Singapore has a unique health system that is well-liked by some segments of the left in the United States (for its low costs and universality) and by the right (for the use of something similar to a health savings account, high deductible plans, and an emphasis on personal responsibility).
And it spends far, far less than the United States does. Yet it achieves some outcomes Americans would find remarkable. Life expectancy at birth is two to three years longer than in Britain or the United States. Its infant mortality rate is among the lowest in the world, about half that of the United States, and just over half that of Britain, Australia, Canada and France. General mortality rates are impressive compared with pretty much all other countries as well.When the World Health Organization ranked health care systems in 2000, it placed the Singapore ranked sixth.
That said, it may not all be perfect; previous reports have said that Singapore is less than transparent with their quality data, so it is not certain if it has overall outcomes amongst disease states with its peers in Japan, South Korea, Taiwan, and the Occident.
I personally, however, am intrigued by the system, and I wonder if something similar to it would be a good sell - perhaps if the left could live with higher deductibles and savings account in exchange for cost controls and universality, would the right agree to allow additional intervention and universality for a system that arguably does more to encourage individual responsibility and family initiative than the current public/private mix the US has?
One final note - Singapore's health system, regardless of right-wing propaganda in America, is not some capitalist utopia:
Initially, Singapore let hospitals compete more, believing that the free market would bring down costs. But when hospitals competed, they did so by buying new technology, offering expensive services, paying more for doctors, decreasing services to lower-class wards, and focusing more on A-class wards. This led to increased spending.In other words, Singapore discovered that, as we’ve seen many times before, the market sometimes fails in health care. When that happened in Singapore, government officials got more involved. They established the proportion of each type of ward hospitals had to provide, they kept them from focusing too much on profits, and they required approval to buy new, expensive technology.Singapore heavily regulates the number of physicians, and it has some control over salaries as well. The country uses bulk purchasing power to spend less on drugs.
Perhaps the size and diversity of the US wouldn't allow it work here although I am skeptical of that because - finances aside (which are due to low Medicare taxes) - the same thing is said about single payer here in the United States, but Medicare which is single payer for the elderly and highly disabled works very well and has high levels of satisfaction.
If you want to read more, please check out the referenced NY Times article.
https://www.nytimes.com/2017/10/02/upshot/what-makes-singapores-health-care-so-cheap.html
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https://www.nytimes.com/2017/10/02/upshot/what-makes-singapores-health-care-so-cheap.html
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