Chapter 3 - Managing Healthcare in Singapore


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These slides are used to illustrate the healthcare system in Singapore. Ranging from Medisave to Restructuring of Hospitals in Singapore, these slides aim to teach the concept of Singapore healthcare in the new Social Studies Secondary Three syllabus. At the end of the slides, they provide a brief snapshot of the healthcare system of Singapore using the various measures such as Medisave, Medishield and Medifund.

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Chapter 3 - Managing Healthcare in Singapore

  1. 1. Chapter 3Managing Healthcare Singapore
  2. 2. Learning Points 1. Identify the challenges governments face in managing healthcare 2. Identify ways that healthcare is paid for in a country
  3. 3. Challenges that most Governments face Public Good Quality Healthcare Increasing Spending
  4. 4. A Public Good Expectation All citizens expect their government to provide basic healthcare. Problem All countries have limited resources. 1
  5. 5. Quality Healthcare Expectation People in developed countries expect more and better healthcare services. Problem People live longer. 2
  6. 6. Rising Spending Expectation 1. Better treatments, 2. More effective medicines 3. Better-qualified medical staff Problem People demand for the best healthcare. 3
  7. 7. How is healthcare paid for? Self Personal Insurance Employer- paid Insurance Government Taxes
  8. 8. • Pay for your own healthcare services when you receive treatment Self
  9. 9. • Pay for your own healthcare services when you receive treatment Self • Buy medical insurance • Claim from insurance to pay for certain medical treatment Personal Insurance
  10. 10. • Pay insurance for workers • Claim from insurance when workers use medical services Employer- paid Insurance
  11. 11. • Pay insurance for workers • Claim from insurance when workers use medical services Employer- paid Insurance • Collect taxes from the people • Use a percentage of taxes to pay for medical services Government Taxes
  12. 12. Recap 1. Identify the challenges governments face in managing healthcare 2. Identify ways that healthcare is paid for in a country
  13. 13. Healthcare in Singapore
  14. 14. Learning Points 1. Identify how the government managed healthcare expenses before the 1980s 2. Identify how the government manages healthcare expenses after the 1980s
  15. 15. SINGAPORE Before 1980s
  16. 16. Hock Lam Street during the 1960s
  17. 17. Bugis Street in the 1960s
  18. 18. Singapore during the 1960s and 1970s
  19. 19. What are the effects of poor housing conditions on people’s health?
  20. 20. Singapore Healthcare in the 1950s and 1960s Health Centre aka Polyclinic Town Areas
  21. 21. Mobile Health Centres Medical staff brought help to the people living away from town areas in mobile health centres (vans).
  22. 22. What did government do? Training The government trained a huge number of nurses and doctors in hospitals to improve healthcare. Education The government also educated people on how to prevent illnesses through health programmes. Physical Education The government introduced physical education to the students to keep people healthy.
  23. 23. Singapore Healthcare after 1960s Improved healthcare services such as having more clinics and medical staff. Health programmes like being healthy at work and going for medical checkups are implemented.
  24. 24. How does the government manage healthcare expenses? Healthcare expenses comes from the government budget.
  25. 25. Concept The amount of money that the government plans on spending to meet the needs of the people. Government Budget
  26. 26. Government Budget is spent on needs of the people. Healthcare Education Transportation Housing
  27. 27. Singapore’s Healthcare Expenditure (2014) Healthcare 4.4% Others 95.6% Expenditure
  28. 28. SINGAPORE After 1980s
  29. 29. Problem Rising Cost of Healthcare Limited Resources Strain on Government Spending
  30. 30. Solution Healthcare Cost Individual Community Government
  31. 31. Solution • Relies on oneself • Be in good health Individual • Provides healthcare services • Provides other support services Community • Keeps healthcare affordable • Promotes healthy lifestyle Government
  32. 32. Do you know the cost of healthcare in Singapore?
  33. 33. Hospital Wards Charges Class of Ward / Charges per day (SGD) A (1&1+) B (1&1+) B2 C Restructured Hospitals AH / CGH / KK / NUH / SGH / TTSH 295 470.80 188 224.70 56 75 29 41 Private Hospitals ESH / GH / MAH / MEH / TMC 500.76 618.46 197.95 260.01 133.75 179.76
  34. 34. Appendicitis
  35. 35. Assume a person is hospitalised due to inflammation of the appendix and undergoes an appendicitis operation. Staying a total of 7 days in a private hospital with 2 days in ICU, his total hospital bill came up to S$8,950.
