Sec 3 Social Studies Chapter 3 (Singapore)

Healthcare in Singapore


Topics• Challenges of managing healthcare• Who pays for the healthcare services?• Singapore healthcare • Have Singapore’s healthcare policies met the

needs of the people?


• What are some complaints that you have about healthcare in Singapore?– Visiting a doctor?– Getting MCs?– Paying for the bills?


• Providing basic healthcare • Providing quality healthcare • Providing affordable healthcare

What are the challenges of managing healthcare in Singapore?

• Providing basic healthcare – E.g. ensuring that there are medical officers and

facilities who are accessible to the citizens of Singapore

• Providing quality healthcare – People in more developed countries expect more

and better healthcare services [this affects the popularity of the government]


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• Providing affordable healthcare [due to increasing expenditure on healthcare] – Over the years, funds have been invested in

research for better treatments, more effective medicines and training for better-qualified medical staff. As a result, the costs of healthcare increases.


• Individual– Out of your own pocket:• people pay for healthcare services

when they receive treatment. [e.g. patients pay the doctor directly after visiting the doctor]

– Personal insurance: • People buy medical insurance and make claims from

the insurance company to pay for certain medical treatment such as surgery.

Who pays for these healthcare services?

• Employer– Employer-paid insurance: Employers pay a certain

sum of money for insurance for their workers. Employers can claim medical fees from the insurance company when medical services are used by their workers.

– Government taxes: Government collects taxes from the people, and uses a certain percentage of the taxes to pay for medical services used.

Who pays for these healthcare services?

• 1960s:– Healthcare: part of Singapore’s plans for

improvement and development after independence – Ensure basic healthcare in Singapore

• E.g. clinics and outpatient dispensaries were built to provide healthcare for a growing population[Outpatient dispensaries: government clinics where patients went for simple medical treatment that did not require hospitalization]

• E.g. Everyone were asked to go for vaccination against diseases (as diseases such as tuberculosis were common)

• E.g. Medical officers and nurses were sent to schools to provide healthcare for students

History of healthcare in Singapore: 1960s

• 1970s:– Background: Singapore’s economy has improved

and the standard of living was higher. People wanted better healthcare services.

– Provision of better quality of healthcare • E.g. Polyclinics replaced outpatient dispensaries, and

provided a wider range of healthcare services such as medical check-ups for babies. • E.g. better quality of healthcare and facilities in

government hospitals.

History of healthcare in Singapore: 1970s

• How is the government managing healthcare today?

What is the approach to healthcare in Singapore today?

Government’s approach to Healthcare in Singapore today.

What is the approach to healthcare in Singapore today?

Medisave• A certain amount of money from people’s

Central Provident Fund (CPF) is put into their Medisave account

• This money can be used to pay hospital bills and certain medical treatment when needed.

How is the Individual responsible for his own healthcare?

• Why Medisave?– Medisave encourages Singaporeans to be

responsible for their own health– Government does not have to increase taxes, or

take on the burden of healthcare in Singapore. – Healthcare as a shared responsibility.


So.. Is Medisave good?• Singaporeans have accepted Medisave as a

way to pay part of their medical bills. • Singaporeans are able to pay for healthcare• Less burden for the government.


• So.. Is Medisave ALL good?

Source A: A view by a heart specialist, Dr Charles Toh, on the medisave scheme in 1983.

With Medisave, people would have to take care of themselves. Sometimes, the financial burden would be transferred to their children when a person cannot pay his hospital bill. Worse of all, what about the people who cannot pay their hospital bills?

Source B: A comment by the retired and former Health Minister, Dr Toh Chin Chye, on

the Medisave Scheme in 1983.

Healthcare is the responsibility of the government. It is the duty of the government to find ways of using taxpayers’ money to meet different objectives. Moreover, smaller companies would find it hard to bear additional costs arising from Medisave.

Source A: A view by a heart specialist, Dr Charles Toh, on the medisave scheme in 1983.

Source B: A comment by the retired and former Health Minister, Dr Toh Chin Chye, on the Medisave Scheme in 1983.

With Medisave, people would have to take care of themselves. Sometimes, the financial burden would be transferred to their children when a person cannot pay his hospital bill. Worse of all, what about the people who cannot pay their hospital bills?

Healthcare is the responsibility of the government. It is the duty of the government to find ways of using taxpayers’ money to meet different objectives. Moreover, smaller companies would find it hard to bear additional costs arising from Medisave.

Bad point: • not all Singaporeans make CPF contributions

and therefore, do not have Medisave. These group of people would be affected by healthcare costs. E.g. Tuition teachers, self-employed Singaporeans.


