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Problems that arise in providing Shared Resposibility Healthcare in Singapore

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Problems that arise in providing Shared Resposibility Healthcare in Singapore

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This article shows the Prime Minister's view on achieving SRH in Singapore. He agrees that it is very difficult to decide on the best amount of funds into healthcare. This is so as if there were too much funds used for healthcare that would mean lesser funds for the other departments. Futhermore, the funds are taxpayer's money therefore need to be more carefully used. Making provision of SRH is difficult task to accomplish

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Health care has always been both an emotional and political issue, said Prime Minister Lee Hsien Loong, and "it is always tempting to say we will do more, we will do better and it will cost less... maybe even free".

But governments have to be trustworthy stewards and present the trade-offs as they are to citizens and not sacrifice tomorrow for today's political gain, he said.

Every dollar the Government spends on health care is a dollar taken from taxpayers.

It is "a dollar we cannot spend on education, housing, defence, or on personal needs of our people", Mr Lee noted.

Opening the Ministerial Meeting on Universal Health Coverage yesterday, he said providing good health care is one of the most important responsibilities of any government - but is very challenging to achieve.

"It requires an honest conversation among ourselves, and hard choices made."

He gave a 30-minute summary of Singapore's health-care evolution, from the days of night soil collectors just 40 years ago to the setting up of MediShield Life, the compulsory all-inclusive health insurance scheme to be introduced later this year.

The two-day meeting at the Grand Copthorne Waterfront Hotel is organised by the Health Ministry.

When it comes to health care, the usual economic models do not work, Mr Lee told the 300-strong audience, including the health ministers from Bangladesh, Brunei, Finland, Indonesia, Myanmar, Thailand and Vietnam.

Expanding capacity for future needs may stimulate a supply-induced demand. As doctors know far more than patients, a "willing buyer, willing seller" model does not work. And protecting patients from financial consequences could lead to overtreatment.

So, a variety of tools are needed, Mr Lee said, from pricing and regulation to incentives, exhortation and, sometimes, even compulsion, "to shape behaviour by doctors, patients, administrators, drug suppliers, in order to produce a good collective outcome".

Giving the keynote address, Dr Margaret Chan, director-general of the World Health Organisation, praised Singapore for achieving a good health-care system at a relatively low cost. "In terms of return on investment, you are No. 1 in the world," she said, pointing to the 4.2 per cent of gross domestic product spent on health care here, compared with the 18 per cent in the United States.

Dr Chan told delegates that each country has to develop its own model of universal health care, based on its culture, existing system and people's expectations.

She outlined Bangladesh's success. Through a few high-impact interventions, such as getting community health workers to cover the shortage of doctors and nurses and building and running 12,000 community clinics, the country now has the longest life expectancy and lowest child mortality in South Asia.

She said: "Any country that really wants to move towards universal health coverage can do so. Even barriers like a dense and very poor population and frequent natural disasters will not stand in the way."
salma@sph.com.sg www.facebook.com/ST.Salma

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Providing good health care a challenge: PM Lee Hsien Loong

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Health care has always been both an emotional and political issue, said Prime Minister Lee Hsien Loong, and "it is always tempting to say we will do more, we will do better and it will cost less... maybe even free".. Read more at straitstimes.com.

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Issues that arise from Shared Responsibility Healthcare 

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Issues that arise from Shared Responsibility Healthcare 

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With every dollar the government spends on healthcare services in Singapore, a dollar is taken from taxpayers and this is a dollar which is not being spent on education, housing, defence or on personal needs of the people. Providing good healthcare services is one of the most important responsibilities of any government but is challenging to achieve it, with the need of balancing the spendings on other areas of concern such as education and defence to ensure that there is not a lack of funds. The source tells us about how the government plans to counter this problem, taking to discussions with delegates from other countries in South-East Asia.

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Health care has always been both an emotional and political issue, said Prime Minister Lee Hsien Loong, and "it is always tempting to say we will do more, we will do better and it will cost less... maybe even free".

But governments have to be trustworthy stewards and present the trade-offs as they are to citizens and not sacrifice tomorrow for today's political gain, he said.

Every dollar the Government spends on health care is a dollar taken from taxpayers.

It is "a dollar we cannot spend on education, housing, defence, or on personal needs of our people", Mr Lee noted.

Opening the Ministerial Meeting on Universal Health Coverage yesterday, he said providing good health care is one of the most important responsibilities of any government - but is very challenging to achieve.

"It requires an honest conversation among ourselves, and hard choices made."

He gave a 30-minute summary of Singapore's health-care evolution, from the days of night soil collectors just 40 years ago to the setting up of MediShield Life, the compulsory all-inclusive health insurance scheme to be introduced later this year.

The two-day meeting at the Grand Copthorne Waterfront Hotel is organised by the Health Ministry.

When it comes to health care, the usual economic models do not work, Mr Lee told the 300-strong audience, including the health ministers from Bangladesh, Brunei, Finland, Indonesia, Myanmar, Thailand and Vietnam.

