Managing Healthcare: Case Studies of Singapore and Britain Chapter 3 Done by: Ms Karen Ang 08/23/10
Essential Questions: <ul><li>To what extent is healthcare the responsibility of the government? </li></ul><ul><li>How effe...
Challenges in managing healthcare <ul><li>Need to provide basic healthcare regardless of whether ppl can afford to pay </l...
Who Pays For It? 08/23/10 Individual Self: People pay for healthcare services directly Personal insurance: Buy insurance a...
Healthcare in Singapore, 1960s-70s <ul><li>1960s: Healthcare was part of Singapore’s overall plans for improvement and dev...
Healthcare in Singapore, 1960s-70s <ul><li>Hospitals, clinics and outpatient dispensaries </li></ul><ul><li>Vaccination </...
Healthcare in Singapore, 1960s-70s <ul><li>1970s: Singapore economy improved, higher standard of living </li></ul><ul><li>...
Healthcare expenditure in 2004 08/23/10
Healthcare Since 1980s <ul><li>Concern: rising cost of healthcare </li></ul><ul><li>National Health Plan, 1983 </li></ul><...
Aims of National Health Plan <ul><li>Build a healthy and physically fit population </li></ul><ul><li>Encourage Singaporean...
National Health Plan 08/23/10 Individual Government Community <ul><li>Encourages self-reliance </li></ul><ul><li>Maintains...
08/23/10 Medisave Scheme Medishield Scheme <ul><li>compulsory </li></ul><ul><li>retirement plan </li></ul><ul><li>6 – 8% s...
Encouraging Self-reliance <ul><li>Medisave Scheme, 1984 </li></ul><ul><li>Certain amount from workers’ CPF channelled into...
Encouraging Self-reliance <ul><li>Medishield, 1990 </li></ul><ul><li>National healthcare insurance scheme </li></ul><ul><l...
Keeping Healthcare Affordable <ul><li>Government subsidies </li></ul><ul><li>Medifund </li></ul><ul><li>Restructuring of h...
Government Subsidies 08/23/10 Ward Class Subsidy Rate Individual A No subsidy 100% B1 20% 80% B2 65% 35% C 80% 20%
Medifund <ul><li>Started in 1993 </li></ul><ul><li>Provide help to those who cannot afford healthcare </li></ul><ul><li>St...
<ul><li>To reduce medical costs </li></ul><ul><li>Health education and campaigns </li></ul><ul><li>Working with Organisati...
Have Singapore’s healthcare policies met the needs of the people? Done by: Ms Karen Ang 08/23/10
08/23/10 Origins of the National Health Service (NHS) Managing the NHS The Welfare State of Britain Effectiveness of the B...
08/23/10 Origins of the Welfare State <ul><li>Sir William Beveridge’s report in 1942 </li></ul><ul><li>recommended that th...
Early Beginnings of the NHS <ul><li>Very popular with the ppl </li></ul><ul><li>All medical services free of charge </li><...
Managing the NHS <ul><li>Managing government spending </li></ul><ul><li>Increasing efficiency </li></ul><ul><li>Providing ...
Managing government spending <ul><li>1980s Margaret Thatcher </li></ul><ul><li>Cut back on govt spending on welfare benefi...
Managing Government Spending <ul><li>Fear that reduction in welfare would result in inferior healthcare services </li></ul...
Increasing Efficiency <ul><li>Problem of insufficient doctors, nurses and facilities to cope with increased demands </li><...
Providing Quality Service <ul><li>By 1980s people felt the NHS had poor standards </li></ul><ul><li>Provide more informati...
Have British Healthcare policies met the needs of the people? Done by: Ms Karen Ang 08/23/10
Conclusion <ul><li>Similar problems, different approaches </li></ul><ul><li>Singapore: shared responsibility </li></ul><ul...
