The document discusses three approaches to managing socio-economic diversity in healthcare: 1) Market-based approach (USA): Individuals bear full responsibility for costs. Issues include high insurance premiums and denial of coverage. 2) Shared responsibility approach (Singapore): Government intervenes and shares costs through subsidies. Both government and individuals share responsibility. 3) Government-financed approach (Sweden): Government provides substantial subsidies and services, with healthcare sometimes being free. Challenges include high taxation rates needed to fund the system. The document uses case studies of the US, Singapore, and Sweden healthcare systems to illustrate the three approaches and their advantages and disadvantages in managing socio-economic diversity.

1. OVERVIEW OF CHAPTER
3) Separation (e.g. South Africa)



2. MANAGE SOCIO-ECONOMIC DIVERSITY
(Case study: Healthcare)
(1) Market-based approach

3. MANAGE SOCIO-ECONOMIC DIVERSITY
(1) MARKET-BASED APPROACH
TB pg. 220
• Citizens have the freedom to decide how much they
wish to pay for healthcare services
• The market determines the price & provision of
healthcare services
• Demand : $
• Supply : $

4. MANAGE SOCIO-ECONOMIC DIVERSITY
(Case study: Healthcare)
(1) MARKET BASED APPROACH
•Q1: How does this approach help to manage
socio-economic diversity? (LINK)
•Q2: What are the problems that might
result?

5. Individuals
Who bears the responsibility for the cost of healthcare?
MANAGE SOCIO-ECONOMIC DIVERSITY
(Case study: Healthcare)
(1) MARKET BASED APPROACH

6. Case Study 3: USA
Both private &
public hospitals
provide
healthcare
MANAGE SOCIO-ECONOMIC DIVERSITY
(1) MARKET-BASED APPROACH
TB pg. 220

7. Case Study 3: USA
US government does NOT intervene in:
• Healthcare service providers
►Have freedom to set prices they want
►Depends on market (demand vs supply)
• Citizens’ choice of healthcare service option
Prices can vary greatly
• E.g. mammogram (in NY): US$100…… US$1,700 or more
MANAGE SOCIO-ECONOMIC DIVERSITY
(1) MARKET-BASED APPROACH
TB pg. 221

8. Case Study 3: USA
US government does NOT intervene in:
• Healthcare service providers
►Have freedom to set prices they want
►Depends on market (demand vs supply)
• Citizens’ choice of healthcare service option
As a result, citizens:
 Have to cope with healthcare cost on their own
 Expected to buy own medical insurance
MANAGE SOCIO-ECONOMIC DIVERSITY
(1) MARKET-BASED APPROACH
TB pg. 221

9. Case Study 3: USA
Keeping healthcare affordable:
• Medical insurance as part of employment package
• Usually for employees of large firms
• Usually for middle / higher SES
Hmm, really affordable?
• Medical insurance premium are high (insurance companies
charge high prices to make profit!)
MANAGE SOCIO-ECONOMIC DIVERSITY
(1) MARKET-BASED APPROACH
TB pg. 222

10. Case Study 3: USA
Challenges faced:
• Small companies not able to pay premiums for workers
• It’s few thousand $$ a year!
• Low income choose not to get insurance
• Premiums are deducted from their pay!
• If people lose their jobs, they lose insurance coverage too!
• Insurance companies refuse to insure those who have been sick in
in the past
• Americans who need healthcare most are being denied!
MANAGE SOCIO-ECONOMIC DIVERSITY
(1) MARKET-BASED APPROACH
TB pg. 224-225

12. Case Study 3: USA
MANAGE SOCIO-ECONOMIC DIVERSITY
(1) MARKET-BASED APPROACH
TB pg. 227

13. MANAGE SOCIO-ECONOMIC DIVERSITY
(Case study: Healthcare)
(1) Market-based approach
(2) Shared responsibility
approach

14. MANAGE SOCIO-ECONOMIC DIVERSITY
(2) SHARED RESPONSIBILITY
TB pg. 228
• Government intervenes through the provision of basic
healthcare services
• Government shares the costs of some aspects of
healthcare

15. MANAGE SOCIO-ECONOMIC DIVERSITY
(Case study: Healthcare)
(2) SHARED RESPONSIBILILITY APPROACH
•Q1: How does this approach help to manage
socio-economic diversity? (LINK)
•Q2: What are the problems that might
result?

