The greatest wealth is health
Singapore already achieves good outcomes in healthcare, with a system that is cost-effective, while providing good care. But the Government is also spending an ever larger percentage of its income on healthcare. And this is inevitable, as the population ages. By 2030, 1 in 4 Singaporeans are expected to be over 65.
While some may be concerned at a rising national healthcare bill, it remains necessary, and the Government will ensure that healthcare services continue to remain accessible and affordable for everyone, through the provision of more healthcare facilities and regular reviews of our social safety nets.
How we spend $10,700,000,000?
In the Financial Year 2017, the Government allocated $10.7 billion to healthcare – the third largest spending by ministry, behind education and defence. This comes to about 2.5% of GDP.
The amount is expected to “rise quite sharply” in the next three to five years as our population ages, Finance Minister Heng Swee Keat has said. He expects it to go up by at least $3 billion by 2020 from current levels.
A jump of another $3 billion by 2020 would mean that in 10 years, the health budget could climb to more than three times its 2010 level, when it was $4 billion.
Here’s a look at what the Government has been spending on.
At least one new hospital every two years.
That’s the rate at which a healthcare facility will pop up in the coming years.
In 2018, Sengkang General and Community Hospitals will open and offer a total of 1,400 beds.
In 2020, Outram Community Hospital, situated near the Singapore General Hospital, is scheduled to be completed and will add 550 beds.
In 2022, the 1,800-bed Woodlands Health Campus will open and have an acute hospital and a community hospital sharing the same building. So will the Integrated Care Hub, a 500-bed community hospital, situated next to Tan Tock Seng Hospital.
This comes on top of the five new hospitals – Khoo Teck Puat Hospital, Ng Teng Fong General Hospital, Yishun and Jurong Community Hospitals, and the CGH-SACH Integrated Building – that have been opened since 2010.
These new hospitals are part of a multi-fold plan to prepare for the expected surge in demand from a rapidly ageing population, while also easing any bed crunch.
After all, an elderly person is three to four times more likely to be admitted to hospital compared to a younger person – and once admitted, they stay for twice as long.
In 2018, the share of Singapore’s elderly population who are 65 and over will match the number of young who are under 15 for the first time.
In tandem with the infrastructure boost, an additional 30,000 healthcare workers will be needed between 2015 and 2020 to cope with the increased demand for healthcare services.
Over the next three years, the Health Ministry is investing $24 million to get those making a mid-career switch on board. The funds will go to various schemes – from new overseas graduate scholarship for those who do not have nursing degrees but want to join the sector, to nursing professional conversion programmes – to help more Singaporeans take up healthcare jobs.
While improving the healthcare hardware, the Government is also investing in the software to improve quality of care.
For instance, close to 600 bed transporters will be rolled out in four public hospitals from June 2018. The technology reduces the number of people needed to move a bed with a patient on it from two persons to one, improving overall productivity.
The Woodlands Health Campus, when completed in 2022, will provide every patient with an electronic device akin to a watch, which monitors vital signs, activity, and location. It will alert nurses when a patient’s blood pressure goes up by too much, or where to locate a dementia patient.
They can also keep tabs on a patient’s condition after he returns home with tele and video conferencing.
Medical Safety Nets
The Government has expanded the healthcare safety net as well to better support lower- and middle-income Singaporeans, especially as many of them have to support both their children and elderly parents.
Two-thirds of households now receive up to 80% subsidy for home and community-based care, such as community hospitals and nursing homes.
More than 1.2 million Singaporeans are also covered under the Community Health Assistance Scheme (CHAS) for outpatient visits.
MediShield Life, which started in 2015, helps Singaporeans pay for their hospital bills and costlier outpatient treatments, such as kidney dialysis, chemotherapy, and radiotherapy. It protects all Singaporeans, regardless of age or health condition, for life.
Close to $4 billion in subsidies will be provided by the Government in the first five years of the scheme to ensure premiums remain affordable for lower- and middle-income households.
The Government also provides periodic top-ups to MediSave, especially for the lower-income and elderly.
In 2017, the Finance Ministry disbursed over $310 million in MediSave top-ups as part of the Pioneer Generation Package and GSTV-MediSave payouts. The top-up amount ranges from $200 to $1,250 per person.
Working hand in hand, these assistance schemes led to around four in five subsidised hospitalisation bills costing less than $100 after MediShield Life, MediSave, and other healthcare benefits.
A Sustainable Increase in Healthcare Expenditure
Healthcare spending will continue to rise as the population ages, and the Government will strive to ensure continued access to quality and affordable healthcare. At the same time, any increase must be sustainable, with an eye on costs, which are ultimately borne by all Singaporeans.
All of us have a part to play in this.
The Government will build more healthcare infrastructure in the community so Singaporeans can receive appropriate care closer to home. Meanwhile, other priority areas such as education, infrastructure and security will need to receive adequate funding as well.
Healthcare institutions will continue to make the most of limited resources, through providing cost-effective treatment and drugs, and leveraging on technology to deliver better care for our patients.
Individuals also have a part to play, too, such as by eating healthily and exercising regularly, monitoring their own health through regular screening, and managing their chronic conditions well.