The raising of income ceilings for subsidies, and the extension of greater help to those paying less already, will reduce the cost of healthcare for more Singapore residents. The careful calibration of means testing, seen in the revision of eligibility criteria for subsidies under the Community Health Assist Scheme, for example, lies at the heart of efforts to keep healthcare affordable while re-emphasising the principle that citizens are responsible for their health. The just-announced changes are incremental, suggesting that the system is working well but that it must be fine-tuned to cater to a changing medical demography characterised by age and the incidence of diseases such as diabetes and kidney failure.
This model lying at the heart of the changes stands apart from welfarist health services adopted in other countries which are marked by runaway costs and falling service standards. It also contrasts with the effective disappearance of public healthcare in some developing countries where privatised care dominates and is beyond the reach of most. Singapore avoids both extremes by focusing on maximising medical outcomes while keeping costs low. According to registered insurance broker Pacific Prime Singapore, the country shows that “an amalgamation of conservative and liberal ideas in healthcare is possible”. The organisation cites analyses in which liberals point to the success of France, Canada and the Scandinavian countries in looking after their populations.
On the conservative side, there are those who would want individuals and not the state to play a fundamental role in healthcare through privately-funded insurance schemes.
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