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Ch 3 Managing Healthcare

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  • Ch 3 Managing Healthcare

    1. 1. Managing Healthcare: Case Studies of Singapore and Britain Chapter 3 Done by: Ms Karen Ang 08/23/10
    2. 2. Essential Questions: <ul><li>To what extent is healthcare the responsibility of the government? </li></ul><ul><li>How effective are the various healthcare models in meeting the people’s needs? </li></ul>08/23/10
    3. 3. Challenges in managing healthcare <ul><li>Need to provide basic healthcare regardless of whether ppl can afford to pay </li></ul><ul><li>Rising expectations and demands for quality healthcare </li></ul><ul><li>Rising cost of healthcare </li></ul>08/23/10
    4. 4. Who Pays For It? 08/23/10 Individual Self: People pay for healthcare services directly Personal insurance: Buy insurance and make claims from the insurance company to pay for treatment Employer Employer-paid insurance: Employers pay a certain sum of money to insure workers. Claims are then made to the insurance companies Government taxes: Govt collects taxes from ppl and uses a portion for medical services
    5. 5. Healthcare in Singapore, 1960s-70s <ul><li>1960s: Healthcare was part of Singapore’s overall plans for improvement and development after independence </li></ul><ul><li>Healthcare measures as part of housing programme </li></ul><ul><li>Need to curb spread of infectious diseases </li></ul>08/23/10
    6. 6. Healthcare in Singapore, 1960s-70s <ul><li>Hospitals, clinics and outpatient dispensaries </li></ul><ul><li>Vaccination </li></ul><ul><li>Medical officers and nurses sent to schools to provide healthcare for students </li></ul>08/23/10
    7. 7. Healthcare in Singapore, 1960s-70s <ul><li>1970s: Singapore economy improved, higher standard of living </li></ul><ul><li>People wanted better healthcare services </li></ul><ul><li>Polyclinic replaced dispensaries </li></ul><ul><li>Facilities in gov hospitals and quality of healthcare improved </li></ul>08/23/10
    8. 8. Healthcare expenditure in 2004 08/23/10
    9. 9. Healthcare Since 1980s <ul><li>Concern: rising cost of healthcare </li></ul><ul><li>National Health Plan, 1983 </li></ul><ul><li>Wanted to encourage public debate on how to manage long-term healthcare needs </li></ul>08/23/10
    10. 10. Aims of National Health Plan <ul><li>Build a healthy and physically fit population </li></ul><ul><li>Encourage Singaporeans to stay well and reward those who do </li></ul><ul><li>Build up individual resources so that those who fall sick will be able to pay </li></ul>08/23/10
    11. 11. National Health Plan 08/23/10 Individual Government Community <ul><li>Encourages self-reliance </li></ul><ul><li>Maintains good health </li></ul><ul><li>Keeps healthcare affordable </li></ul><ul><li>Promotes healthy lifestyle </li></ul><ul><li>Provides some healthcare services </li></ul><ul><li>Provides support services </li></ul>
    12. 12. 08/23/10 Medisave Scheme Medishield Scheme <ul><li>compulsory </li></ul><ul><li>retirement plan </li></ul><ul><li>6 – 8% salary </li></ul><ul><li>voluntary </li></ul><ul><li>medical plan </li></ul><ul><li>small sum through </li></ul><ul><li>Medisave </li></ul>Encouraging Self-Reliance
    13. 13. Encouraging Self-reliance <ul><li>Medisave Scheme, 1984 </li></ul><ul><li>Certain amount from workers’ CPF channelled into Medisave accounts </li></ul><ul><li>Can be used to pay hospital bills and certain medical treatment </li></ul><ul><li>Shared responsibility between government and individual </li></ul><ul><li>No need to raise taxes to pay for rising healthcare costs </li></ul>08/23/10
    14. 14. Encouraging Self-reliance <ul><li>Medishield, 1990 </li></ul><ul><li>National healthcare insurance scheme </li></ul><ul><li>Covers large medical bills for illnesses not covered under Medisave </li></ul><ul><li>For people who require long-term treatment of more serious illnesses </li></ul>08/23/10
