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Experts urge reform of Singapore's healthcare policy

20 February 2013

(From left) Panellists Dr Lam, Assoc Prof Phua, Prof Koh, Dr Lim and Assoc Prof Tambyah engaging in a lively discussion at the Tembusu Forum on healthcare policy

Photo: Lianhe Zaobao © Singapore Press Holdings Ltd
While Singapore's healthcare system has served the country well till now, experts felt the time has come to restructure it in view of an increasingly ageing population. NUS academics, practitioners and government officials gave their perspectives on possible reforms at the Tembusu Forum on healthcare policy and values on 18 February.

Kick-starting the conversation, Professor Tommy Koh, Rector of Tembusu College at NUS, noted that the Singapore government has done relatively well as evidenced by the World Health Organization's ranking which placed the country as having the sixth best healthcare system in the world. This was achieved with a 4 per cent Gross Domestic Product (GDP) spending. For comparison, the US spends about 18 per cent of its GDP on healthcare.

The panellists gave an overview of the evolution of Singapore's health system, delving into its model, structure, care-giving and financing options over the years.

Associate Professor Phua Kai Hong, from the Lee Kuan Yew School of Public Policy at NUS, opined that the current medical financing which covers about 15 per cent of Singapore's total healthcare expenses has to be reviewed. He underscored the need for a balanced structure of taxes, insurance and savings.

Agreeing, Dr Jeremy Lim, who is the Chair of the Steering Committee of the NUS Initiative to Improve Health in Asia, said: "In this national conversation, how can we ensure better financial protection of the individual, even if the state assumes a little bit more of this risk? If we can do that, I think many Singaporeans [would be able to] genuinely have that peace of mind".

For Dr Lam Pin Min, Chairman of the Government Parliamentary Committee for Health, the local hybrid system has its strengths by offering universal medical coverage for all Singaporeans via the 3Ms - Medisave, Medishield and Medifund. However, Singapore must be mindful of the impending silver "tsunami", the increased need for homecare and care-giver support, changing disease patterns and the global shortage of medical manpower. To address this, Dr Lam proposed more financial assistance for the needy and urged the Ministry of Health to also consider the social, political and economic conditions.

Arguing for a larger government contribution, Associate Professor Paul Tambyah from the NUS Yong Loo Lin School of Medicine offered the solution of a single-payer premium system instead of the 3Ms.

The 200-strong audience comprising mainly students learnt more from the panel discussion during the Question and Answer session. The topics raised included the single-payer premium system adopted by countries such as Taiwan, the importance of preventive services, as well as the different perceptions of healthcare by the government and the population.

A flagship event of Tembusu College, the Tembusu Forum provides a platform for Tembusu College residents and the larger community to discuss important global and regional issues.