THE STATE OF HEALTH: SINGAPORE

Healthcare policy changes and what they mean for

Singaporeans and the healthcare ecosystem

CONTENTS

1. Executive Summary

2. Healthcare in Singapore

3. Healthcare 2020 Master Plan

4. What Are the Changes to the Healthcare System?

5. How Will This Impact Industry Subsectors?

Patients Healthcare Providers, Hospitals & Clinics Pharma and Medical Device Industries

6. Conclusion

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1. EXECUTIVE SUMMARY

Starting January 2014, Singapore has begun instituting changes to

existing healthcare policies.

While older Singaporeans, low-income families and those who

require outpatient treatments will benefit most from these

modifications, all stakeholders in the health ecosystem will be

affected in some way.

Outlined in this document is an overview of the health policy

changes in Singapore and suggestions for how various stakeholders

can update their communications strategies based on the changing

priorities and needs of the market.

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2. HEALTHCARE IN SINGAPORE

Singapore has established strong fundamentals in healthcare

excellence, providing strong infrastructure and universal coverage for

its citizens, while dedicating a relatively small portion of its GDP (4%)

on healthcare.1

As a result of the emphasis on quality care, Singaporeans have

experienced positive effects, including high life expectancy (#4 in the

world2) and the lowest infant mortality rate in the world.3

However, as one of the fastest-aging populations in Asia, Singapore

faces challenges ahead in the form of greater demand for

specialised elderly care, constraints on healthcare infrastructure and

rising costs.

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1World Competitiveness Yearbook 2010, IMD. 2World Health Organisation 2008. 3UN Inter-agency Group for Child Mortality Estimation 2012.

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3. HEALTHCARE 2020

To address these challenges, in 2012, the Ministry of Health introduced

Healthcare 2020, a master plan to ensure Singapores healthcare system better meets the needs of the people.

The plan focuses on using the three pillars of Accessibility, Affordability

and Quality to measure the effectiveness of healthcare in the country.

Image reprinted from HealthScope June-July 2012 issue.

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HEALTHCARE 2020 (CONTINUED)

In the next few years, improvements to healthcare in Singapore will revolve

around these strategies:

Working more closely with community clinics and

general practitioners (GPs)

Improvements to MediShield, the national health

insurance system

Subsidies for high cost drugs and treatment

Efforts and financial aid to be allocated to raising

health workforce productivity and capacity

Healthcare subsidies for a wider range of

Singaporeans

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4. SPECIFIC CHANGES

Community

Health

Assist Scheme

(CHAS)

Subsidy for

Specialist

Outpatient

Clinics

Former System

Beneficiaries need to

be at least 40 years old

to qualify for CHAS

50% subsidy for patients

who fall under the

lower middle income

bracket

Medisave

for outpatient

treatment

Age restriction removed and

is now open to those below

40

System as of Jan 2014

An increase of 10-20% for

outpatient treatment

subsidies; means testing will

be applied

Healthcare Item1

Medisave can only

be used for

chemotherapy and

major outpatient

operations

Increased coverage for

Medisave, which now covers

vaccinations such as

pneumococcal and

influenza for high-risk groups

MediShield

now

MediShield Life

Coverage only

applicable for people

under 90 and is an

optional scheme

Age ceiling lifted; those with

pre-existing illnesses are

covered; MediShield Life is

mandatory and premiums

will be higher

1http://www.straitstimes.com/breaking-news/singapore/story/budget-2014-relief-the-elderly-cpf-boost-all-workers-20140221

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5. HOW WILL THIS IMPACT

INDUSTRY SUBSECTORS?

Patients

Healthcare Providers, Hospitals & Clinics

Pharma and Medical Device Industries

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After revision of the Community Health Assist Scheme,

young people who belong to the lower income group

now qualify for subsidised healthcare (previously

available only to individuals above the age of 40)

and increased healthcare options.

The Ministry of Health (MOH) has dramatically

increased the number of surgical procedures paid for

through MediShield and Medisave. Previously, 1,600

procedures were covered; as of January 2014,

MediShield Life and Medisave cover about 2,350

procedures.

