Case studies of healthcare in singapore and britain
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  • Welfare system Cradle-to-grave
  • Efficiency Quality Spending
  • Reforms
  • Efficiency Quality Spending

Case studies of healthcare in singapore and britain Case studies of healthcare in singapore and britain Presentation Transcript

  • How much responsibility should thegovernment/ individual take for thehealthcare of an individual citizen? Britain (90% govt, 10% ind) v.s. Singapore (50% ind, 40% govt, 10% community)
  • Managing Healthcare in Britain
  • British Welfare System• Recommended by Beveridge Report (by Sir William Beveridge) to end poverty, diseases and unemployment after WWII• Welfare system to look after citizen from ‘cradle to grave’ started in 1948
  • Healthcare: National Health Service (NHS)• Basic healthcare services are free for all citizens• Healthcare system based on meeting the needs of the people, rather than focusing on the ability to pay
  • Healthcare: National Health Service (NHS)Benefits:•Ensures that the people hada minimum standard ofwelfare for a decent life•People were happy with thesystem and continuedsupporting the government
  • Main problem:Inability to handle demand
  • Main problem: Inability to handle demand• Methods to solve problems must(In your explanation)(1)Reduce demand(2)Increase resources(3)Change the way the resources are usedso that patients who really need the services can access it
  • Problems and Solutions Problems ProblemsOver-expenditure on Low quality of Low efficiencyHealthcare service Solutions SolutionsEncouraging self- Encouraging self- Increase efficiency Increase efficiency Provide quality Provide qualityresponsibility responsibility service service •• Privitisation within Privitisation within•• Some services were no Some services were no NHS NHS •• NHS Plan (2000) NHS Plan (2000) longer free longer free •• NHS Improvement Plan NHS Improvement Plan (2004) ––Providing (2004) Providing choices choices
  • 1) Encouraging self-responsibility Problem: Over-expenditure on Healthcare• Managing spending by encouraging self- responsibility – Cutting back on government spending on healthcare – Create a system where the individual is more responsible for one own’s healthcare and welfare Margaret Thatcher (1980s)
  • 1) Encouraging self-responsibility • Encourage responsibility for own health – Medicine, dental treatment and optical services were no longer free except for some groups: e.g. • Expectant mothers • Students under 19Helps to reduce demand andwastages!
  • 1) Encouraging self-responsibility• Managing spending by encouraging self- responsibility – Cutting back on governmentre itish we ept Br spending on healthcare acc g to illin !! – Create a system where the individual is unw more this responsible for one own’s healthcare and welfare Margaret Thatcher
  • 1) Encouraging self-responsibility “..NHS remains the symbol of social justice.. So that every patient can access treatment whenever they want and need … ”Tony Blair (2000)
  • 1) Encouraging self-responsibility “..We decided to make a historic commitment to a sustained increase in NHS spending. We would spend the money if, but only if, we also changed the inefficiency of theTony Blair (2000) NHS… ”
  • 1) Encouraging self-responsibility • Increasing taxes – Increases in National Insurance contributions in 2003 – Spent £69 billion for NHS (15.8% of budget)Tony Blair (2000)
  • 2) Privatization Problem: Low efficiency• Policy of Privatization • Contract out non-medical services – laundry, cleaning, catering – Private companies are concerned with profit-making, thus they would try to remain competitive and efficient • Hospitals can concentrate on medical services  improve their own efficiency
  • 3) Increase quality of service Problem: Low quality service Focus: •Patients were given more information to make informed choices of treatment and care •Putting the needs of patients as top priority
  • 3) Increase quality of serviceNHS Improvement Plan (2004)More choices: Patients could choose from four differenthealthcare providers and NHS would pay for thetreatmentNHS Direct: provide medical advice over the phone topatients with minor illnesses  saves time and money
  • Has the British Healthcare Policies met the needs of the people?Many different opinions from the people…. • People of Britain identify themselves with and feel strongly about it • British citizens are grateful for the system • Many great improvements to the system
  • Has the British Healthcare Policies met the needs of the people?Many different opinions from the people…. • No real improvements to the system – still low efficiency and quality of service • Excessive government spending • More reforms needed to meet the changing needs of the population
  • Problems and Solutions Problems ProblemsOver-expenditure on Low quality of Low efficiencyHealthcare service Solutions SolutionsEncouraging self- Encouraging self- Increase efficiency Increase efficiency Provide quality Provide qualityresponsibility responsibility service service •• Privitisation within Privitisation within•• Some services were no Some services were no NHS NHS •• NHS Improvement Plan NHS Improvement Plan longer free longer free (2004) ––Providing (2004) Providing choices choices
  • Healthcare in Singapore
  • Healthcare in Singapore
  • • Challenges of managing healthcare• Who pays for the healthcare services in Singapore?• Singapore healthcare system – Individual, Government, Community• Have Singapore’s healthcare policies met the needs of the people? Healthcare in Singapore
  • • What are some complaints that you have about healthcare in Singapore? – Visiting a doctor? – Getting MCs? – Paying for the bills? Healthcare in Singapore
  • • Providing basic healthcare• Providing quality healthcare• Providing affordable healthcare What are the challenges of managing healthcare in Singapore?
  • To ensure that all Singaporeans who need the healthcare service can afford it..(In your explanation)(1)Reduce demand(2)Increase resources(3)Change the way the resources are used(4)Make healthcare affordableso that patients who really need the services can accessit
  • Government’sapproach toHealthcare inSingapore today. What is the approach to healthcare in Singapore today?
