Singapore Health something to ponder

Singapore spends a third of what the U.S. does on health care (as a percentage of GDP) yet has better health indicators. Of course, much of this may be attributable to lifestyle differences rather than a superior health care system. Nevertheless, the Singapore system has some very interesting characteristics:

• There are mandatory health savings accounts: “Individuals pre-save for medical expenses through mandatory deductions from their paychecks and employer contributions… Only approved categories of medical treatment can be paid for by deducting one’s Medi-save account, for oneself, grandparents, parents, spouse or children: consultations with private practitioners for minor ailments must be paid from out-of-pocket cash…”

• “The private health care system competes with the public health care, which helps contain prices in both directions. Private medical insurance is also available.”

• Private health care providers are required to publish price lists to encourage comparison shopping.

• The government pays for “basic health care services… subject to tight expenditure control.” Bottom line: The government pays 80% of “basic public health care services.”

• Government plays a big role with contagious disease, and adds some paternalism on top: “Preventing diseases such as HIV/AIDS, malaria, and tobacco-related illnesses by ensuring good health conditions takes a high priority.”

• The government provides optional low-cost catastrophic health insurance, plus a safety net “subject to stringent means-testing.”

• Almost all care is subject to significant co-pays. Instituting co-pays is an important means to control cost.

So a proven system, not socialist or fascist.