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Chapter 3  Managing Healthcare In S Ingapore
 

Chapter 3 Managing Healthcare In S Ingapore

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    Chapter 3  Managing Healthcare In S Ingapore Chapter 3 Managing Healthcare In S Ingapore Presentation Transcript

    • CHAPTER 3 MANAGING HEALTHCARE: Case Studies of Singapore & Britain
    • Chapter at a Glance:
      • To what extent is healthcare the responsibility of the government?
      • What makes a healthcare system effective?
    • Trigger Activity:
      • Your Classmate John has been missing from school for a week.
      • Then you heard the news that John has been hospitalised:
    • Trigger Activity:
      • You have heard that medical treatment is very expensive.
      • You are worried if John could afford the bill.
    • Trigger Activity:
      • How will you help John ?
      • How affordable do you think healthcare is?
      • Do you think healthcare is a basic need?
    • Managing Healthcare
      • The need to provide basic health care for the sick who can’t afford.
      • How to provide healthcare given the limited resources and competing needs of the country
      What challenges do governments face in managing health care?
    • Less developed country More Developed Country Comparison of Healthcare between two countries:
    • Comparison between two countries: Less developed country More Developed Country Mauritania in West Africa
      • Only one large hospital in the capital city.
      • Infectious diseases are common in the rural areas.
      • There are insufficient doctors, nurses, clinics and medicine.
      Sweden in Europe
      • Main concern -To continue to provide good quality healthcare for the citizens.
      • Healthcare services are provided by the government.
      • The money for healthcare comes from taxes.
    • How is healthcare paid for? Healthcare provider, .e.g. hospital and clinic Individual
      • Self
      • Patients pay the doctor directly after each visit
      Individual
      • Personal Insurance
      • Make claims from the insurance company
      Employer
      • Employer-paid insurance
      • Employers pay a certain amount for insurance for their workers
      Employer
      • Govt. collect Taxes and uses a % to pay for medical services used.
    • Healthcare in Singapore
      • How was healthcare managed in the 1960s & 1970s?
      • Part of overall plans for improvement & development after independence.
      • Healthcare measures were part of public housing programme .
    • The situation in the 1970s…
      • The economy had improved
      • People enjoyed a better standard of living.
      • Thus, they wanted better healthcare.
    • The solution:
      • Old outpatient dispensaries were replaced with polyclinics.
      • They provided a wide range of healthcare & conveniently located in town centres.
      • Facilities in government hospitals and the quality of healthcare were improved.
      • Money came from government budget.
    • Healthcare services in the 1970s
    • How has the approach to manage healthcare changed since the 1980s?
      • Concerns- rising cost of providing healthcare.
      • National Health Plan- aim to encourage public debate on the suggestions made on how to manage the long-term healthcare needs of the people.
    • What are the messages behind the following three slides ?
    • An Extract of Speech made by then Health Minister Mr.Goh Chok Tong in 1981
      • Resources are finite in terms of funds, doctors and nurses. Providing welfare in healthcare will affect people’s incentive to work. It is necessary to pay for the services you want.
    •  
      • Initiated in 1983 and implemented since 1984
      • To build a healthy and physically fit population.
      • To encourage Singaporeans to stay well and reward those who do.
      • To build up individual financial resources so that those who fall sick will be able to pay.
      Singapore's National Health Plan
    • Approach to healthcare in Singapore
      • Health care policies not to strain government spending
      • Encourage self responsibility and community support
      • Govt. to maintain affordable healthcare policies
    • Approach to healthcare in Singapore
      • Individual
      • Encourage self reliance
      • Maintains good health
      Government
      • Keeps healthcare affordable
      • Promotes healthy lifestyle
      Community
      • Provides some healthcare services.
    • Medisave Medishield Medifund PRIMARY CARE ACUTE CARE CATASTROPHIC (LONG TERM CARE) Financing Method Private Payment Compulsory Savings Social/Private Insurance PUBLIC SUBSIDIES Taxes PUBLIC HEALTH SERVICES (Eldershield) (Elderfund)
    • Encouraging Self-Reliance
      • 1. Medisave
      2. Medishield
    • Encouraging Self-Reliance
      • 1. Medisave
      • Introduced in 1984.
      • Comes from the Worker’s CPF (6-8%)
      • To pay for hospital bills and certain medical treatment.
      • Impact:
      • Singaporeans are better able to afford health care.
      • They share the cost with the government.
      • A shared responsibility- lighten the government’s burden.
    • What you have learnt in Chapter 2 :
      • A “Bill” will be debated in parliament before a law is passed
      • People were encouraged to give feedback
    • The importance of feedback:
      • With more feedback from people, Medisave has been extended to pay for more types of medical treatment
      Source: The Straits Times, 30 th January 2008.
    • Encouraging Self-Reliance 2. Medishield
      • To help people who cannot afford long-term treatment.
      • National Healthcare insurance.
      • Pay with medisave.
      • Make claims to pay for treatment not covered by Medisave.
      • Impact:
      • People can meet their specific needs.
      • Can pay for long-term treatment of serious illnesses.
    •  
    • Keeping Healthcare Affordable The government’s concerns: Sharing responsibility, Limited resources, Providing safety nets. Government Subsidies
      • Given to Nursing homes, government hospitals and polyclinics.
      • ¼ of government spending on healthcare.
      • Different rates of subsidies to the different class wards .
      Medifund
      • Given to needy Singaporeans.
      • Low-income workers & self-employed people.
      • Apply at the hospital
      Restructuring of hospitals
      • More freedom for hospitals to re-organise to meet the needs of Singaporeans
      • To cut down subsidies
    • Public Hospital Subsidies
    • Promoting a Healthy Lifestyle
      • A way of coping with the rising cost of health care.
      • A good health no need medical treatment savings on medical expenses.
    • Promoting a Healthy Lifestyle
      • Anti-smoking campaigns
      • Community health screening
      • Schools- Towards a healthy school tuckshop
      • Activities organised by the Health Promotion Board
      • Encourage healthy eating ( low in fat and calories)
    • Working with organisations Community hospitals
    • Did You Know ?
      • Who founded The Nursing Home Foundation?
      • What services does it provide?
      • Read the two articles on Figures 3.26 and 3.27.
      • What is your opinion if you were Mr. Tay Chew Guan in Figure 3.27?
      Have Singapore’s healthcare policies met the needs of the people?
    • Have Singapore’s healthcare policies met the needs of the people?
      • Medisave helps to pay for hospital bills.
      • Medishield helps those who do not have enough in their medisave.
      • The elderly and the unemployed who do not have the opportunity to save for healthcare can depend on the government or community
    • Have Singapore’s healthcare policies met the needs of the people? For those who say Singapore is ‘stingy’ in spending on healthcare, I say, you must look at the better outcome; whether its sickness rate, life expectancy, or infant mortality rate, you will discover that Singapore has done quite well.
      • The health of Singaporeans has improved over the years
      • High quality health care
      • High life expectancy
      • Low Infant mortality
      • Healthcare spending is less than 3% of GDP
      Healthcare would always be borne by Singaporeans (medishield, taxes…)
    • A view from Russia with Love:
      • LOCAL HEALTHCARE PROVIDERS WOO MORE MEDICAL TOURISTS
      • From Russia with love of S'pore's medical facilities Cancer man picks S'pore over the US, China, Korea By Ng Wan Ching January 30, 2008
      “ In my country, patients lose hope….There is lack of proper equipment…..(Here) the doctors are always smiling, the equipment is up-to-date. I feel better about my chances here.- Mr.Laptev