    15. 15. Keeping Healthcare Affordable <ul><li>Government subsidies </li></ul><ul><li>Medifund </li></ul><ul><li>Restructuring of hospitals </li></ul><ul><li>Means-testing </li></ul>08/23/10
    16. 16. Government Subsidies 08/23/10 Ward Class Subsidy Rate Individual A No subsidy 100% B1 20% 80% B2 65% 35% C 80% 20%
    17. 17. Medifund <ul><li>Started in 1993 </li></ul><ul><li>Provide help to those who cannot afford healthcare </li></ul><ul><li>Started with $200million </li></ul><ul><li>Interest earned is provided to hospitals to help needy patients </li></ul><ul><li>Patients can apply for the fund at hospital </li></ul>08/23/10
    18. 18. <ul><li>To reduce medical costs </li></ul><ul><li>Health education and campaigns </li></ul><ul><li>Working with Organisations: </li></ul><ul><li>Some voluntary welfare organisations (VWOs) organisations given grants to provide medical care </li></ul><ul><li>Community hospitals </li></ul>Promoting a Healthy Lifestyle 08/23/10
    19. 19. Have Singapore’s healthcare policies met the needs of the people? Done by: Ms Karen Ang 08/23/10
    20. 20. 08/23/10 Origins of the National Health Service (NHS) Managing the NHS The Welfare State of Britain Effectiveness of the British healthcare system
    21. 21. 08/23/10 Origins of the Welfare State <ul><li>Sir William Beveridge’s report in 1942 </li></ul><ul><li>recommended that the govt put an end poverty, disease and unemployment </li></ul><ul><li>rebuild people’s lives after WWII </li></ul><ul><li>Britain after World War II </li></ul><ul><li>high unemployment and poverty </li></ul><ul><li>‘ cradle to grave’ policy: minimum standard </li></ul><ul><li>for a decent life (pg. 83) </li></ul><ul><li>- NHS is part of the welfare state: free healthcare for ppl </li></ul>
    22. 22. Early Beginnings of the NHS <ul><li>Very popular with the ppl </li></ul><ul><li>All medical services free of charge </li></ul><ul><li>Br. Gov expected demand for healthcare to increase and then stabilise </li></ul><ul><li>Hwr, demand was overwhelming </li></ul><ul><li>By 1951, the NHS was unable to meet these demands </li></ul><ul><li>A small fee was charged </li></ul>08/23/10
    23. 23. Managing the NHS <ul><li>Managing government spending </li></ul><ul><li>Increasing efficiency </li></ul><ul><li>Providing quality </li></ul>08/23/10
    24. 24. Managing government spending <ul><li>1980s Margaret Thatcher </li></ul><ul><li>Cut back on govt spending on welfare benefits </li></ul><ul><li>Wanted to create a system that would make the individual more responsible </li></ul><ul><li>Reason: govt was spending too much on welfare benefits </li></ul>08/23/10
    25. 25. Managing Government Spending <ul><li>Fear that reduction in welfare would result in inferior healthcare services </li></ul><ul><li>2000: PM Tony Blair promised increased spending on healthcare </li></ul><ul><li>Accompanied by increases in National Insurance contributions </li></ul>08/23/10
    26. 26. Increasing Efficiency <ul><li>Problem of insufficient doctors, nurses and facilities to cope with increased demands </li></ul><ul><li>Tatcher policy of privatisation </li></ul><ul><li>Reduce govt subsidies </li></ul><ul><li>Save costs </li></ul><ul><li>Make the NHS more efficient </li></ul><ul><li>Services no longer free except for a few groups of ppl </li></ul>08/23/10
    27. 27. Providing Quality Service <ul><li>By 1980s people felt the NHS had poor standards </li></ul><ul><li>Provide more information to help patients decide on own treatment </li></ul><ul><li>Problem of long waiting time </li></ul><ul><li>NHS Plan (2000) </li></ul><ul><li>NHS Improvement Plan (2004) </li></ul><ul><li>NHS Direct </li></ul>08/23/10
    28. 28. Have British Healthcare policies met the needs of the people? Done by: Ms Karen Ang 08/23/10
    29. 29. Conclusion <ul><li>Similar problems, different approaches </li></ul><ul><li>Singapore: shared responsibility </li></ul><ul><li>Britain: provide welfare </li></ul>08/23/10

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