  36. 36. Breakdown of Hospital Bill Amount Payable (S$) Room & Board (5 days) 750 Hospital Miscellaneous Expenses • Prescription drugs • Diagnostic Procedures • Operating Theatre Fees 2,950 Anaesthetic Fee 500 Surgeon’s fee 1,700 ICU (2 days) 2,250 Post-Hospitalisation Treatment 800 Total 8,950
  37. 37. Role of an Individual Self-reliance
  38. 38. Concept Citizens to be responsible for themselves and take care of themselves. Self-reliance
  39. 39. Medisave (what is it?) Medishield (what is it?) How?
  40. 40. Central Provident Fund (CPF) Employer Contribution (15%) Employee Contribution (20%) CPF
  41. 41. Ordinary Account (23%) Special Account (7.5%) Medisave Account (9%) CPF
  42. 42. Medisave Pay hospital bills & medical treatment MedisaveCPF Saving Scheme
  43. 43. MediShield National healthcare insurance scheme MedishieldMedisaveCPF
  44. 44. Why is Medishieldrequired? Isn’t Medisavesufficient?
  45. 45. For people • who need long-term treatment and • who cannot afford their treatment fees or hospitalisation fees and • whose Medisave cannot cover the fees.
  46. 46. Self-reliant Singaporeans The government does not need to increase taxes This lightens the government’s load Singaporeans pays for their own healthcare
  47. 47. Problem Does every Singaporean have CPF? How are they going to pay for their healthcare costs?
  48. 48. Role of the Community Community needs to provide healthcare and support services. It is impossible for the government to run all of them. Reason
  49. 49. The Community can be divided into 2 categories. Voluntary Welfare Organisations (VWOs) Private Organisations
  50. 50. Voluntary Welfare Organisations Examples Ren Ci Community Hospital St. Andrew’s Community Hospital
  51. 51. Private Organisations Example National Kidney Foundation Singapore It caters to the needs of specific groups of people such as the poor or those with a particular illness.
  52. 52. Role of the Community They are given government grants to run Community Hospitals Nursing Homes Day Rehabilitation Centres.
  53. 53. Role of the Government Use limited resource Provide public services Meet the needs of the people
  54. 54. Do you know? has been allocated to MOH for FY2013 to 1. keep healthcare affordable and 2. promote good health. $5.7 billion
  55. 55. How does the government keep healthcare affordable? 1
  56. 56. Government Subsidies (to who?) Medifund (what is it?) Restructuring of Hospitals Means-testing
  58. 58. The government gives direct subsidies to public general hospitals, polyclinics and some nursing homes for elderly.
  59. 59. Lower income group receive the most subsidies. High Income Middle Income Low Income
  60. 60. The government gives different rates of subsidies to the different classes of wards in hospitals.
  61. 61. Class C receives the most in subsidies.
  62. 62. MEDIFUND
  63. 63. was set aside by the government in 1993. $200 million
  64. 64. Target People who cannot pay for their medical fees despite Medisave, Medishield and government subsidies.
  65. 65. E.g. low-income workers, self-employed people who do not make any CPF contributions.
  66. 66. People who need help apply for the fund at the hospital where they are being treated.
  68. 68. Concept Hospitals have the freedom to reorganise to meet the needs of the people Restructuring of Hospitals
  69. 69. Hospital becomes financially independent from the government where they have their own board of directors.
  70. 70. Therefore, the government is able to reduce the amount of subsidies to hospitals.
  72. 72. Concept Lower-income group will receive a higher amount of subsidies than the higher-income group. Means-testing
  73. 73. Mean-testing Determine if the patient is able to afford healthcare through a check on his financial background. Monthly income Ownership of Private Property
  74. 74. Belief Subsidies should benefit patients who need them the most.
  75. 75. The government gives heavy subsidies to polyclinics and government hospitals especially to class B2 and C wards.
  76. 76. How does the government promote a healthy lifestyle? 2
  77. 77. Why? By having health programmes in schools and workplaces
  78. 78. Prevention is better than Cure.
  79. 79. The Great Singapore Workout
  80. 80. How successful is the healthcare policies in Singapore?
  81. 81. Effective Provide Singaporeans with the money to pay for healthcare Ineffective There are still groups of people who are still not able to pay for their own medical expenses. 1. Elderly 2. People who are unable to work How are they going to pay for their own healthcare then?
  82. 82. SUMMARY
  83. 83. Singapore Shared Responsibility in Healthcare Individual Self-reliance Maintains good health Community VWOs Private Organisations Government Keep healthcare affordable Promotes a healthy lifestyle
  84. 84. Individual Self- reliance Medisave Medishield Maintains good health
  85. 85. Government Keeps healthcare affordable Government Subsidies Medifund Restructuring of Hospitals Means-testing Promotes a healthy lifestyle
  86. 86. Created by Goh Bang Rui Follow me on @slideshare. @gohbangrui