SINGAPORE (2014 rank of 1)
- Singapore spent 4.2 % of its GDP on healthcare, amongst the lowest amongst developed nations. Only 36 % of the health care expenditure in 2012 was by government – however the government plays a very large role in regulating healthcare. Healthcare represented 11 % of all government expenditure.
Singapore provides close to 100 % insurance coverage for its citizens and permanent residents. - At the “Universal Healthcare Summit” in Feb ’15, the Prime minister announced a four step program to improve efficiency futher. The steps were to
- Divide Singapore into several catchments for healthcare provision purposes – it started with 6 catchments that have since reduced to 4. Each catchment is anchored by its own tertiary care network working in an autonomous manner.
- Network each catchment – and connect primary and secondary care providers in a seamless fashion to Tertiary providers with the use of technology. Co-opt private primary care providers into the network alongside government ones and allow for seamless flow of patient information without compromising on confidentiality
- Develop and communicate a “rightsiting” logic to all members – to streamline patient flows and avoid bottlenecks at tertiary facilities
- Lay emphasis on Health Promotion and prevention measures through an independent Health Promotion Board.
- Government funded healthcare for its citizens in 4 ways as detailed below
- Government Subsidies made healthcare affordable overall
- “Medisave” programs cater to the basic healthcare needs of a family. Families are forced to save a certain part of their income for future healthcare contingencies. There is no risk pooling but any money that is unused can be saved and carried forward
- “Medishield Life” is a risk pooling product that insures families for contingencies and higher order medical needs that might exceed “Medisave” savings. This is an insurance product. With effect from December 2015, “Medishield Life” is compulsory - i.e members will not be allowed to opt in and out as they could earlier. Medisave funds all chronic diseases and conditions that afflict a small proportion of the population
- “Medifund” acts as the final safety net to provide for catastrophic events that aren’t funded by any of the previous mechanisms