sec 3 social studies chapter 3 (singapore)
TRANSCRIPT
Healthcare in 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?
Healthcare in Singapore
• What are some complaints that you have about healthcare in Singapore?– Visiting a doctor?– Getting MCs?– Paying for the bills?
Healthcare in Singapore
• 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]
What are the challenges of managing healthcare in Singapore?
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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.
What are the challenges of managing healthcare in Singapore?
• 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.
How is the Individual responsible for his own healthcare?
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.
How is the Individual responsible for his own healthcare?
• 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.
How is the Individual responsible for his own healthcare?
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.
How is the Individual responsible for his own healthcare?
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
How is the Individual responsible for his own healthcare?
Why MediShield? • To help people who
require long-term treatment of more serious illnesses but are unable to pay for their hospitalization
How is the Individual responsible for his own healthcare?
Is MediShield good?• Healthcare is made more
affordable• Needs of specific groups
of Singaporeans are catered to
How is the Individual responsible for his own healthcare?
Summary• Medi-S2
– Medisave– MediShield
How is the Individual responsible for his own healthcare?
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
How is the Government responsible for healthcare?
Is government subsidies good? • Ensures that basic healthcare is affordable for
Singaporeans
How is the Government responsible for healthcare?
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
How is the Government responsible for healthcare?
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.
How is the Government responsible for healthcare?
So… Is Medifund good?• Ensures that basic healthcare is affordable for
Singaporeans
How is the Government responsible for healthcare?
HURRAY FOR Medifund!!! HURRAY FOR Medifund!!!
Restructuring of hospitals • Hospitals would have more freedom to
reorganize to meet the needs of Singaporeans
How is the Government responsible for healthcare?
Why restructure?• Needs of Singaporeans will be more catered
to. • Government would be able to reduce the
amount of subsidies to hospitals.
How is the Government responsible for healthcare?
So… Is restructuring good? • People were concerned that restructuring
would mean higher hospital bills. Feedback was given to the government.
How is the Government responsible for healthcare?
How is the Government responsible for healthcare?
Why means-testing?• Ensure fair distribution of government
subsidies [no ‘freeloaders’ or abuse of the healthcare system]
How is the Government responsible for healthcare?
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!
How is the Government responsible for healthcare?
So… Is Means-testing good? • currently being debated about in the
Parliament, to consider how such a policy would affect Singaporeans.
How is the Government responsible for healthcare?
• Summary – Government subsidies– Restructuring– Medifund– Means-testing
M&Ms R.Really Good!
How is the Government responsible for healthcare?
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 is the Government responsible for healthcare?
• 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.
How is the Government responsible for healthcare?
How is the Government responsible for healthcare?
• 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
How is the Community responsible for healthcare?
• 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.
How is the Community responsible for healthcare?
• 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