Chapter 3 - Managing Healthcare in Singapore

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Follow me on slideshare. http://www.slideshare.net/gohbangrui These slides are used to illustrate the healthcare system in Singapore. Ranging from Medisave to Restructuring of Hospitals in Singapore, these slides aim to teach the concept of Singapore healthcare in the new Social Studies Secondary Three syllabus. At the end of the slides, they provide a brief snapshot of the healthcare system of Singapore using the various measures such as Medisave, Medishield and Medifund. Any comments are welcome. Thank you.

Transcript of Chapter 3 - Managing Healthcare in Singapore

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Chapter 3Managing Healthcare

Singapore

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Learning Points1. Identify the challenges governments face

in managing healthcare

2. Identify ways that healthcare is paid for in a country

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Challenges that most Governments face

Public Good Quality Healthcare

Increasing Spending

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A Public GoodExpectationAll citizens expect their government to provide basic healthcare.

ProblemAll countries have limited resources.

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Quality HealthcareExpectationPeople in developed countries expect more and better healthcare services.

ProblemPeople live longer.

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Rising SpendingExpectation1. Better

treatments,2. More effective

medicines3. Better-qualified

medical staff

ProblemPeople demand for the best healthcare.

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How is healthcare paid for?

Self Personal Insurance

Employer-paid Insurance

Government Taxes

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• Pay for your own healthcare services when you receive treatment

Self

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• Pay for your own healthcare services when you receive treatment

Self

• Buy medical insurance

• Claim from insurance to pay for certain medical treatment

Personal Insurance

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• Pay insurance for workers

• Claim from insurance when workers use medical services

Employer-paid Insurance

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• Pay insurance for workers

• Claim from insurance when workers use medical services

Employer-paid Insurance

• Collect taxes from the people

• Use a percentage of taxes to pay for medical services

Government Taxes

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Recap1. Identify the challenges governments face

in managing healthcare

2. Identify ways that healthcare is paid for in a country

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Healthcare in Singapore

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Learning Points1. Identify how the government managed

healthcare expenses before the 1980s

2. Identify how the government manages healthcare expenses after the 1980s

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SINGAPOREBefore 1980s

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Hock Lam Street during the 1960s

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Bugis Street in the 1960s

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Singapore during the 1960s and 1970s

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What are the effects of poor housing conditions on people’s health?

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Singapore Healthcare in the 1950s and 1960s

Health Centre

aka Polyclinic

Town Areas

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Mobile Health Centres

Medical staff brought help to the people living away from town areas in mobile health centres (vans).

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What did government do?Training

The government trained a huge number of nurses and doctors in hospitals to improve healthcare.

Education

The government also educated people on how to prevent illnessesthrough health programmes.

PhysicalEducation

The government introduced physical education to the students to keep people healthy.

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Singapore Healthcare after 1960s

Improved healthcare services such as having more clinics and medical staff.

Health programmes like being healthy at work and going for medical checkups are implemented.

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How does the government manage healthcare expenses?Healthcare expenses comes from the government budget.

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Concept

The amount of money that the government plans on spending to meet the needs of the people.

Government Budget

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Government Budgetis spent on needs of the people.

Healthcare Education Transportation Housing

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Singapore’s Healthcare Expenditure (2014)

Healthcare4.4%

Others95.6%

Expenditure

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SINGAPOREAfter 1980s

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ProblemRisingCost of

Healthcare

LimitedResources

Strain on Government

Spending

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Solution

Healthcare Cost

Individual

Community

Government

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Solution• Relies on oneself • Be in good health

Individual

• Provides healthcare services

• Provides other support services

Community

• Keeps healthcare affordable

• Promotes healthy lifestyle

Government

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Do you know the cost of healthcare in Singapore?

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Hospital Wards ChargesClass of Ward / Charges per day (SGD)

A (1&1+) B (1&1+) B2 C

Restructured Hospitals AH / CGH / KK / NUH / SGH / TTSH

295470.80

188224.70

5675

2941

Private HospitalsESH / GH / MAH / MEH / TMC

500.76618.46

197.95260.01

133.75179.76

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Appendicitis

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Assume a person is hospitalised due to inflammation of the appendix and undergoes an appendicitis operation.

Staying a total of 7 days in a private hospital with 2 days in ICU, his total hospital bill came up to S$8,950.

