Bmc social studies_chapter3_healthcare(spore&uk systems)
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Bmc social studies_chapter3_healthcare(spore&uk systems) Presentation Transcript

  • 1. Healthcare Provision(Singapore and UK) Should the State provide…?
  • 2. Lesson Agenda After the lesson, students would be able to:  Appreciate the various stages of healthcare provision in Singapore.  Understand the various schemes to support healthcare in Singapore.  Practice an approach to Comparison questions (SBQ).
  • 3. Healthcare Provision in Singapore 1960’s  Healthcare measures linked to public housing because Singapore was overcrowded.  Healthcare programmes focussed on public hygiene  Eg. govt. cleared squatters and slums – citizens relocated to HDB flats. Clinics and hospitals were built to meet growing pop.  Effects of overcrowding reduced - public health improved and spread of major diseases minimized.
  • 4. Healthcare Provision in Singapore 1970’s  Economy improved & standard of living went up – citizens now wanted better quality healthcare. (F)  Polyclinics built conveniently within HDB estates to replace “out-patient dispensaries” (E1 + E2)  Better facilities in government hospitals – sophisticated equipment and treatment. Healthcare costs rising. (L)
  • 5. Healthcare Provision in Singapore 1980s to the present  Government observed - population is ageing. healthcare costs will rise.  Government resources would be taken away to pay for healthcare.  1980s, Govt. developed a new approach to healthcare:
  • 6. National Health Plan Healthcare = Shared responsibility.  The Individual + the Government + the Community = Healthcare provision in Singapore
  • 7. Healthcare Provision in Singapore The Individual  Self-reliance:  1984 Introduced MediSave Account. 8% of monthly contribution to CPF channelled to MediSave.  Singaporeans to take charge of their own healthcare.  MediSave further enhanced - includes Medishield (for those who do not have CPF Accounts) and Eldershield (for those above 40 who have disabilities)
  • 8. Healthcare Provision in Singapore The Individual (Self-Reliance) - MediShield:  This is a national healthcare insurance scheme.  Just like insurance – Singaporeans pay for MediShield from monthly contributions from MediSave.  Allows greater financial cover for rising healthcare costs.
  • 9. Healthcare Provision in Singapore The Individual (Self-reliance) - Eldershield  This is another insurance scheme. Targeted for those above 40.  It uses CPF MediSave accounts to pay premiums. Caters for those who have not built up enough savings in their MediSave accounts.  Provides assistance for those who cannot pay for high Medishield premiums.
  • 10. Healthcare Provision in Singapore The Government  Keeping healthcare affordable (Government Subsidies)  Provide government subsidies to hospitals, polyclinics and nursing homes.  Government saved $200mill and from the interest it gets it provides Medifund to subsidize hospital wards.  Hospital authorities decide how to use funds for individual cases.
  • 11. Healthcare Provision in Singapore The Government  Keeping healthcare affordable (Restructured Hosp.)  Restructuring means – Hospitals now have freedom to reorganise to better meet needs to Singaporeans  Government has flexibility to reduce the amount of subsidies when necessary  Keeping healthcare affordable (Means testing)  Govt must ensure fairness in subsidies.  Lowest income receive most. Higher income receive less.  Important because - Subsidies must benefit patients who are in most need of them.
  • 12. Healthcare Provision in Singapore The Government (Promoting Healthy Lifestyle)  A healthy person does not need a lot of medical care  Government encourages citizens to keep healthy.  This means a well-balanced diet & habit of physical exercise.  This will reduce the reliance on healthcare provision in the later years. This keeps healthcare affordable.
  • 13. Provision of Healthcare in Singapore The Community- healthcare support  Some patients require help to fully recover after discharge.  Voluntary & private organizations given grants to operate these facilities.  Grants given to provide specialised healthcare services: NKF and SATA (Singapore Anti Tuberculosis Assoc.)  Eases the burden of healthcare costs to the Govt as many agencies are providing these services.
