Question:
Discuss about the Universal Health Care In Singapore.
Health care can be considered one of the necessities that each and every individual of the society has a right to. However, various external and internal factors continue to influence the health care provided to different sectors of the society. These elements are diverse, and they vary greatly, ranging from race to gender to age to socioeconomic status, and all the different factors facilitate health care disparities in both accessibility of care and quality of care. However there have been some strategies being implemented to reduce the disparities prevalent in the health care system by the global healthcare monitoring authorities, and universal health coverage policy is one of the robust steps that have been taken to improve the situation. Out of all the countries that have implemented universal health coverage scheme, Singapore had been the country that has achieved excellent progress in their health care system by incorporating this strategy. And that is the reason why the healthcare system of Singapore is considered as the role model for other countries to look up to (Boerma et al., 2014). This assignment will attempt to explore how Singapore has adapted to the universal health coverage scheme and how it has contributed to overall progression in both their health care system. Overview of Singaporean health care:
As per the recent statistics shared by the World Health Organization, the healthcare system in place in Singapore is ranked 6th position from the top of the global list and is considered to be the provider of 4th best healthcare standards in global comparison. Along with that, it has to be mentioned that Singapore is also deemed to have the best health care system in all of Asia, and Singapore proudly serves as the showcasing representative for providing outstanding medical technology and optimal health care standards. The island state has a population of 5.4 million and the surprising elements that attract the attention of the world towards its revolutionary health care system, is the universal coverage or accessibility that it has provided, and appreciable health benefits provided at minimal government spending. According to the Alma-Ata principle of WHO, one of the most significant components of global health improvement strategies is the universal health coverage; the health care system of Singapore entertains universal health coverage at the heart of their policies and principles (Boerma et al., 2014).
The presiding health care body for Singapore is the Ministry of Health or MOH, and this authoritative entity is responsible for policies and protocols being designed and implemented in Singapore. The mission statement for the health care system in place in Singapore is to accelerate multidimensional transformation in the healthcare sector by means of introducing infocomm-enabled care delivery system. To meet this goal the MOH invested 6.6 billion dollars in the year of 2015 which is approximately 30% higher than that of 2014. Elaborating more on the history of the progress made by the MOH in the past decade, it has to be mentioned that the turning point for the health care system had been the establishment of health promotions board in the year 2001, which facilitated the disease prevention and national health programs in the nation. The health care system of the nation in the present day scenario is governed by the healthy living masterplan, that by the end of 2020 acclaims to make extensive health care services accessible and affordable for all the citizens regardless of their socio-economic standing.
Regarding annual government expenditure, Singapore takes pride in the fact that it spends half of what the rest of the developed countries spend on the healthcare, roughly 4.7% GDP. There are three core principles that have been developed over the course of the past decade in the Singaporean health care system; the first principle integrates the concepts of preventative health care strategies with robust health promotional campaigns and promoting healthy lifestyles. It has to mentioned in this context, that under the guidance of Mr Khaw Boon Wan, the health minister for Singapore in the past decade, the government realized the need for integrative early and accessible primary health care services; and improvement can only be facilitated by improving both the quality and cost-effectiveness of care (Chongsuvivatwong et al., 2011). The second principle of Singaporean health care system promotes healthy living by the “3M” system, Medisave, Medishield, and Medifund. Medisave can be defined as the national insurance scheme which provides the citizens with both primary hospitalization expenses and few outpatient treatments as well, by their compartmentalized savings for the medical expenses. Medishield, on the other hand, is a rather complementary scheme to the Medisave scheme, which provides the citizens with catastrophic insurance coverage. Lastly, Medifund is the endowment fund that is operated and generated by the government which is designed to help the citizens with their health care expenses is not compatible to be covered by their Medisave and Medishield. This health care coverage scheme is the key facilitator in the radically low annual government spending in the nation and yet having decent life expectancy rates (Moh.gov.sg.).
Considering the progress of the healthcare delivery pattern of Singapore, it has to be mentioned that 80% of the advanced primary care is provided by the public hospitals and the entire transition in the dependency from the privatised sectors to public sectors happened in the last decade itself. The growth in the public health care services can be represented by the fact that in the year 2010, there had been 11509 hospital beds, with 8881 from public sectors and rested from privately owned facilities. Hence it can be stated that the health care system of Singapore has witnessed a progressive growth in the last decade and adhering to the idea of universal health coverage has helped it attain the place that it has in the global list (Guinto et al., 2015).
The primary understanding of the universal health coverage scheme is the fact that it entertains the accessibility given to each and every citizen using curative, preventative, palliative and rehabilitative health services. The principle objectives of the universal health coverage scheme are to establish and maintain equity in health care service accessibility, maintaining the quality benchmark for the services provided and protecting the citizen from the financial risk of healthy acre expenses so that all the socio-economic sectors of the society can avail similar health care coverage. It was declared by the WHO in the year of 1989 in the Alma Ata declaration for all the nations to follow. For the Singaporean context, one of the key measures taken to improve the health care services had been to adhere to the UHC scheme (Holmes, 2012).
