health care in Singapore is essentially a dual system with the government providing the majority of hospital services while the private sector provides most of the primary health care services. The second chapter will focus on the various methods of financing health care in Singapore For example Medisave and Medishield) and the government's underlying principles regarding health policy. The introduction of the National Health Plan (NHP) has seen a greater responsibility being placed on the individual for maintaining his or her own standard of health and paying for health care. The third chapter will examine the reasons behind the rising cost of health care. Among the causes are· that of the higher expectations of the population, along with the reduction in government subsidies, greater cost-recovery from medicine and the commodification of medicine, which occurred simultaneously, thus leading to escalating health costs. The third chapter will then consider how public concern has been generated, especially in the political arena, by rising health costs. In the conclusion, the dilemma facing the government in its health policy will be examined, along with some recommendations for improving the state of health cate in Singapore. The various alternatives that the government is considering will also be detailed. The government is trying to strike a balance between the two goals of efficiency and equity in health care, by introducing market mechanisms in the health sector and still providing subsidies and exerting a moderating influence in the health sector. The primary sources for this academic exercise include reports from government bodies, for example the Ministry of Health (MOH), the Ministry of Finance, and the Health Review Committee; reports of parliamentary debates; speeches from ministers and government officials, and newspapers. Secondary sources comprise of books and articles related to health care and health policy, primarily in Singapore. Two interviews have also been conducted with academics, both of whom are lecturing in the National University of Singapore (NUS). Associate Professor Mukul Asher is from the Department of Economics and Statistics, while Dr Phua Kai Hong, is from the Department of Community, Occupational and Family Medicine.
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1993
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