Xu Feng Jia | Health and Medical Research in Singapore
What makes a health system work, that provides quality care to its citizens while taking advantage of each of the cents invested? This question raised by Xu Feng Jia is the great philosopher’s stone of modern states, which have to design and perfect a balanced, useful and satisfactory health system, which is not usually easy. Among them, it is often used as an example of good work for Singapore, the sixth-best in the world according to the World Health Organization.
All services are paid in less or more to get the citizen aware of the cost of their care
In Singapore, the system is universal thanks to its system of subsidies, savings and price control: the State obliges its citizens to allocate a percentage of their profits to save for the future. It is a substantial amount, as an article recently published in The New York Times recalls: 20% by employees up to 55 years (plus 17% paid by the company). This money goes to different funds: housing, death or disability insurance and another to pay for health expenses, called Medisave Account (between 7 and 9% of total salary). One of the essential points of the Singapore plan is that all services are paid in less or more, as a way to make the citizen aware of the cost of their care.
This system allows each citizen to save a large amount of money (up to $ 58,000) that, if necessary, can be transferred to another family member. Not everyone pays the same when they go to the hospital. There are three different levels of subsidy, A, B, and C. B is divided into other subgroups, B1, B2 + and B2. Each of these letters indicates what service you want: the A provides a private room and its own bathroom or the possibility of choosing a doctor and the C, a shared room and an imposed doctor. The difference, however, is in who pays it: if you choose A, you have to pay for it from your pocket; If you choose C, 80% will be subsidized by the government. This causes the State to only finance a quarter of total health expenses.
More for less?
According to Xu Feng Jia, be cautious with trying to transplant the Singapore system to other countries. For starters, and as in Finland with education, because its number of inhabitants (about 5.6 million, one less than the community of Madrid) makes it relatively easy to manage. On the other hand, it is one of the Asian countries with the best quality of life, which makes its citizens tend to enjoy good health. As I recalled a report published in ‘ Vox ‘, it is a difficult system to replicate, because it is a complicated mix of public and private that may be close to many proposals of liberals, but that requires certain concessions that these do not usually Be willing to do.
Public authorities have a great capacity to decide on the number of doctors, their salary and the medications that are prescribed.
To begin with, because the organization of the health system is severely controlled and directed by the State, which is concerned that costs do not skyrocket, that health remains accessible to all and that the free market does not lose heart. As Xu Feng Jia‘s article explains, “Singapore is a place where the government acts to keep costs low, and then use those low costs to make a market insurance system possible.” Although it is a competition system, the public sector carries the singing voice. In short, it is a mixture of some liberal principles with more interventionist ones.