Now one of the key principles that have been followed in order to ensure optimal adherence to the UHC is a strong policy focus at promotional and preventative care pattern for the non-communicable diseases. The Singaporean health care system adapted to a philosophy that boasts a shared responsibility between the government and the citizens to ensure healthy living. Their health care policies like affordable care policy hint at compliance to this key philosophy, so that there is an informed responsibility of the patients and their families to ensure healthy living, while the government overlooks the funding and maintaining cost-effectiveness of the entire health care services. The cost-effectiveness of the healthcare expenditure is maintained in the Singaporean health care services by the help of incentivising the health care providers; so that the financial risk to citizens is mitigated effectively. Hence it can be stated that the government of the Singaporean context provides a safety net to the citizens while the citizens contribute financially according to their preferences for their future in a government controlled insurance scheme (Ibrahimipour et al., 2011).
It has to be mentioned in this context that the main principle of the UHC is to ensure that health care services are accessible to each and every sector of the society and there should not be any disparity in the delivery of the care services. In order to maintain compliance with this key principle of UHC, a robust and sound monitoring policy is a mandate for the government. In case of Singaporean health care, there is no such monitoring framework, however it has to be mentioned that the key indicators for accessibility, quality and affordability is reported by the Key performance indicator system to the ministry of health (McKee et al., 2013).
he healthcare system in Singapore has seen a drastic change in the past decade, and the most of the credit for the same goes to the initiatives invested by the government. Between the window of 1999 to 2010, the Singaporean health care has seen a rapid boost in the life expectancy in general facilitated by a radical decrease in the premature mortality, coronary heart conditions, cancer and stroke. And this appreciable outcome in the healthcare sector has achieved by the Singaporean government by just spending 4% of the annual GDP. Now this has been possible for the nation to achieve only by the health care expenditure maintenance scheme introduced by the Singaporean government under the guidance of the former health minister Mr Khaw Boon Wan (Tan et al., 2014).
The revolutionary steps that the government has taken to ensure the overall accessibility of the health care services distributed to the citizens with equity rather than equality is commendable. The public funding scheme introduced by the government has three different yet interconnected variables. As discussed above, these three elements are nothing hut three insurance coverage schemes that allow the citizens to invest their share in accordance to their affordability and in turn be able to access excellent hospitalisation expenses and along with that coverage for specific outpatient care services as well. Elaborating more on this context, it has to be mentioned in this context that Medisave allowed the citizens to save their own pennies so that their own future can be secured in terms of primary health care expenses, while Medishield provided coverage to the citizens for catastrophic health care needs or incidences. Lastly, the Medifund is the endowment scheme that is the proverbial safety net for the citizen from the government and for the unfortunate ones whose insurance coverage cannot cover the health care expenses they have exhausted. This public funding scheme or system incorporates the principle of equity into the entire scenario so that the support is given to the individuals who need it the most (Tangcharoensathien et al., 2014).
Now it has to be mentioned in this context, that the uniqueness of the health care system established in Singapore does not provide a linear or equal health care services to all socioeconomic sectors of the society. Instead, this health care system covers the different needs of different sections of the society with justice and equity. Hence, this initiative from the Singapore government provides the essential element that ensures adherence to the UHC scheme maintaining absolute accessibility to the citizens. Along with that it also has to be mentioned that the Singapore governments deserves more appreciation for the incentivising scheme that propels the healthcare providers to adhere to the system, and along with that the monitoring indicator system also ensures that the compliance to the UHC scheme is not interrupted in any manner (Wirtz et al., 2017).
Conclusion:
On a concluding note, it has to be mentioned that the Singapore has been successful in presenting an illustration at a remarkable development in the extensive health care delivery for all the nations to follow. By the virtue of three pillars of progress, incentivising, coverage monitoring, and financial protection, it has been able to reduce their annual spending at health to the half of what the rest of the world pays. And yet maintain a quality standard that is truly enviable; all the while shifting the focus of the citizens to public health sectors from privatised entities. Hence, it can be hoped that the initiatives taken by the government in facilitating this revolutionary transition can be an excellent benchmark for the rest of the countries to follow in order to establish equity and uncompromised quality in health care.
References:
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Boerma, T., Eozenou, P., Evans, D., Evans, T., Kieny, M. P., & Wagstaff, A. (2014). Monitoring progress towards universal health coverage at country and global levels. PLoS medicine, 11(9), e1001731.
Chongsuvivatwong, V., Phua, K. H., Yap, M. T., Pocock, N. S., Hashim, J. H., Chhem, R., … & Lopez, A. D. (2011). Health and health-care systems in southeast Asia: diversity and transitions. The Lancet, 377(9763), 429-437.
Guinto, R. L. L. R., Curran, U. Z., Suphanchaimat, R., & Pocock, N. S. (2015). Universal health coverage in ‘One ASEAN’: are migrants included?. Global health action, 8(1), 25749.
Holmes, D. (2012). Margaret Chan: committed to universal health coverage. The Lancet, 380(9845), 879.
Ibrahimipour, H., Maleki, M. R., Brown, R., Gohari, M., Karimi, I., & Dehnavieh, R. (2011). A qualitative study of the difficulties in reaching sustainable universal health insurance coverage in Iran. Health policy and planning, 26(6), 485-495.
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Moh.gov.sg. (2017). Moh.gov.sg. Retrieved 7 October 2017, from https://www.moh.gov.sg/
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