An Analysis of the Healthcare Systems in Singapore and Finland

This essay undertakes a comparative analysis of the healthcare systems in Singapore and Finland, examining their funding models, governance structures, and key health indicators. It begins by exploring the diverse funding mechanisms in both countries, including government subsidies, insurance sc...Read More

Running head: HEALTH SYSTEM IN SINGAPORE AND FINLAND
HEALTH SYSTEM IN SINGAPORE AND FINLAND
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The healthcare is very dynamic as well as complex in the environment. Healthcare
leaders need transparency about the health system in order to deliver efficient and effective
health. To understand better the policies, health system and preventive measures, one needs
to understand another country in the same manner. The health system can be broadly
understood with the help of multiple elements starting from the funding system to governance
and until the quality of the health system (DeSalvoet al., 2016). The goal of this essay is to
understand the health system of Singapore as well as Finland. With the help of comparison
and differences between both the countries, health leaders and other stakeholders of
healthcare will be able to understand the status of the health system in the country.
The funding system of Singapore has multiple layers in the system. The appropriate
funding is very much crucial. A government needs to keep this sector as priority while
allocating budget for every segments. This multiple layer of system lead to participation from
governments, private employees or any individuals as well as the insurance company or
industry (Thomaset al., 2016). The first system is subsidies, here the government provides
subsidized testing or any diagnosis. Subsidies cover primary care, intermediate unitcare,
hospitalisation along with day surgery, outpatient clinics and many others. The second system
is Medisave, it comes under the central provident fund. Here individuals of Singapore build
their savings account for future needs of medical. They will contribute 7-8 percent of
monthly salary and can access the Medisave (cpf.gov.sg, 2020). The third system is the
Medishield. It is health insurance schemes. These schemes let an individual pay their bills in
large hospitals. The fourth funding system is Medifund, and it is a government endowment
fund. The fifth funding system is private insurance; it gives coverage for every patient to seek
treatment in private hospitals. There is another funding system like corporate healthcare
benefits or Insurance or any other preventive healthcare. All these schemes include in the
funding system of the Singapore health system.

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The health funding in Finland is done with the help of multiple sources. The first
provisional system is the municipal system, the national health insurance system and
occupational schemes. The fundamental financing is done with the help of local authorities
that comes under municipalities. The health system in Finland is decentralised. The
healthcare system is based on public healthcare services. There are multiple agencies under
the Ministries of social affairs as well as health. National Institute for health and welfare
(THL), Finnish Medicines Agency (Fimea), Radiation and Nuclear safety authority, Finnish
institute of occupational health and National supervisory authority for welfare and health
(Keskimäkiet al., 2019). There are some other key players in funding the health system of
Finland. Private organisation or companies, independent professional practitioners and other
reimbursement schemes. Another scheme under National health insurance, people of the
country can access free healthcare. In comparison to Finland, Singapore's funding system and
insurance scheme are different. It involved the government as well as individuals of the
country.
The government of Singapore has allocated around 10.7 billion to the sector of
healthcare. This sector has been spent the largest after education and defence by the
government of Singapore. The overall GDP is 4.47% in the sector of healthcare
(worldbank.org., 2020). With the funding rate in the health system, the infrastructure is going
to enhance. The government is planning to increase as a minimum of one hospital every two
years. The workforce will increase leading to increase healthcare professionals to provide a
high quality of care. The improvement in technology is necessary in order for efficient
diagnosis and treatment, and the investment b government will help in achieving it.
Additionally, the government has also expanded the safety of the health system.
The GDP of health expenditure in Finland is 9.493% (worldbank.org, 2020). The
largest areas include outpatient care, long-term care, and the inpatient care department along

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with the pharmaceutical department. Finland is focusing on technology and innovation to
enhance the quality of care.
Singapore's health system follows the three pillars of philosophy. The first approach is
building a strong population with the help of healthy routines. The second approach is living
a healthy life through the 3M system. That includes Medisave, Medishield along Medifund.
The third pillar is that the government keeps the cost of healthcare low for providing
accessible healthcare for everyone (Healthcare System in Singapore, 2020). The main
regulators in the Singapore health system are Minister of Health (MOH), central provident
fund (CPF), and Monetary Authority of Singapore (MAS). The major responsibility of MOH
is to regulate the services of health. It can be health education, awareness and prevention of
diseases, monitoring the quality of health services. All the funds and schemes including
saving plans are governed by CPF. There is three types of accounts in the CPF; those are
ordinary account, special account and Medisave account. MAS regulates the financial aspect
of the health system.
Finland has a decentralised administrative health system. The municipalities control
the core health system. The health system is governed by the parliament, government and
Ministry of Social Affairs and health (MSAH). Parliament and the ministries of social affairs
govern Social Insurance Institution as well as the municipalities and their federations.
Municipalities have the majority of responsibility to look after health centres, district
hospitals and private healthcare providers. Further, health stations and PHC or specialist
clinics work under the governance of municipalities. The major function and responsibilities
of the MSAH are defining as well as monitoring service quality, accessing along with
ensuring equivalent deliveries of facilities, determining the process of supplies for instance,
facility delivery or purchasing. MSAH is responsible for NHI, occupational health, medicines
as well as safety. They provide a track for making health policy along with preparing

