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Singapore fails to meet needs of marginalized

February 1, 2021

Topics: Quote of the Day

By Tessa Oh
Today, Updated January 31, 2021

Singapore’s healthcare system can do better by taking into consideration the experiences of people from marginalised communities in order to more effectively meet their healthcare needs.

This point was raised by several speakers on Friday (Jan 29) during a panel discussion held at Yale-NUS College on how the healthcare system here can be made more equitable.

During the discussion, the panellists were asked to outline their vision for healthcare equity in Singapore.

Dr Tambyah (Dr Paul Tambyah, senior consultant at the National University of Singapore and president-elect of the International Society of Infectious Diseases) said his hope is for Singapore to switch to a single-payer universal healthcare system, where the costs of essential healthcare for all residents are covered by a single public system.

Raising the examples of the healthcare systems in Scandinavia, Taiwan and the United Kingdom, Dr Tambyah said a similar model can be explored here.

“(The Scandinavians) have a pretty good track record, and that may be something that we can look at,” he said.



By Lee Chien Earn
The Commonwealth Fund, June 5, 2020

Singapore has achieved universal health coverage through a mixed financing system. The country’s public statutory insurance system, MediShield Life, covers large bills arising from hospital care and certain outpatient treatments. Patients pay premiums, deductibles, co-insurance, and any costs above the claim limit. MediShield Life generally does not cover primary care or outpatient specialist care and prescription drugs. MediShield Life is complemented by government subsidies, as well as a compulsory medical savings account called MediSave, which can help residents pay for inpatient care and selected outpatient services. In addition, individuals can purchase supplemental private health insurance or get it through an employer.

Patients who wish to obtain additional coverage for private hospitals or care in private wards in public hospitals can purchase private insurance. Integrated Shield Plan holders can also purchase insurance riders that provide additional complementary coverage. There are also private insurance options, offered by for-profit insurers, that are not integrated with MediShield Life.

MediFund is an endowment fund set up by the government in 1993 that serves as a safety net for Singaporeans who need further help with the remaining cash component of their health care bills at public health care institutions.



By Don McCanne, M.D.

Conservatives in the United States frequently praise Singapore’s method of financing health care. Actually it is a quite fragmented, dysfunctional system. Apparently it does not meet the needs of the medically marginalized, though they do have a safety net of sorts. You can learn further details by reviewing The Commonwealth Fund’s description of it.

What is interesting is that Dr. Paul Tambyah, a consultant at the National University of Singapore, expresses the view that Singapore would benefit by switching to a single payer, universal health care system. It appears that their current system is not so ideal after all.

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About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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