Health in Singapore
Singapore’s healthcare sector boasts global repute — it is one of the world’s most efficient healthcare systems with government spending accounting for only 2.2 percent of GDP while achieving a high life expectancy of 82.8 years (2016) and a low infant mortality rate of 2.4 per 1000 live births (2016).
The impressive numbers notwithstanding, healthcare demand is growing rapidly in Singapore and this trend is expected to continue. The country’s healthcare budget has more than doubled, from S$4 billion in 2010 to S$10 billion in 2017.
Trends Contributing to Increased Healthcare Costs and Consumption
An ageing population, the increasing burden of chronic diseases and a rise in healthcare costs are among the major factors contributing to an increase in healthcare sending, as acknowledged in the Healthcare Industry Transformation Map, which was published in November 217.
In addition to the factors contributing to healthcare spending, the old age dependency ratio is in Singapore is also expected to rise from 12.3 percent to 15.9 percent between 2015 and 2021. This is in addition to an already growing prevalence of non-communicable diseases such as diabetes.
To counter these trends in healthcare, Singapore’s Ministry of Health (MOH) has developed a strategy termed the Three Beyonds. This includes moving beyond healthcare to health; beyond hospital to community; and beyond quality to value. The MOH plans to execute this strategy by working with healthcare providers, professionals and research institutions to enhance jobs and skills, raise productivity and catalyse innovation. Enhancing skills will help create a workforce for the future; the use of cost-effective technology will increase productivity and better patient; and innovative solutions can be leveraged to develop superior patient-centric solutions.
Beyond Healthcare to Health
The objective of this beyond is to reduce the use of the healthcare system where possible. As Singapore has prospered, it has also witnessed an increase in lifestyle-related diseases, which pose a strain on both the nation’s healthcare system, as well as the economy at large. And given that most Singaporeans have health insurance through government schemes in addition to private insurance plans, there is a tendency to visit healthcare facilities more often than is necessary and a willingness to bear additional medical costs, as they are covered by insurance. Given these considerations, it is imperative for the government to address healthcare concerns.
The MOH is prioritising preventive initiatives such as implementing stricter regulations on cigarette smoking, as well as raising the legal smoking age. In addition, initiatives such as the National Steps Challenge started by the Health Promotion Board (HPB) encourage Singaporeans to walk more and lead a healthier lifestyle. There are increasingly other initiatives such as those encouraging Singaporeans to eat healthier, get their health screening done more regularly and campaigns calling for healthier lifestyles.
Beyond Hospital to Community
Rising medical costs and an increasing array of acute illnesses have prompted Singapore to consider healthcare delivery beyond hospitals to communities. This ensures patients with chronic illnesses receive quick and convenient healthcare, reducing healthcare expenses for the government. It requires co-ordinated efforts by all stakeholders to ensure patients receive effective care within their homes post discharge while also avoiding frequent readmission to hospitals. In addition, a collaborative approach among public and private sector insurance companies is necessary to examine their outpatient insurance coverage to support this initiative.
The MOH is also encouraging innovations in medical devices, allowing new technologies to be implemented. This can facilitate data collection of patients who are moved to their homes following treatment. Patient healthcare records may soon be readily available to a range of healthcare providers ensuring quick and effective care when needed.
Beyond Quality to Value
The MOH established the Agency for Care Effectiveness (ACE) in 2015. The agency researches current health technologies in drugs, devices and medical services. These assessments are shared with healthcare institutions, doctors and patients to make better informed decisions on effective treatment options for illnesses. The desired outcome is a win-win situation for all stakeholders and the Singapore government.
In November 2018, the MOH released a fee benchmark on private sector surgeon fees in order to control spiralling medical fees charged by private doctors. This also forms a part of the strategy to give access to better medical treatment for all at reasonable prices.
Completing the Transformation
The goal to deliver beyond hospitals to communities can only be achieved by a robust medical infrastructure along with strong cyber security measures to manage patient records. This data could also be invaluable for health technology start-ups seeking to close gaps in medical services.
Meeting the objective of quality to value will require the Singapore government to develop a more collaborative process of assessing drugs, devices and medical services and, in turn, make informed decisions on extension of subsidies. This will encourage advancements in the healthcare field by various stakeholders in the ecosystem, providing better healthcare prospects for both the government and its citizens.
The Singapore government’s success in addressing the country’s healthcare challenges and in actually transforming the sector will depend on effective implementation and involvement from all stakeholders including patients. These efforts are instrumental in ensuring a strong and healthy workforce — a crucial component of a growing economy. It will also need collaborative efforts by both private and public sectors along with stronger monitoring systems through the ecosystem to check on things like fees and insurance claims. The government is also looking to facilitate medical innovation growth which will assist in the development of better treatment options. Likewise, its citizens must be encouraged to embrace healthier lifestyles.
