Chapter

3: Managing Healthcare
Case studies of Singapore and Britain

Lesson Objec=ves
In this chapter, you will learn about:
Challenges that governments face in managing healthcare Healthcare in Singapore and Britain in the 60s and 70s Approaches to manage Healthcare since 80s

How is healthcare paid for in Singapore?

Self Employer paid insurance Personal Insurance Government Taxes
Onus is on self to pay for services.

employers claim medical fees from insurance companies when medical services used by employees. insurance plans bought for personal coverage in =mes necessity

tax collected is used for the needy ci=zens.

Challenges in Singapore
To provide quality healthcare and managing healthcare expenditure 1960s
self-government in 1959 rapid urbanisa?on led to pollu?on indiscriminate li@ering improper disposal of rubbish health care important for na?on building

1970s
wealthier and be@er-educated people demand for be@er-quality medical services need for specialisa?on of medical services

Goals of the Na=onal Health Plan

Ensure a healthy and physically t popula=on Encourage and reward Singaporeans for leading a healthy lifestyle. Encourage individuals to accumulate nancial resources to pay for their medical expenses.

Community
Provide some healthcare services and support service. Keep healthcare aordable

Government

Individual

Medisave

introduced in 1984; CPF contribu=on that can be used to pay for hospital bills and certain medical treatments when needed.

Medishield

Na=onal Healthcare Insurance Scheme Some claims that cannot be made using MediSave can be made using Medishield. Especially for people who require long-term treatment illnesses.

What is Medifund and Why was it ini=ated?

Established in 1993. Primarily caters to the needy who cannot pay for their hospital bills and self- employed people who do not make CPF contribu=ons and who accordingly have no Medisave. The government ini=ated a fund with some $200 million and the accumulated interest was u=lized to provide for needy pa=ents.

Medifund
Medifund can be used to pay for HIV treatment and maybe cancer in future Applica=ons to Medifund are means tested to ensure taxpayers' money only subsidises those who are most in need. Every year, Medifund distributes some S$60m to S$70m to pa=ents to help towards inpa=ent and outpa=ent costs.

Government Policies to keep Healthcare aordable

Government subsidies Medifund Restructuring of hospitals Means tes=ng

Hospitals have greater freedom to reorganize to cater to the healthcare demands of Singaporeans Governments way of coping with rising medical cost

enabled the government to reduce subsidies to hospitals.

Restructuring of Hospitals

Promo=ng Healthy Lifestyle

Adopt a healthy lifestyle. Ideally, a person of good health is less likely to require medical treatment. Health Promo=on Board carries out various programmes to educate the general public. Schools and workplaces also emphasize healthy habits> exercising, healthy diet.

LASTLYWorking with organisa=on

Tap on the community to provide some healthcare support. Voluntary welfare organiza=ons and some private organiza=ons are given grants to run community hospitals and nursing homes.

Hospitals run by voluntary welfare organisa9ons

Organisa9ons that provide specic healthcare or support services

There are s=ll some groups of people who cannot pay for healthcare services.

The elderly who do not have the opportunity to save for healthcare.

Those who are unable to work.

They have to depend on the government for their healthcare needs.

Healthcare in Britain

Post WWII Britain witnessed poverty, massive unemployment, and diseases were widespread. Sir William Beveridge studied the situa=on and delivered The Beveridge Report. Cradle to grave

Sir William Beveridge

Established in 1948.

Free medical services to all Bri=sh ci=zens, i.e healthcare became a public good.

Every ci=zen consents and contributes to a na=onal fund that helps the needy people of Britain.

NHS

 Ini=ally the NHS was highly popular, however in 1951 the NHS was unable to meet the demands of the people. Why?

Why?
Rising cost Overwhelming demand More healthcare needs .e.g dentures, spectacles, hearing aids Medical treatment without considera=on

 Since healthcare was funded by the Bri=sh government its healthcare expenditure was raised. This meant that the government had to collect more taxes from the people to manage the rising healthcare costs.

Budget set aside for the NHS

 In the 1980s Margaret Thatchers government sought to reduce government spending on healthcare by priva=za=on.

Margaret Thatcher, Prime Minister of Britain (1979 - 1990)

NHS plan (2000) called for an increase in the amount of government spending =ll 2004. NHS Improvement plan (2004). Improving healthcare services. Pa=ents can choose from 4 healthcare service providers whilst NHS pays for their treatment.

LASTLY..
Have Bri=sh healthcare policies met the needs of the people?