If you’re going to get sick, Singapore is the place to do it.
Ranked as one of the most efficient systems on the planet, the city-state’s public health-care program is used by 80% of residents.
More important, Singapore spends less on health care than any other wealthy country in the world. In 2013, 4.7% of its gross domestic product went to health; the United States spent 17.9%, according to the World Bank.
So what’s its secret? The Ministry of Health requires all citizens to participate in a health savings program called Medisave, which ensures that they have enough put aside to cover future expenses. Residents also receive health care subsidies based on income level. Medical costs must be clearly presented, and the government controls insurance companies.
“Price and outcome transparency are very important to quality,” said William Haseltine, chairman and president of ACCESS Health International Inc. and a former professor at Harvard Medical School and the Harvard School of Public Health. “Without it, it is very difficult to manage a health care system.”
In his book, “Affordable Excellence: The Singapore Healthcare Story,” Haseltine says that Singapore understood early on the need to integrate health with every aspect of urban planning. Housing, water, food, air quality, road traffic, parks and more were considered to be part of a holistic health system.
Paying attention to social and environmental conditions such as these is a hallmark of successful health care systems, says Kisha B. Holden, associate professor of psychiatry and behavioral sciences at the Morehouse School of Medicine, who specializes in health disparities.
Quality health programs pay attention to the needs of the people being served, she says. They have attractive financial systems, provide community education and focus on preventive care — all of which Singapore does.
Haseltine says some of Singapore’s more successful health campaigns have included rental bicycle, trans fat-free and anti-smoking programs. There’s also an entire government agency, the Health Promotion Board, dedicated to promoting healthy diets, exercise, health education and regular screenings.
“They have developed a very high-quality health care system that provides uniform care regardless of income,” Haseltine said.
He believes the principles that make the Singapore health system work so well can also be applied in other places.
“It is important to look at what can be done. High-quality health care can be delivered at the fraction of the cost.”