  • 14. Making Comparisons What is a comparison?  It is a way of evaluating two (or three) items or subjects  using a category or classification. For example:  You can compare two bags according to their colour (one classification) or  according to their prices (second classification).  You are not describing the differences or similarities! You are stating what makes them different or similar
  • 15. Making Comparisons Note: The two bags are different in colour. (Inference). Bag A has a bright red colour while Bag B has a dull blue colour. (Support)
  • 16. Let’s practice! Alfred always kept to himself and never spoke to anyone. Melissa spoke only when spoken to Inference? Alfred & Melissa are similar in the way they deal with others Support: I know this because, Source A tells me that “Alfred kept to himself…” Similarly, Source B tells me that Melissa “…only spoke when spoken to…”
  • 17. Let’s Practice Can you come up with your own examples?  Come up with two sources and figure out how you are going to compare them  Present to the class…
  • 18. Lesson Re-cap What is the challenge of governments in providing healthcare? What was Singapore’s healthcare system like in the 1960s and 70s? What are the principles healthcare provision here…since the 1980’s?
  • 19. Welfare State & Healthcare Provision in UK Before the 20th Century, the British government did not provide much medical care for its citizens. The poor, aged or homeless had to depend on private charities, friends or family to help them pay for healthcare. After the war – Government felt it was necessary to look after these groups of people. The state would look after its citizens – for free
  • 20. Welfare State & Healthcare in the UK In a Welfare state, the government looks after its citizens from ‘cradle-to-grave’. This means that the government would ensure that every citizen would have a minimum standard of welfare to live a ‘decent’ life:  Each citizen would have a job  Each citizen would have a home  Each citizen would have access to healthcare.
  • 21. NHS in the initial years Initial success: It was popular with the people. The government provided free basic medical service for all citizens. Free medical treatments: This means that all medical services, dental and even optical treatments were FREE.
  • 22. Buzz Break What are the advantages and disadvantages of living under a welfare system? Advantages Disadvantages
  • 23. Initial years of NHS Govt. expected demand to increase & then stabilize. However increases went beyond expectations.  Too many people wanted healthcare services  Treatments prescribed without consideration for costs. By 1951 NHS could not meet expectations.  “Free at the point of service” was not working  Now had to charge for some treatments
  • 24. Britain and the NHS now Ageing pop & rising health costs affects Britain too. The British approach is to ensure that healthcare spending is put to good use:  No wastage or unnecessary expenditures.  Resources cater for specific patient needs.
  • 25. Managing healthcare in UK (1980s) Managing government spending:  The government is expected to provide healthcare to everyone.  Healthcare costs rise. This means government has to collect more taxes.  In the 1980s – new government in Britain wanted to reduce expenditure in healthcare.
  • 26. Managing healthcare-Thatcher’s policies Prime Minister Thatcher’s approach :  Cut back on government spending on welfare benefits including healthcare.  Return some services to be provided by private companies (privatization).  Healthcare should also be the responsibility of the individual.
  • 27. Challenges faced by UK Challenge 1: Loss of people’s support :  Reduction in healthcare spending = NHS could not continue to provide free health services.  Citizens used to receiving free healthcare – now very unhappy.  Government concerned about losing the support from citizens.  Healthcare policy needed to be carefully balanced to meet citizens’ expectations & managing costs
  • 28. Challenges faced by UK Challenge 2: Cost increase & increasing tax contribution:  Healthcare costs are rising.  Britains National Insurance contributions (which partly paid for NHS services) also had to increase.  This was not always popular. Increases meant there would be less money for people to spend on other things.
  • 29. Challenges faced by UK Challenge 3: Increasing efficiency  Demand for healthcare grew with an ageing population.  Numbers of people paying taxes to support the NHS was declining.  Despite cuts to healthcare spending - still not enough resources to support the demand.
  • 30. Challenges faced by UK Challenge 4: Privatization.  The aim was to reduce government subsidies.  To save costs and make NHS more efficient.  Private companies would now provide some services to the public.  E.g. All non-medical services would be supplied by private companies under a contract  Cleaning services and catering.
  • 31. Challenges Challenge 5: Providing Quality Services  By the late 1980s demand for services was high.  NHS system could not cope with this demand. Lead to declining standards in the NHS.  Govt responded by providing patients with info on their treatment - they can monitor rising costs themselves. But long queues still common.
