Health Care Systems, Policy and Financing in Singapore - Case Study Example

Health Care Systems, Policy and Financing in Singapore By: Singapore has a unique policy to health care. The policy combines free market principles and careful government control. This paper will conduct a detailed analysis of the healthcare system of Singapore. It will identify the key contextual factors affecting the healthcare system. It will then analyse the performance of the healthcare system and financing. The paper will discuss the health care resource allocation in Singapore and the medical service providers. Lastly, the paper will highlight the recommendations on improving healthcare in Singapore. The Singapore Health Care is a complex system that is fundamentally context-dependent. Contextual factors have the potential to affect the health system. These contextual factors include national, state, local and organizational policies, characteristics of the leadership of the healthcare systems, and the healthcare resources (Meng-Kin, 2014). The national, state, local, and organizational policies can either positively or negatively affect Singapore healthcare systems. These policies influence the conditions that influence the health status of people. For instance, national policies influence upon community health that can affect all other factors influence overall health. These policies affect housing, education, income, access to food, the availability and quality of health care, and the environment in which people live (Meng-Kin, 2014). Health Systems Resources are categorized into three branches: Physical capital, Consumable, and Human Resources (Meng-Kin, 2014). The total funds are normally directed to capital and recurrent expenses. The capital expenses fund the training of people, investments in buildings and equipment. The training of persons and investments in buildings and equipment concern the human resources and physical capital respectively. On the other hand, recurrent expenses fund the labour costs, maintenance, and other recurrent, which concerns consumables. For the system to be effective and efficient, the resources must be sufficient and appropriately utilized and managed. Without these, the patients will suffer in the end (Yeo, 2013). The governance of Singapore ensures the health systems resources are appropriately managed. The government is aware that adequate health system resources are necessary for quality services to be delivered to the people. However, some cases of resource constraints in the country often affect both the quality and quantity of the health system (Ng, 2014). Lack of resources will take almost 2-4 months to impact the health system. This is the time left to clear the available resources in the system, such as the consumables and pharmaceuticals. Obviously, good leadership is essential for the success of any organization. When it comes to healthcare systems, leadership is not only important, but also critical to the system’s success. Leadership directly impacts the healthcare system in Singapore because it ensures a culture that fosters safety and quality, provides planning and provision of services that meet the needs of the patients, and ensures the availability of resources (human, financial, physical, and information). Leadership influences the system almost immediately. It does not take a very long time. Leaders of a healthcare organization can establish and promulgate the organization’s mission, vision, and goals. They are the ones who strategically plan for the provision of healthcare services, acquire and allocate resources, and set priorities for improved performance (Schyve, 2012). Singapore is very successful in creating an excellent healthcare system. Their main pillars are ensuring a healthy population with access to preventive care, ensuring personal responsibility towards healthy living through the ‘3M’ (Medisave, Medishield, and Medifund) system, and ensuring manageable healthcare costs through control of the supply of the healthcare services and providing heavy subsidies at public healthcare institutions (Meng-Kin, 2014). The principal actor in Singapore healthcare system is the Ministry of Health. It has the responsibility for the system. The ministry specifically ensures the essential medical services remain affordable and available to all Singaporeans through policy planning and coordination (Meng-Kin, 2014). Most public hospitals in Singapore have been restructured, and they run as private autonomous companies (Meng-Kin, 2014). This idea was to improve efficiency and financial discipline. The public hospitals are structured in six regional healthcare clusters that consist of primary care polyclinics, tertiary care hospitals, and specialty centres (Meng-Kin, 2014). There is adequate funding for developments towards improved healthcare. The government and the clinicians lead the development. However, there is no involvement of patients in developing the healthcare system. The Singapore government ensures the healthcare provided to the people is appropriate to the needs of Singaporeans and based on current clinical knowledge. The ministry allocates a lot of money for research and studies on healthcare. The studies are to monitor the patients’ perception of care and providers (Ng, 2014). The Singapore government has a very different approach to financing its health systems. The government’s philosophy of health care delivery is based on individual responsibility and community support. The patients are supposed to contribute some money towards their medical expenses. Additionally, when demanding better services, patients are expected to pay more (Yeo, 2013). Government subsidies often help to keep Singapore’s basic health care affordable. The government usually helps Singaporeans pay their