As MediShield transitions to MediShield Life, enrolment

will become compulsory for everyone Those who are

already enjoying personal or company insurance will

be doubly covered by insurance, providing them with

the option to withdraw from private schemes and

save money on premiums.

HOW WILL THIS IMPACT

PATIENTS?

More young people

will qualify for

subsidies

More operations and

procedures will be

covered

MediShield Life may

overlap with existing

health insurance

coverage

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As more Singaporeans gain access to a wider

variety of treatments, there is a need for large-scale

education efforts to determine who qualifies for

increased financial support and the benefits and

drawbacks of specialised plans.

Increased access to testing creates more

opportunities for preventative health campaigns.

If a Singaporean requires healthcare beyond the

limits of current plans, additional coverage may

require higher premiums. Insurance providers may

overhaul their offerings to cater to more specialised

groups and may levy higher charges to go with it.

For Singaporeans aged 65 and older as of 2014,

MediShield Life will now cover medical bills regardless

of pre-existing conditions and will offer a further 50%

off specialist outpatient clinic fees. They will also

receive a further Medisave top-up of S$200 to S$800,

depending on their age group.

HOW WILL THIS IMPACT

PATIENTS?

Communication Opportunities

Pioneer Generation

to receive greater

support for medical

bills

Higher premiums for

specialised plans

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Clinics and hospitals may become more

crowded

A greater pool of individuals is now eligible for

coverage. Assuming the number of healthcare

providers remains about the same, existing resources

may be strained by increased demand. However, this

may also present market entry opportunities for

healthcare providers.

Increased eligibility may stretch

healthcare resources

Adoption of innovative health information technology

can increase efficiency by effectively managing

complex patient records and outfitting patients with

more information so that they can make informed

decisions about their treatments.

Innovations in health

technology

HOW WILL THIS IMPACT HEALTHCARE

PROVIDERS, HOSPITALS & CLINICS?

Clinics and hospitals may become more

crowded

Greater need for

clinical data and

information sharing

Providers can become part of proactive disease

awareness initiatives, prevention campaigns,

educational sessions and roundtables to identify best

practices for addressing new and evolving challenges.

Opportunities include partnerships with pharma and

medical device industries and community outreach

programs, such as educational sessions in the

heartlands. Digital extensions like web resources and

apps can expand campaigns reach and influence.

As data sharing between hospitals, providers and

clinics improves, providers will carry some of the

burden to explain and to help provide fixes for any

deficiencies identified in the healthcare system.

Communication Opportunities

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Out-of pocket costs for patients will be lower as

coverage increases for medications. More patients

may start seeking treatments for chronic conditions

like anxiety, osteoarthritis and Parkinson's disease.

Public health campaigns, building disease awareness

and drives for early detection and treatment remain

strong communication opportunities for pharma and

medical device industries.

Companies may also consider partnership

opportunities with governmental organisations to

improve patient compliance and to address unmet

needs.

HOW WILL THIS IMPACT

PHARMA AND MEDICAL DEVICE

INDUSTRIES?

Lower out-of pocket

costs for

medications

Wider availability of

surgical operations

The number of covered surgical procedures rose

almost 50% from about 1,600 to 2,350 to include

operations for abnormal heart rhythm and piles.

Procedures have been reclassified to better reflect

improvements in technology and their relative

complexity.

Pharmacist as

gatekeeper

As a key touchpoint in the medical service process,

pharmacists are usually the last point of contact for

patients. This is significant as educational programs

and initiatives for these important yet overlooked

stakeholders can bolster a campaign at an

additional point of contact with patients.

Communication

Opportunities

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Singaporeans are just beginning to understand the implications of

new healthcare policies.

The fast-changing health landscape provides a slew of opportunities

for the private and public sector to lead large-scale education

efforts, upgrade digital capabilities, drive disease awareness and

prevention campaigns as well as provide platforms to discuss and

shape the future of healthcare in Singapore.

As the Singapore governments approach evolves and as 2020 healthcare goals come into view, it is important for all subsectorshealthcare providers, hospitals and companies in the

pharmaceutical, medical device and biotech industriesto continue growing and tailoring their communication efforts to match

the changing nuances and needs of the local communities.

6. CONCLUSION

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Edelman Health

Phone: +65 6733 1110

E-mail: singapore@edelman.com