MediShield • National healthcare insurance scheme• Medisave is used to pay for this scheme• Patients can make claims from MediShield to

pay for large hospital bills that Medisave does not cover.


MediSave STILL not enough..

Lucky got MediShield…

MediSave STILL not enough..

Lucky got MediShield…

(MediShield)• Changes are made to MediShield to help cater

to the specific needs of people• E.g. people above 40 years old would be able

to pay for healthcare in case of disability if they pay premiums for MediShield. – Premiums: the money that you pay regularly for

insurance


Why MediShield? • To help people who

require long-term treatment of more serious illnesses but are unable to pay for their hospitalization


Is MediShield good?• Healthcare is made more

affordable• Needs of specific groups

of Singaporeans are catered to


Summary• Medi-S2

– Medisave– MediShield


MS2

Government subsidies • direct subsidies are given to government

hospitals, polyclinics and some nursing homes for the elderly

Why such subsidies?• To ensure that basic healthcare services are

available for all Singaporeans

How is the Government responsible for healthcare?

• government gives different rates of subsidies to the different classes of wards in hospitals

• E.g. Class C wards receive the most in subsidies (80%)

• Why such subsidies? – To ensure that healthcare remains affordable

especially for the lower-income group


Is government subsidies good? • Ensures that basic healthcare is affordable for

Singaporeans


HURRAY FOR Government subsidies!

HURRAY FOR Government subsidies!

Medifund• $200 million and the interest earned from this

fund, is given to public hospitals to provide help for needy patients

• patients who need help can apply for this fund at the hospital


Why Medifund?• For Singaporeans who are unable to afford

healthcare despite Medisave, Medishield and government subsidies.

• E.g. low-income workers, or self-employed people.


So… Is Medifund good?• Ensures that basic healthcare is affordable for

Singaporeans


HURRAY FOR Medifund!!! HURRAY FOR Medifund!!!

Restructuring of hospitals • Hospitals would have more freedom to

reorganize to meet the needs of Singaporeans


Why restructure?• Needs of Singaporeans will be more catered

to. • Government would be able to reduce the

amount of subsidies to hospitals.


So… Is restructuring good? • People were concerned that restructuring

would mean higher hospital bills. Feedback was given to the government.



Why means-testing?• Ensure fair distribution of government

subsidies [no ‘freeloaders’ or abuse of the healthcare system]


Why means-testing?• E.g. For patients staying in Class C wards in hospitals, they

receive more govt subsidies as compared to patients in Class A wards.

• Rich families may choose to stay in a Class C ward just to save on cost even though they can afford a Class A or B ward.

• Govt subsidies – given to a family who does not need the help.– Other poor families who need the money, does not get the money!


So… Is Means-testing good? • currently being debated about in the

Parliament, to consider how such a policy would affect Singaporeans.


• Summary – Government subsidies– Restructuring– Medifund– Means-testing

M&Ms R.Really Good!


Why?• One way to cope with rising

costs of healthcare for BOTH the government and individuals. a healthy person will not require medical treatment and therefore, he can save on medical expenses.


• How?– Schools and workplaces have programmes to

emphasise on the need to maintain good health– E.g. regular physical exercises and a well-balanced

diet are encouraged.



• Government provides monetary aid to organisations that provide healthcare support services

How is the Community responsible for healthcare?

• Why?– The community can provide some healthcare

support services for Singaporeans. [Some patients who are discharged from hospitals may still need medical care.]

– It is not possible for the government to run all healthcare services


• Examples: – Voluntary welfare organisations and private

organisations are given money by the government to run community hospitals, nursing homes and day rehabilitation centres for patients. [E.g. St. Andrews’ Community Hospital]

– Support is given by the government to oragnisations that provide specific healthcare support services.


• Is healthcare in Singapore affordable?– YES• Medisave helped patients who have little savings afford

healthcare• Medishield and Medisave helped patients pay for part

of hospital’s bill

• Is healthcare in Singapore affordable?– NO• Elderly who used to work but had no schemes to help

them make compulsory savings – dependent on family members, community and government• People who are unable to work – dependent on

government for their healthcare needs

• Are healthcare policies in Singapore successful?– Yes

• High quality of healthcare services• Increased life expectancy• Low infant mortality• Used only less than 3% of GDP • People are more aware of the need to be responsible for their

own healthcare – Medishield/ Medisave• Medifund for the needy• Community help/ services for the needy

• Are healthcare policies in Singapore successful?– No• Old people without medisave/ insurance not able to

afford healthcare services• Healthcare costs is continuing to rise• Still very much dependent on government subsidies

Education

Sec 3 Social Studies Chapter 3 (Singapore)