Expanding capacity for future needs may stimulate a supply-induced demand. As doctors know far more than patients, a "willing buyer, willing seller" model does not work. And protecting patients from financial consequences could lead to overtreatment.

So, a variety of tools are needed, Mr Lee said, from pricing and regulation to incentives, exhortation and, sometimes, even compulsion, "to shape behaviour by doctors, patients, administrators, drug suppliers, in order to produce a good collective outcome".

Giving the keynote address, Dr Margaret Chan, director-general of the World Health Organisation, praised Singapore for achieving a good health-care system at a relatively low cost. "In terms of return on investment, you are No. 1 in the world," she said, pointing to the 4.2 per cent of gross domestic product spent on health care here, compared with the 18 per cent in the United States.

Dr Chan told delegates that each country has to develop its own model of universal health care, based on its culture, existing system and people's expectations.

She outlined Bangladesh's success. Through a few high-impact interventions, such as getting community health workers to cover the shortage of doctors and nurses and building and running 12,000 community clinics, the country now has the longest life expectancy and lowest child mortality in South Asia.

She said: "Any country that really wants to move towards universal health coverage can do so. Even barriers like a dense and very poor population and frequent natural disasters will not stand in the way."
salma@sph.com.sg www.facebook.com/ST.Salma

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Providing good health care a challenge: PM Lee Hsien Loong

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Health care has always been both an emotional and political issue, said Prime Minister Lee Hsien Loong, and "it is always tempting to say we will do more, we will do better and it will cost less... maybe even free".. Read more at straitstimes.com.

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Over the years, as the Singapore government manages healthcare through "Shared Responsibility", funds have been invested in research for better treatments, more effective medicines and training for better-qualified medical staff. At the same time, all citizens still expect to have a basic, better yet affordable healthcare. This source elaborates on the challenges faced and the healthcare policies of Singapore, whether the needs of the people are met and who is paying the healthcare services.

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Sec 3 Social Studies Chapter 3 (Singapore)

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As the government in Singapore manages healthcare through the "Shared Responsibility" approach, several problems come about. They include a public good whereby countries have limited resources yet citizens expect to be provided basic healthcare; quality healthcare where people in developed countries expect better healthcare services and rising spending, expecting to have the best healthcare. This source tells us about the problems the government faces as well as ways that healthcare is paid for in Singapore.

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Chapter 3 - Managing Healthcare in Singapore

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Follow me on slideshare. http://www.slideshare.net/gohbangrui These slides are used to illustrate the healthcare system in Singapore. Ranging from Medisave to ...

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How the Shared Responsibility model keeps healthcare affordable

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How the Shared Responsibility model keeps healthcare affordable

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With the increasing expenditure on healthcare, it is kept affordable as employers pay a portion of money for insurance for workers and the government uses a certain percentage of taxes to pay for the medical services used. Means-testing is also used to ensure that government subsidies are given to patients who need them the most to ensure fair distribution of government subsidies, abolishing any 'freeloaders' or abuse of the healthcare system, keeping it affordable for the citizens.

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How Shared Responsibility Healthcare in SG works

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How Shared Responsibility Healthcare in SG works

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Healthcare in Singapore comes in 4 forms, namely Medisave, Medishield Life, ElderShield and Medifund. As Singapore takes a "Shared Responsibility" approach with regards to healthcare, the government does not freely give monetary handouts to aid with citizens medical bills, instead these 4 schemes are put in place.
These schemes generally involve the Singaporean citizen or PR paying monthly/yearly premiums which accumulates the money to be used when required, specifically for medical reasons. Except for Medifund, which is a scheme exclusive to citizens, where the government reimburses needy citizens, on a case-to-case basis, factoring in their health issues, their medical bills, and their social and financial situation.

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Singapore offers an extensive social security system to ensure everyone can have access to healthcare, but this is not available to expats unless they have become permanent residents.

Even if you do not need health insurance to get a visa for Singapore, you should still ensure you are able to afford help in an emergency.

Accident and Emergency Departments in Singapore have a fixed rate for people of all nationalities.

You can choose from a variety of different insurance covers and should ensure that your choice covers everything you may need in the future, such as dental care.

If you are going to relocate to Singapore, you needn't worry about your health. Healthcare in Singapore boasts excellent quality standards, both in the public and private sector. The system of public healthcare in Singapore consists of several government schemes for citizens and permanent residents. These schemes reimburse a substantial part of medical bills. Nonetheless, most participants still need to cover some costs from their own pocket - or via supplementary insurance.

Government healthcare in Singapore is subsidized and organized by the CPF, the Central Provident Fund Board, and the Ministry of Health. The CPF is an integral part of Singapore's social security in general. Its provisions for public healthcare in Singapore include the four insurance plans described below.

Medisave: Saving Up for Medical Costs

Established in 1984, Medisave is the oldest component of public healthcare in Singapore. Every Singaporean and permanent resident employee needs to put away an annual 8 to 10.5% of their income. The money is collected in a dedicated savings account, where it accrues tax-free interest. The exact percentage depends on the person's age. Contributions are lowest for those under 35 and highest for the 50+ age group.