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Breakdown of Hospital Bill Amount Payable (S$)

Room & Board (5 days) 750

Hospital Miscellaneous Expenses• Prescription drugs • Diagnostic Procedures • Operating Theatre Fees

2,950

Anaesthetic Fee 500Surgeon’s fee 1,700ICU (2 days) 2,250Post-Hospitalisation Treatment 800Total 8,950

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Role of an IndividualSelf-reliance

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Concept

Citizens to be responsible for themselves and take care of themselves.

Self-reliance

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Medisave(what is it?)

Medishield(what is it?)

How?

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Central Provident Fund (CPF)Employer

Contribution(15%)

Employee Contribution

(20%)

CPF

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Ordinary Account

(23%)

Special Account(7.5%)

MedisaveAccount

(9%)

CPF

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Medisave

Pay hospital bills &

medical treatment

MedisaveCPF

Saving Scheme

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MediShieldNational healthcare insurance scheme

MedishieldMedisaveCPF

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Why is Medishield required?

Isn’t Medisave sufficient?

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For people

• who need long-term treatment and

• who cannot afford their treatment fees or hospitalisation fees and

• whose Medisave cannot cover the fees.

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Self-reliant Singaporeans

The government

does not need to increase

taxes

This lightensthe

government’sload

Singaporeans pays for their

ownhealthcare

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ProblemDoes every Singaporean have CPF?

How are they going to pay for their healthcare costs?

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Role of the CommunityCommunity needs to provide healthcare and support services.

It is impossible for the government to run all of them.

Reason

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The Communitycan be divided into 2 categories.

Voluntary Welfare Organisations

(VWOs)

Private Organisations

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Voluntary Welfare OrganisationsExamples

Ren CiCommunity Hospital

St. Andrew’s Community Hospital

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Private OrganisationsExample

National Kidney Foundation Singapore

It caters to the needsof specific groups of people such as the poor or those with a particular illness.

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Role of the CommunityThey are given government grants to run

Community Hospitals Nursing Homes Day Rehabilitation

Centres.

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Role of the Government

Use limited resource

Provide public services

Meet the needs of the people

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Do you know?

has been allocated to MOH for FY2013 to

1. keep healthcare affordable and

2. promote good health.

$5.7 billion

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How does the government keep

healthcare affordable?

1

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Government Subsidies (to who?)

Medifund(what is it?)

Restructuringof Hospitals Means-testing

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GOVERNMENT SUBSIDIES

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The government gives direct subsidies to public general hospitals, polyclinics and some nursing homes for elderly.

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Lower income group receive the most subsidies.

High IncomeMiddle Income

Low Income

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The government gives different rates of subsidies to the different classes of wards in hospitals.

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Class Creceives the most in subsidies.

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MEDIFUND

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was set aside by the government in 1993.

$200 million

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TargetPeople who cannot pay for their medical feesdespite Medisave, Medishield and government subsidies.

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E.g. low-income workers, self-employed people who do not make any CPF contributions.

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People who need help apply for the fund at the hospital where they are being treated.

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RESTRUCTURING OF HOSPITALS

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Concept

Hospitals have the freedom to reorganise to meet the needs of the people

Restructuring of Hospitals

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Hospital becomes financially independent from the government where they have their own board of directors.

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Therefore, the government is able to reducethe amount of subsidies to hospitals.

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MEANS-TESTING

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Concept

Lower-income group will receive a higheramount of subsidies than the higher-incomegroup.

Means-testing

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Mean-testingDetermine if the patient is able to afford healthcare through a check on his financial background.

Monthly income Ownership of Private Property

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BeliefSubsidies should benefit patients who need them the most.

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The government gives heavy subsidies to polyclinics and government hospitalsespecially to class B2 and C wards.

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How does the government promote a

healthy lifestyle?

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Why?

By having health programmes in schools and workplaces

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Prevention is better than

Cure.

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The Great Singapore Workout

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How successful is the healthcare policies in Singapore?

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EffectiveProvide Singaporeans with the money to payfor healthcare

IneffectiveThere are still groups of people who are still not able to pay for their own medical expenses.1. Elderly2. People who are unable to work

How are they going to pay for their own healthcare then?

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SUMMARY

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SingaporeShared Responsibility in Healthcare

Individual

Self-reliance

Maintains good health

Community

VWOs

Private Organisations

Government

Keep healthcare affordable

Promotes a healthy lifestyle

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Individual

Self-reliance

Medisave

Medishield

Maintains good health

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Government

Keeps healthcare affordable

Government Subsidies Medifund

Restructuring of Hospitals Means-testing

Promotes a healthy lifestyle