16. IndividualsGovernment
Who bears the responsibility for the cost of healthcare?
MANAGE SOCIO-ECONOMIC DIVERSITY
(Case study: Healthcare)
(2) SHARED RESPONSIBILILITY APPROACH

17. Case Study 4: Singapore
Both private &
public hospitals
provide
healthcare
Different hospital ward types:
- A class (unsubsidized)
- B2 & C (heavily subsidized)
Usually by VWOs
(w govt subsidies)
MANAGE SOCIO-ECONOMIC DIVERSITY
(2) SHARED RESPONSIBILITY
TB pg. 228

18. Case Study 4: Singapore
“An important policy was to require
co-payment to discourage over-
consumption and over-treatment,
which has
become a
problem in
many
advanced
countries.”
GOVERNMENT
• Access for all Singaporeans
• Heavy govt subsidies
• Provision of tiered subsidies
• Promote healthy lifestyle
COMMUNITY
• Provide some
healthcare services
• Provide support
services
INDIVIDUAL
• Self-reliance
(salary  CPF  Medisave)
• Carefully make
healthcare choices
• Take care of
personal health
MANAGE SOCIO-ECONOMIC DIVERSITY
(2) SHARED RESPONSIBILITY
TB pg. 229

20. Case Study 4: Singapore
Challenges faced?
• Rising healthcare cost
• How to continue to keep healthcare affordable?
• Growing demand for healthcare
• Growing population
• Aging population
• Greater need for medical treatment
• Increasing life expectancy
• Sedentary lifestyles
MANAGE SOCIO-ECONOMIC DIVERSITY
(2) SHARED RESPONSIBILITY
TB pg. 236-239

22. Do you think healthcare should be made free for everyone?
What are the costs and benefits of free healthcare for everyone?
MANAGE SOCIO-ECONOMIC DIVERSITY
(Case study: Healthcare)

23. MANAGE SOCIO-ECONOMIC DIVERSITY
(Case study: Healthcare)
(1) Market-based approach
(2) Shared responsibility
approach
(3) Government
financed approach

24. MANAGE SOCIO-ECONOMIC DIVERSITY
(3) GOVERNMENT FINANCED
TB pg. 241
• Government provides substantial subsidies and services
for most of the healthcare needs of its citizens
• Healthcare services could sometimes be free

25. MANAGE SOCIO-ECONOMIC DIVERSITY
(Case study: Healthcare)
(3) GOVERNMENT FINANCED APPROACH
•Q1: How does this approach help to manage
socio-economic diversity? (LINK)
•Q2: What are the problems that might
result?

26. Government
Who bears the responsibility for the cost of healthcare?
MANAGE SOCIO-ECONOMIC DIVERSITY
(Case study: Healthcare)
(3) GOVERNMENT FINANCED APPROACH

27. Case Study 5: Sweden
Keeping healthcare affordable:
• All citizens have access to healthcare services regardless
background or socio-economic status
• Public healthcare – owned and financed by govt
• Private healthcare – receives funding from govt
• Payment ceiling for healthcare visits & medication
MANAGE SOCIO-ECONOMIC DIVERSITY
(3) GOVERNMENT FINANCED
TB pg. 242-243

28. Case Study 5: Sweden
Challenges faced?
• High taxation
MANAGE SOCIO-ECONOMIC DIVERSITY
(3) GOVERNMENT FINANCED
TB pg. 244

29. + Value Added Tax (VAT) + Goods and Services Tax (GST)
Singapore’s Personal Income Tax
(Progressive Tax)
2012-2016
Sweden’s Personal Income Tax Rate
2014

30. Case Study 5: Sweden
Challenges faced?
• High taxation
• But growing ageing population!
• Growing no. of people needing healthcare
• More immigrants & citizens of the European Union (EU)
consuming Sweden’s healthcare services
MANAGE SOCIO-ECONOMIC DIVERSITY
(3) GOVERNMENT FINANCED
TB pg. 245

31. MANAGE SOCIO-ECONOMIC DIVERSITY
SUMMARY
(1) Market-based approach
(2) Shared responsibility
approach
(3) Government-financed
approach

32. $$$$$$
Who bears the responsibility for the cost of healthcare?
MANAGE SOCIO-ECONOMIC DIVERSITY
RECAP
GOVERNMENT
Government
Financed

33. $$$$$$
GOVERNMENTINDIVIDUAL
Shared
Responsibility
Who bears the responsibility for the cost of healthcare?
MANAGE SOCIO-ECONOMIC DIVERSITY
RECAP

34. $$$$$$
INDIVIDUAL
Market-Based
Approach
MANAGE SOCIO-ECONOMIC DIVERSITY
RECAP
Who bears the responsibility for the cost of healthcare?

35. GOVERNMENT-
FUNDED
SHARED
RESPONSIBILITY
MARKET BASED
APPROACH
MANAGE SOCIO-ECONOMIC DIVERSITY
(Case study: Healthcare)

36. OVERVIEW OF CHAPTER