Driving The Quality of Healthcare in Singapore

Introduction to Healthcare

Healthcare is the maintenance or improvement of health through the prevention, diagnosis, and treatment of disease, illness, injury, and other physical and mental impairments in people. Healthcare services are delivered by health professionals, including doctors, physician assistants, dentists, nurses, pharmacists, psychologists, and other health professions. It encompasses the work done in providing primary, secondary, and tertiary care, as well as in public health (World Health Organization, 2020).

Driving The Quality of Healthcare in Singapore

Healthcare in Singapore is under the responsibility of the Singapore Government's Ministry of Health. Singapore has an efficient and extensive healthcare system. It was ranked sixth in the World Health Organization's ranking of the world's health systems in the year 2000. Bloomberg ranked Singapore's healthcare system as the most efficient in the world in 2014 (World Health Organization, 2000; Bloomberg, 2014). Singapore has a non-adjusted universal healthcare system where the government ensures the affordability of healthcare within the general healthcare system through a system of mandatory savings, subsidies, and price controls. This ensures that regardless of income level, all Singaporeans can afford healthcare services.

Singapore's healthcare system employs various types of financing mechanisms that include nationalized health insurance plans and deductions from the mandatory savings plan, known as the Central Provident Fund (CPF), for working Singaporeans and permanent residents. These plans are designed to reduce the misuse of healthcare services. Out-of-pocket charges vary widely for each service and level of subsidy. At the highest level of subsidy, although each out-of-pocket cost is usually low, expenses can accumulate and become significant for patients and families.

A section in the CPF allocates a portion of one's monthly salary savings for future medical expenses and approved medical insurance plans. The medical savings account, Medisave, accumulates funds that are individually tracked, and such funds can be shared across an entire extended family. The vast majority of Singapore citizens have substantial savings in this plan. One of three levels of subsidy is chosen by the patient at the time of the healthcare episode.

Launched in 1990, Medishield is a low-cost basic insurance scheme intended for those whose savings are insufficient to meet their medical expenses. Premiums can be paid out of Medisave accounts. Another plan, Medishield Life, replaced Medishield in November 2015. The scheme helps to pay for hospital bills and selected outpatient treatments. The government provides premium subsidies to lower- to middle-income residents, the elderly, and new policyholders transitioning from cheaper policies. Eldershield is a severe disability insurance scheme that insures against the cost of private nursing homes and related expenses. Since 2002, individuals with a CPF Medisave account are automatically enrolled in the scheme at age 40, unless they opt out. Three private insurers, Aviva, Great Eastern, and NTUC Income, managed ElderShield. It had 1.2 million policyholders as of 2015, with $2.6 billion collected in premiums, and around $100 million in payout claims and $130 million in premium refunds between 2002 and 2015. In addition to the insurance plans, Medifund is a government endowment fund for those who cannot meet their assessed contribution (Ministry of Health Singapore, 2015).

The Integrated Shield Plan

The Integrated Shield Plan (IP) includes both the MediShield Life component and an additional private insurance coverage component run by private insurers to cover optional benefits in public hospitals and private clinics. Premiums for the IP can be paid by the Medisave funds. This integration ensures comprehensive coverage for a wide range of healthcare services, providing peace of mind to policyholders who seek enhanced medical benefits (Ministry of Health Singapore, 2020).

References:

- World Health Organization. (2000). The World Health Report 2000: Health systems: Improving performance. Retrieved from https://www.who.int/whr/2000/en/
- Bloomberg. (2014). Most efficient healthcare 2014: Countries. Retrieved from https://www.bloomberg.com/
- Ministry of Health Singapore. (2015). ElderShield. Retrieved from https://www.moh.gov.sg/
- Ministry of Health Singapore. (2020). Integrated Shield Plans. Retrieved from https://www.moh.gov.sg/