Singapore has become “Pte Ltd” gov.
Public hospitals are divided into geographical clusters and operated by private companies. The private companies are Singapore Health Services Pte Ltd (SingHealth), National Healthcare Group Pte Ltd (NHG) and National University Health System (NUHS).
Shares in SingHealth and NHG are held by the Ministry of Health Holdings Pte Ltd (MOH Holdings). NUHS is a joint venture between NUS and MOH Holdings. In turn, MOH Holdings is privately owned, wholly or partially, by the government.
As these are private companies, they are therefore funded privately, either by private owners, the government or profits from running the hospitals, or all three. They do not issue shares to the public. As such, they do not need to submit financial statements to the stock exchange for public scrutiny. Needless to say, they are profit seeking entities.
The good thing is that since they are subject to market forces, at least partially, standards of health care is good. Also, even though they charge market prices, Singaporeans and PRs are subsidized.
I am writing this because I am rather vexed that the Government is running profit seeking private companies, because, one way or another, state resources will be used, but it is not accountable to the public. Also, besides the Government, there may be other corporate or individual shareholders, who would be benefiting from state resources. If there are, who are these shareholders?
What’s worse, they operate public hospitals providing essential medical services which every citizen should have access. Yet, they are profit seeking entities purporting to provide a public good. In time to come, the people may have to pay an arm and a leg, for essential medical services. Certainly, something is not right and there is a conflict of interest.
This brings me to Medishield Life. It is a non-profit, mandatory hospitalization insurance for Singaporeans and PRs administered by CPF, a government statutory board. As the entity representing the people, Medishield Life has a duty to ensure that the people get their money’s worth for every cent that they pay in insurance premium.
Yet, Medishield Life and MOH Holdings both report to the Government. What is to prevent the Government from getting Medishield Life to increase premiums so that MOH Holdings can have a better bottom line?
Therefore, decisions to increase premiums cannot be made unilaterally, but has to be debated in parliament. Medishield Life has to be transparent with its accounts and MPs have to scrutinize all financial assumptions, including basis for so-called medical inflation.
Unfortunately, we now live in a business-run society. Public good that were once provided by the state for a minimal sum, is now privatized to seek maximum profit, benefiting a small segment of society enormously. The people have to be ever vigilant.