medical expenses through a financial framework. This framework consists of Medisave, Medisave-Approved Integrated Shield Plans, and Medifund. The CPF board is in charge of administering Medisave and Medishield schemes. Medisave It is Singapore’s healthcare savings scheme. Citizens are expected to contribute a portion of their CPF savings. The contributions go to their respective Medisave Accounts. Medisave pays for hospitalization of the citizens, and payment of the premiums of Midishield and Medisave-approved Integrated Shield Plans (Meng-Kin, 2014). Medishield In some cases, a patient’s Medisave and cash savings can be wiped out if one has a serious illness. In these cases, MediShield comes to assistance. It is a medical insurance scheme. The scheme is designed to help pay part of patient’s expenses arising from hospitalization and outpatient treatments for serious illness (Meng-Kin, 2014). The scheme has deductible and co-insurance characteristics. ‘Deductible’ is the minimum claimable amount that a person would need to pay when making a MediShield claim. It applies to the claimable amount rather than the incurred bill. An individual is required to pay the deductible once in a policy year. ‘Co-insurance’ is the arrangement of paying a portion of the claimable amount with the remaining amount paid by MediShield (Meng-Kin, 2014). The premiums for this scheme are affordable. They are always low to encourage participation in the scheme. The premiums range from S$50 for people below 20 years to S$1,190 for those aged 86 to 92 years (Meng-Kin, 2014). For those who joined when they are before the age 60 years, they will enjoy premium discount. This discount increases every 10 years of MediShield membership (Meng-Kin, 2014). Medisave-approved Integrated Shield Plans This is a very high insurance cover. It is designed as a single product. It includes both the benefits offered by the private insurers and MediShield. A policyholder of this cover will enjoy the benefits of being a MediShield member and premium discounts while the private insurers protect then by providing a higher coverage. The withdrawal limit of this policy is subject to the $800 Medisave provision per insured person, per policy year, if the insured person is below 66 years (Meng-Kin, 2014). For people between 66 to 75 years old, 79 to 80 years old and 81 years the withdrawal limit is increased to $1,000, $1,200, and 1,400 respectively (Meng-Kin, 2014). Medifund The Singapore government created it as an endowment fund. It is a safety net to help the needy citizens who are unable to pay their medical expenses. It is for the people who are unable to afford the subsidized charges at restructured hospitals, even with their Medisave and MediShield (Central Provident Fund Board, 2003). The Singapore government does not support the idea of financing the medical services. The providers of the finance are the citizens themselves. The government supports the idea of co-payment, a central feature of Singapore’s approach to cost containment. The CPF is the one that provides finance for the system. Each Singaporean citizen contributes approximately 40% of their gross salaries to their CPF (Central Provident Fund Board, 2003). The Singaporean government, through the Ministry of Health, has the responsibility of providing Healthcare services in that country. The ministry is charge of distribution of healthcare resources in the country. Experts credit the ministry for developing a universal health care system that emphasizes on affordability achieved through compulsory savings and price controls, and a strong public-private partnership (Ng, 2014). The ministry divides equally the resources, acquired through a combination of compulsory savings from payroll deductions, a national health insurance plan, and government subsidies, to all healthcare facilities in the country. Additionally, the ministry is in charge of actively regulating the supply and prices of healthcare services in the country to monitor the costs carefully (Meng-Kin, 2014). There are many Health Care providers in Singapore. Example of Health Care providers in Singapore are Raffles Medical, Q&M Dental Group, and Healthway Medical (Ng, 2014). Q&M is a private dental healthcare group with more than 55 dental clinics, four dental centres, a mobile dental clinic and two dental supplies and equipment distribution companies in Singapore (Ng, 2014). Healthway Medical Corporation is a network of private outpatient medical service providers. It offers medical services in healthcare, dental and specialist services (Ng, 2014). Raffles Medical Group is the largest private group practice in Singapore (Ng, 2014). It serves over one million patients and 6,500 corporations, through a network of 78 multi-disciplinary clinics across Singapore (Ng, 2014). Recommendations The Singapore government has done a recommendable work in the health care systems. However, there is a need for harnessing of information technology. Singapore is developing a National Health Information System that will allow the seamless flow of information across all health care establishments. Improvement of information technology will lead to increase in quality of care. References Board, C. P. F., 2003. My CPF: Your Healthcare Needs...Stretching your Medisave Dollars. Healthcare Financing Framework In Singapore. Meng-Kin, L., 2014. Health care systems in transition II. Singapore, Part I. n overview of health care systems in Singapore. Ng, A. W., 2014. Performance Measurement and Optimization of Resource Allocation in a Health Care System, Hong Kong: College of Professional & Continuing Education. Schyve, P., 2012. Leadership in healthcare organisations, San Diego: The governance institute. Yeo, J., 2013. The Healthcare Industry – Healthcare Service Providers. Read More