Follow me on slideshare. http://www.slideshare.net/gohbangrui 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. Any comments are welcome. Thank you.

1. Chapter 3Managing Healthcare
Singapore

2. Learning Points
1. Identify the challenges governments face
in managing healthcare
2. Identify ways that healthcare is paid for in
a country

3. Challenges that most
Governments face
Public Good Quality
Healthcare
Increasing
Spending

4. A Public Good
Expectation
All citizens expect
their government
to provide basic
healthcare.
Problem
All countries have
limited resources.
1

5. Quality Healthcare
Expectation
People in
developed countries
expect more and
better healthcare
services.
Problem
People live longer.
2

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. How is healthcare paid for?
Self Personal
Insurance
Employer-
paid Insurance
Government
Taxes

8. • Pay for your own
healthcare services
when you receive
treatment
Self

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. • Pay insurance for
workers
• Claim from
insurance when
workers use medical
services
Employer-
paid Insurance

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. Recap
1. Identify the challenges governments face
in managing healthcare
2. Identify ways that healthcare is paid for in
a country

13. Healthcare in Singapore

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. SINGAPORE
Before 1980s

16. Hock Lam Street during the 1960s

17. Bugis Street in the 1960s

18. Singapore during the 1960s and 1970s

19. What are the effects of poor housing
conditions on people’s health?

20. Singapore Healthcare in
the 1950s and 1960s
Health Centre
aka Polyclinic
Town Areas

21. Mobile Health
Centres
Medical staff brought
help to the people
living away from town
areas in mobile health
centres (vans).

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. 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. How does the government manage
healthcare expenses?
Healthcare expenses comes from the
government budget.

25. Concept
The amount of money that the government
plans on spending to meet the needs of the
people.
Government Budget

26. Government Budget
is spent on needs of the people.
Healthcare Education Transportation Housing

27. Singapore’s Healthcare Expenditure
(2014)
Healthcare
4.4%
Others
95.6%
Expenditure

28. SINGAPORE
After 1980s

29. Problem
Rising
Cost of
Healthcare
Limited
Resources
Strain on
Government
Spending

30. Solution
Healthcare
Cost
Individual
Community
Government

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. Do you know the cost of healthcare in
Singapore?

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

36. Appendicitis

38. 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.

39. 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

40. Role of an Individual
Self-reliance

41. Concept
Citizens to be responsible for themselves and
take care of themselves.
Self-reliance

42. Medisave
(what is it?)
Medishield
(what is it?)
How?

43. Central Provident Fund (CPF)
Employer
Contribution
(15%)
Employee
Contribution
(20%)
CPF

44. Ordinary
Account
(23%)
Special
Account
(7.5%)
Medisave
Account
(9%)
CPF

45. Medisave
Pay hospital
bills &
medical
treatment
MedisaveCPF
Saving Scheme

52. MediShield
National healthcare insurance scheme
MedishieldMedisaveCPF

53. Why is Medishieldrequired?
Isn’t Medisavesufficient?

54. For people
• who need long-term treatment and
• who cannot afford their treatment fees
or hospitalisation fees and
• whose Medisave cannot cover the fees.

55. Self-reliant Singaporeans
The
government
does not need
to increase
taxes
This lightens
the
government’s
load
Singaporeans
pays for their
own
healthcare

56. Problem
Does every
Singaporean have
CPF?
How are they going
to pay for their
healthcare costs?

57. Role of the Community
Community needs to provide healthcare and
support services.
It is impossible for the government to run all
of them.
Reason

58. The Community
can be divided into 2 categories.
Voluntary Welfare
Organisations
(VWOs)
Private
Organisations

59. Voluntary Welfare Organisations
Examples
Ren Ci
Community Hospital
St. Andrew’s
Community Hospital

60. 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.

61. Role of the Community
They are given government grants to run
Community
Hospitals
Nursing Homes
Day Rehabilitation
Centres.

62. Role of the Government
Use
limited
resource
Provide
public
services
Meet the
needs of
the people

63. Do you know?
has been allocated to MOH for FY2013 to
1. keep healthcare affordable and
2. promote good health.
$5.7 billion

64. How does the government keep
healthcare affordable?
1

65. Government
Subsidies
(to who?)
Medifund
(what is it?)
Restructuring
of Hospitals
Means-testing

66. GOVERNMENT
SUBSIDIES

67. The government gives direct subsidies to public general
hospitals, polyclinics and some nursing homes for elderly.

68. Lower income group receive the
most subsidies.
High
Income
Middle
Income
Low Income

69. The government gives different rates of
subsidies to the different classes of wards in
hospitals.

70. Class C
receives the
most in
subsidies.

71. MEDIFUND

72. was set aside by the government in 1993.
$200 million

73. Target
People who cannot pay for their medical fees
despite Medisave, Medishield and government
subsidies.

74. E.g. low-income workers, self-employed people
who do not make any CPF contributions.

75. People who need help apply for the fund at the
hospital where they are being treated.

76. RESTRUCTURING OF
HOSPITALS

77. Concept
Hospitals have the freedom to reorganise to
meet the needs of the people
Restructuring of Hospitals

78. Hospital becomes financially independent
from the government where they have their
own board of directors.

79. Therefore, the government is able to reduce
the amount of subsidies to hospitals.

80. MEANS-TESTING

81. Concept
Lower-income group will receive a higher
amount of subsidies than the higher-income
group.
Means-testing

82. Mean-testing
Determine if the patient is able to afford
healthcare through a check on his financial
background.
Monthly income Ownership of
Private Property

83. Belief
Subsidies should benefit patients who need
them the most.

84. The government gives heavy subsidies to
polyclinics and government hospitals
especially to class B2 and C wards.

85. How does the government promote a
healthy lifestyle?
2

86. Why?
By having health programmes in schools and
workplaces

87. Prevention
is better than
Cure.

89. The Great Singapore Workout

90. How successful is the healthcare
policies in Singapore?

91. 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?

92. SUMMARY

93. Singapore
Shared Responsibility in Healthcare
Individual
Self-reliance
Maintains good
health
Community
VWOs
Private
Organisations
Government
Keep healthcare
affordable
Promotes a
healthy lifestyle

94. Individual
Self-
reliance
Medisave
Medishield
Maintains
good health

95. Government
Keeps healthcare
affordable
Government
Subsidies
Medifund
Restructuring of
Hospitals
Means-testing
Promotes a
healthy lifestyle

96. Created by
Goh Bang Rui
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