1. Managing Healthcare Case Studies of Singapore and Britain

2. 2.1 Challenges facing governments Healthcare is a public good Less developed countries have no basic healthcare Developed countries provide better healthcare Money from healthcare come from taxes

3. 2.1 Challenges facing governments Providing quality healthcare vs Increasing expenditure on healthcare People are treated better in hospitals Better medicine leads to higher costs

4. 2.2 Paying for Healthcare Individual: Self (Savings) Individual: Personal Insurance Employer: Employer-paid insurance Employer: Government taxes

5. 3. Healthcare in Singapore 3.1 How was healthcare managed in the 1960s and 1970s? 3.2 How has the approach to manage healthcare changed since the 1980s? 3.3 Have Singapore’s healthcare policies met the needs of the people?

6. 3.1 How was healthcare managed in the 1960s and 1970s? 1960s Healthcare as part of public housing programme –Squatters cleared Hospitals, clinics and outpatient dispensaries built Vaccination Medical Officers and nurses sent to schools

7. 3.1 How was healthcare managed in the 1960s and 1970s? 1970s Better standard of living S’poreans wanted better healthcare Polyclinics replaced dispensaries Facilities in hospitals improved Expenditure on healthcare comes from the govt budget

8. 3.2 How has the approach to manage healthcare changed since the 1980s? Encouraging Self-Reliance –Medisave –Medishield Keeping Healthcare affordable –Government subsidies –Medifund –Restructuring of Hospitals –Means Testing Promoting Healthy Lifestyle Working with Organisations

9. 3.2 How has the approach to manage healthcare changed since the 1980s? National Health Plan Approach to Healthcare –Individual Self-reliance Maintain good health –Government Keep healthcare affordable Promotes healthy lifestyle –Community Provide support services

10. Encouraging Self-Reliance Medisave –Certain amount of CPF contributions channeled to Medisave –Amount used to pay for hospital bills, medical treatments –Over the years, people have accepted Medisave as a means to pay medical bills –With Medisave, people share the costs of healthcare with the government –Government need not raise taxes to pay for rising healthcare costs

11. Encouraging Self-Reliance Medishield –People with long-term illnesses not able to pay their medical bills –National healthcare insurance scheme –Patients pay for scheme using Medisave –Patients make claims from Medishield –Over the years, use of Medishield has expanded.

12. Keeping Healthcare Affordable Government subsidies –Direct subsidies given to govt hospitals, polyclinics and some nursing homes –Ensure basic healthcare available to all –Different rates of subsidies to different classes of wards, e.g. Class C wards receive the most

13. Keeping Healthcare Affordable Medifund –Some needy S’poreans still cannot afford their medical bills –Medifund set up to help those not able to pay –Started with a fund of $200 million –Interest earned given to public hospitals to provide help –Patients need to apply for the fund at the hospital

14. Keeping Healthcare Affordable Restructuring of Hospitals –Restructuring means that hospitals have more freedom to reorganise to meet people’s needs –Govt also able to reduce hospital subsidies –However, many felt that restructuring meant higher hospital bills

15. Keeping Healthcare Affordable Means-testing –One concern is subsidies provided should benefit patients who need them most –Resources more fairly distributed if those who cannot afford get the most –More well-to-do would benefit less –Checking of patients ability to pay is means- testing

16. Promoting a Healthy Lifestyle One way of coping with rising healthcare If a person is in good health, he will not need medical treatment Schools and workplaces have programmes to emphasise good health

17. Working with Organisations Community also provides healthcare services for the people Not possible for govt to run all healthcare Voluntary welfare organisations and some private hospitals given grants to run services Support is given by govt to organisations to provide services These services cater to needs of the poor or a particular illness

18. 3.3 Have Singapore’s healthcare policies met the needs of the people? Despite various schemes, some people still cannot afford healthcare services The elderly is one such group Another group is those who are unable to work Has the health of the people of Singapore improved over the years?