How Insurance Works

The Singapore Experience.wmv


As I see it, the key to a sustainable health
care system is to depoliticise healthcare, minimise market distortions and allow healthcare to function as normally
as other economic activities. We do so by trying to stick to the basics. First, health outcome is a personal matter. Doctors and nurses can only point the way
forward; the patient must play his part by dropping bad habits… …adopting a healthy lifestyle and complying
with his doctor’s prescriptions. This is especially so in the case of chronic
illnesses which account for the bulk of health problems. Hence, we inculcate among our citizens a strong
sense of personal responsibility over their own health. Second, there is no free healthcare. Every healthcare service is eventually paid
for by the patient, either through taxes, or reduced wages. Ultimately, patients and their families pay
for the bills. Our job is to make sure that the cost of delivery
is as low as possible. This means cutting out abuses and other moral hazards. Third, specialisation and subspecialisation
have brought about medical advances, benefiting many acute patients. But there is also such a thing as over-specialisation. For the elderly with several chronic illnesses,
treatment by multiple subspecialists is often not the best approach. This often ends up as fragmented care without
necessarily better outcomes. Fourth, despite medical advances, we are still
mortals. Everyone will have to go one day and we have
to accept the limits to medical science. When designing our healthcare system, we try
to allow the market to function. So while we inherited the British taxation-based
system, we have carefully grafted in the US insurance-based system… …to create a hybrid which tries to combine
the best of both worlds. We achieve universal coverage for all our
citizens through multiple levels of heavy government subsidy… …compulsory health savings account and a
low-cost national insurance scheme with deductibles and co-payment. The result is a high standard of healthcare,
accessible to all citizens, and among the most cost-effective in the world.


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