  • 32. Response of Challenges NHS Plan (2000)  Based on feedback from patients, staff and doctors.  Increase government spending up to 2004.  To offer patients more convenient services  Could make use of facilities in private hospitals without the patients paying for it.
  • 33. Response to Challenges NHS Plan (2004)  Patients had a choice of 4 different healthcare providers. Treatment paid for by NHS.  Every patient have access to their own records on the Internet (HealthSpace).  Patient’s with minor illness can get advice from doctors over the phone (NHS Direct).
  • 34. Let’s Compare No one system is better than the other. The UK system works in there because:  people’s expectations are different  Standard of living is high etc. Singapore system of healthcare works here because of our different cultural and social characteristics
  • 35. Comparison 1: How citizens participate in the system UK S’pore Citizens make use of benefits –  Promote self-reliance among Govt. manages costs by citizens – Govt. plans for citizens carefully controlling to share the costs of their own government spending. healthcare Citizens pay two types of taxes:  MediSave and Medishield from Income tax & National citizen’s CPF contributions. Insurance tax
  • 36. Comparison 2: Keeping Healthcare affordableUK S’pore Privatization to reduce:  Government subsidies  given to nursing homes, polyclinics  Operating costs  Govt. subsidies  Medifund  Given to hospitals to use to off-set  Increase efficiency patient’s bill (needy cases) Every individual encouraged to  Restructured hospital be responsible for welfare and  Govt. is able to give less subsidies. health (except for expectant mothers, mothers with young  Means Testing  ensure that Govt. subsidies given to children and students below 19) patients who need.
  • 37. Comparison 3: Lifestyle choices and role of community UK S’pore Citizens encouraged…but no  Government provides support by government programme or championing healthy lifestyle policy to promote healthy choices through Health Promotion lifestyles. Board (a govt. agency) Community provides nursing  Government gives grants (sums of support, social services etc…but money for specific purposes) to these are self-funded. VWOs to operate: day rehabilitation centres, nursing homes and community hospitals Government (through NHS) for discharged patients still seen as the main provider of healthcare services and aftercare
  • 38. The Comparison Question 3 Steps to answering the question:  Step 1: Identify the type of comparison required  Step 2: locate similarities and/or differences  Step 3: Write out the answer – do not describe differences or similarities.
  • 39. Comparison Questions Type 1 (Similarities or Differences ONLY):  Provide, support & explain similarities only; or  Provide, support & explain differences only Possible question words:  What are the similarities between these 2 sources?  In what ways are Sources A and B similar?  How do the 2 sources differ?  What are the differences between the 2 sources?
  • 40. Comparison Question Type 2 (Similarity & Differences):  Provide, Support & Explain 2 Similarities + 1 Diff.  Provide, Support & Explain 2 Differences + 1 Sim Possible question words:  How similar are these 2 sources?  How different are Sources A and B?  To what extent are the 2 sources similar?  How far are these 2 sources different?  How far does Source A support/differ from Source B?
  • 41. Comparison Question Step 2: “locate” similarities and/or differences. Read the sources – search for:  What the sources have in common  What makes the sources different  look for POV (point-of-view),  tone (Negative tone, positive tone etc.) Don’t describe the differences!  Common mistake: A is red in colour and B is blue in colour, therefore they are different.  Try: The difference bet. A and B is colour.
  • 42. Comparison Question – Type 1 Template and guiding wordsCommon factor Support ExplainBoth sources differ or are This is shown in Source A, Source A (Make explanationsimilar in (state criteria for “…” However as seen in linking inference of Source Acomparison) Source B, “…” to the issue of the question) …However, Source BInfer highlights/comments that (Make explanation linkingSource A shows that (state inference of Source B to theinference) …whereas issue of question)Source B comments (stateinference) Repeat Infer, Support and Explain (ISE) for every similarity/difference inference that has been identified.
  • 43. Comparison Questions Conclusion for comparison questions:  Link similarities/differences back to the question issue and;  Highlight the connection difference or similarity) with the issue.
  • 44. Lesson recap Are there any differences between the Singapore healthcare system and that of the UK? What are the features of Singapore’s National Healthcare Plan? What were some of the challenges that British governments faced in managing the NHS?