  • Medisave• A certain amount of money from people’s Central Provident Fund (CPF) is put into their Medisave account• This money can be used to pay hospital bills and certain medical treatment when needed. How is the Individual responsible for his own healthcare?
  • • Why Medisave? – Medisave encourages Singaporeans to be responsible for their own health – Government does not have to increase taxes, or take on the burden of healthcare in Singapore. – Healthcare as a shared responsibility. How is the Individual responsible for his own healthcare?
  • • Brainstorm: Is Medisave all good and sufficient? How is the Individual responsible for his own healthcare?
  • • So.. Is Medisave enough?Source A: A view by a heart specialist, Dr Charles Toh, on the medisavescheme in 1983.With Medisave, people would have to take care ofthemselves. Sometimes, the financial burden wouldbe transferred to their children when a personcannot pay his hospital bill. Worse of all, what aboutthe people who cannot pay their hospital bills?
  • Is Medisave all good?Source B: A comment by the retired and former Health Minister, Dr Toh Chin Chye, on the Medisave Scheme in 1983. Healthcare is the responsibility of the government. It is the duty of the government to find ways of using taxpayers’ money to meet different objectives. Moreover, smaller companies would find it hard to bear additional costs arising from Medisave.
  • Bad point:• Not all Singaporeans make CPF contributions and therefore, do not have Medisave. – E.g. Tuition teachers, self-employed Singaporeans. How is the Individual responsible for his own healthcare?
  • MediShield• National healthcare insurance scheme• Medisave is used to pay for this scheme• Patients can make claims from MediShield to pay for large hospital bills that Medisave does not cover. MediSave STILL MediSave STILL not enough.. not enough.. Lucky got Lucky got MediShield… MediShield… How is the Individual responsible for his own healthcare?
  • Why MediShield?• To help people who require long-term treatment of more serious illnesses but are unable to pay for their hospitalization How is the Individual responsible for his own healthcare?
  • Is MediShield good?• Healthcare is made more affordable• Needs of specific groups of Singaporeans are catered to – Dependent on the premiums you can pay How is the Individual responsible for his own healthcare?
  • Maintaining Good Health• Stay strong and healthy by doing more exercises and eating right• Save possible expenses on healthcare How is the Individual responsible for his own healthcare?
  • Summary MS 2• Medi-S2 – Medisave – MediShield• Maintain good health How is the Individual responsible for his own healthcare?
  • Government’sapproach toHealthcare inSingapore today. What is the approach to healthcare in Singapore today?
  • • Government provides monetary aid to organizations that provide healthcare support services How is the Community responsible for healthcare?
  • • Why? – The community can provide some healthcare support services for Singaporeans. – It is not possible for the government to run all healthcare services How is the Community responsible for healthcare?
  • • Examples: – Voluntary welfare organisations and private organisations are given money to run community hospitals, nursing homes and day rehabilitation centres for patients How is the Community responsible for healthcare?
  • Government’sapproach toHealthcare inSingapore today. What is the approach to healthcare in Singapore today?
  • Government subsidies• Direct subsidies are given to government hospitals, polyclinics and some nursing homes for the elderly• Subsidies to lower classes of wards in hospitals (Class C)  to help the needyWhy such subsidies?• To ensure that basic healthcare services are available for all Singaporeans How is the Government responsible for healthcare?
  • Medifund• $200 million and the interest earned from this fund, is given to public hospitals to provide help for needy patients• Patients who need help can apply for this fund at the hospital How is the Government responsible for healthcare?
  • W M hy edifund?• For Singaporeans who are unable to afford healthcare despite Medisave, Medishield and government subsidies. – E.g. low-income workers, or self- employed people. How is the Government responsible for healthcare?
  • So… Is Medifund good?• Ensures that basic healthcare is affordable for Singaporeans HURRAY FOR HURRAY FOR Medifund!!! Medifund!!! How is the Government responsible for healthcare?
  • Through Medishield and MedisaveNote: Government’s role here is to encourage. How is the Government responsible for healthcare?
  • Why?• A healthy person will not require medical treatment and therefore, he can save on medical expenses. How is the Government responsible for healthcare?
  • • How? – Schools and workplaces have programmes to emphasise on the need to maintain good health • E.g. physical education classes in schools • E.g. posters to encourage healthy eating in canteens How is the Government responsible for healthcare?
  • How is the Government responsible for healthcare?
  • Government’sapproach toHealthcare inSingapore today. What is the approach to healthcare in Singapore today?
  • Is healthcare in Singapore affordable? YES! •Medisave helped patients who have little savings afford healthcare •Medishield and Medisave helped patients pay for part of hospital’s bill
  • Is healthcare in Singapore affordable? NO! • Elderly who used to work but had no schemes to help them make compulsory savings – dependent on family members, community and government • People who are unable to work – dependent on government for their healthcare needs
  • Is healthcare in Singapore successful? YES! • High quality of healthcare services • Increased life expectancy • Low infant mortality • Used only less than 3% of National Income • People are more aware of the need to be responsible for their own healthcare – Medishield/ Medisave • Medifund for the needy • Community help/ services for the needy
  • Is healthcare in Singapore successful? NO! • Old people without medisave/ insurance not able to afford healthcare services • Healthcare costs is continuing to rise • Still very much dependent on government subsidies
  • Government’sapproach toHealthcare inSingapore today. What is the approach to healthcare in Singapore today?