Also, those who earn less than 1,500 SGD per month contribute to Medisave at special rates. The self-employed pay into the plan according to their net income. You can accumulate up to 49,800 SGD in your Medisave account - this limit is called the Basic Healthcare Sum (BHS). Any overflow goes into different CPF funds, e.g. your Retirement Account.

Singaporean citizens and permanent residents can use their Medisave money to pay for specific medical costs at all public healthcare institutions, as well as approved private hospitals and clinics. Those costs mainly include bills for inpatient hospital care, day surgery, psychiatric treatment, specific chronic diseases (e.g. diabetes, asthma, or depression), therapies for people with cancer or HIV-positive patients, childbirth, and selected health screenings. For a complete and up-to-date list of treatments covered by the Medisave scheme, see the CPF website.

However, there are certain daily, monthly, or yearly withdrawal limits on Medisave healthcare in Singapore. All fees exceeding those limits must be paid for by other means. Your immediate family members (parents, spouse, and children) can provide for you from their account, but the limits apply to these contributions as well.

Medishield Life: Assistance for Larger Medical Bills

To help those with serious illnesses, whose Medisave account may not be nearly enough to account for their bills, the government founded another plan for healthcare in Singapore. Introduced in late 2015 and replacing the previous Medishield scheme, Medishield Life works as a so-called "catastrophic illness insurance scheme" that makes provisions for hospitalization, surgery, and selected outpatient treatment. Every citizen or permanent resident is automatically insured via Medishield Life unless they choose to opt out of the program.

Participants pay annual premiums according to their age group: only 50 SGD for those under 21, but up to 1,190 SGD for patients aged 86 to 90 (as of 2016). These premiums can be taken from your or your family's Medisave account. However, even if you have Medishield Life healthcare in Singapore, you still pay a yearly deductible sum before you get any reimbursements. There will also be co-payments on each fee.

Again, you can take the co-payments from your Medisave account as long as you don't meet the withdrawal limit for particular conditions. Then you must pay the rest in cash. Private insurance companies in Singapore offer a top-up for Medishield Life coverage: the Integrated Shield Plan is a private insurance in addition to your Medishield Life plan, meaning you can take advantage of better hospital wards and private sector care, which would otherwise not be covered with just Medishield Life.

ElderShield: Supporting You through Your Later Years

The third pillar of government-subsidized healthcare in Singapore is called ElderShield. As the name implies, this insurance schemes assists elderly patients with severe long-term disabilities. Singaporean citizens and permanent residents are automatically enrolled at the age of 40 but have the option to opt out and join at a later date if they want. From the age of entry to the age of 65, those insured via ElderShield pay a fixed yearly premium. This is higher the older an insured person is at the age of entry to ensure people pay a similar amount overall. For example, a 40-year-old Singaporean woman who joined the scheme after September 2007 will pay an annual lump sum of 217.76 SGD for the next 26 years. The premiums for men are usually lower, due to their lower life expectancy.

If ElderShield participants become severely disabled in old age - i.e. they need help with tasks such as washing, dressing, or feeding themselves - the program assists with nursing care. They get monthly cash payouts of 400 SGD for up to six years to cover some of the related costs. There are three government-approved insurance providers in Singapore that offer ElderShield plans: Aviva, Great Eastern, and NTUC Income. If you want bonus coverage with higher payouts or a longer period of time, you have to buy so-called ElderShield supplements from one of these three companies.

Medifund: Ensuring Healthcare Remains Affordable for Citizens

Last but not least, a further healthcare scheme in Singapore caters to the needs of the poor and the elderly. Singaporean citizens who cannot afford their medical bills can apply for financial assistance under Medifund, Medifund Junior, or Medifund Silver. Medifund Junior is aimed at helping children in needy families, while Medifund Silver is aimed at elderly people in need of financial assistance. They receive treatment only at accredited facilities. There they have to talk to a Medical Social Worker about government aid.

The reimbursement they get is decided on a case-to-case basis. It normally depends on their health issues, their medical bills, and their social and financial situation. Medifund explicitly includes citizens only. Even permanent residents without citizenship are not eligible for this program.

Again, it needs to be emphasized that expats with temporary passes - e.g. residence/work permits for foreign employees - have no access to public healthcare in Singapore. We will tell you more about insurance options for expatriates in the second part of this guide.
We do our best to keep this article up to date. However, we cannot guarantee that the information provided is always current or complete.

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Singapore offers an extensive social security system to ensure everyone can have access to healthcare, but this is not available to expats unless they have become permanent residents. Even if you do not need health insurance to get a visa for Singapore, you should still ensure you are able to afford help in an emergency.

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Challenges that arise from Shared Responsibility Healthcare

This source shows us the many different challenges that have aroused in Singapore for the past many years. This includes MediShield, Medisave and CPF contributions. It also tells us the role of the government, how they can help us with healthcare in SG.

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MANAGING HEALTHCARE Case-Study of Singapore