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legislation and its implication. The regional government promotes the private and public
health. At the local level, the main responsibility of municipalities is to provide basic services
like primary as well as secondary education. Municipalities can often provide facilities with
the help of neighbouring municipalities (Tynkkynen et al., 2019).Federation of municipalities
include district hospital; they are administered as well as funded by the municipalities. Each
member of the municipalities must be a member of at least a single hospital. MSAH is also
responsible for a health information system. However, Finnish Institute for Health and
Welfare is regulating as well as providing guidelines. Health information is widely used to
understand as well as analyze the different targeted populations within the country. Both
countries have an effective health system. Finland has decentralised governance of
management in the health system. Most of the regulation is governed by the municipalities.
They play the entire core elemental role. On the contrary, Singapore has a different health
system compared to Finland. Singapore has joined and shared responsibility within the
government and individuals.
Population health indicators can be measured with the help of multiple elements. The
first element is the maternal mortality rate. The risk of death during pregnancy can be
represented with the help of the maternal mortality rate. Complication during pregnancy leads
to death as well as disability among women. A maternal death refers to the death of a woman
though pregnant before within 42 days of closure of pregnancy. Live birth means complete
extraction from its mother of creation of conception regardless of the extent of pregnancy that
later such separation shows an indication of life. For instance, beating of a heart or definite
movement of voluntary muscles. In Finland, the maternal mortality rate is three deaths per
one lakh live births in the year 2017 (who.int, 2020). In contrast to Singapore, the maternal
mortality rate of 8 deaths per one lakh live births in the year of 2017 (who.int, 2020).

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The infants' mortality rate is the amount of deaths under a single year of age
happening among the live births in a given geographic area per thousand live births.
According to the mortality rate of Singapore is higher as compared to Finland. The infant
mortality rate in Singapore is 2.3 per thousand live births (worldbank.org, 2020). On the other
hand, the infant mortality rate in Finland is 1.4 per thousand live births (worldbank.org,
2020).
Life expectancy at birth can be defined as the average measure of years that new-
borns could assume to live if they were to pass through life subject to the phase-specific
mortality rates of a given period. The life expectancy at birth in Singapore is 82.895 for the
year 2017 (worldbank.org, 2020). On the other hand, the life expectancy at birth in Finland is
81.429 as for the year of 2017 (worldbank.org, 2020).
Population health indicators help in measuring the effectiveness of the health of a
particular nation. These indicators give the idea of health status for a particular country. It can
be measured with the help of calculating the mortality rate such as maternity mortality rate,
infants mortality rate and life expectancy at birth. It helps in understanding the concept of
mortality and will work in preventing or avoiding these rates. The major reflection of
population health indicators is analysing the performance of healthcare services as well as the
characteristics of populations. Singapore and Finland have different rates of mortality rate in
all the aspects. It can be understood that Finland has a lesser mortality rate as compared to
Singapore. In both the indicator, maternity mortality rate along with infant mortality rate,
Singapore needs to focus on reducing the rate of mortality. However, Singapore is having
more life expectancy at birth as compared to Finland. Health leaders must work to ensure to
improve the quality of population health with the improvement of quality measurement.

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Low birth weight infants rate are those whose weight is below 2,500 grams. In
Finland, the percentage of low birth weight is 4.1 percent in the year of 2015. If considers in
numbers than 2.4 numbers in thousands. On the other hand, Singapore has 9.6 percent and 4.8
numbers in thousands of low birth weight infants (who.int, 2020).
Obesity can be defined as having a body mass index of thirty or more than it has.
Singapore's obesity in males is 6.1 percent and in females 7.4%. These results in gives a total
amount of 6.8 percent (Singapore Mortality, 2020). On the other hand, Finland has obesity in
a male of 23.4% and in a female is 22.2 percent, which gives a total amount of 22.8 percent
of obesity (Finland Mortality, 2020). Diabetes is a male in Singapore is 10.7 percent and in
the female with 7.7 percent, that gives an overall of 9.1 percent. On the other hand, Finland
has diabetes in a male of 8.7 %, and in a female of 6.8 %, that gives an overall of 7.7 percent
(Vandersmissen & Godderis, 2015).
In the year 2017, Singapore reached 5 percent of the population diagnosed with
asthma. On the other hand, Finland 0.21 percent of total death due to asthma (Metsälä et al.,
2018). Hypertension leads to critical health difficulties, along with it increases the threat of
heart disease. High blood pressure is an alternative name for hypertension. The major risk
factors are tobacco smoking and may others. Singapore has around 10% to 15% of the
population who suffered from high blood pressure. On the other hand, Finland hasa high risk
of blood pressure with a high blood sugar level. Around 40% of the population has faced
raised blood pressure (Keskimet al., 2020).
In the year 2018, the total number of cancer patients 26,164 has been registered as
new cases. In addition, about 13,093 deaths have occurred due to cancer (International
Agency for Research on Cancer, 2020). On the other hand, Finland has 33,271 number of
new cases due to cancer. In addition, it leads to the deaths of 12,749 people (International

7HEALTH SYSTEM IN SINGAPORE AND FINLAND
Agency for Research on Cancer, 2020). Understanding the health system priority area is very
much essentials. In order to have a clear vision about the health system of the country, these
indicators give an overview of the status of health in that country. It also delivers equivalent
as well as actionable information across the priority area of the region. Comparing both the
countries of Singapore and Finland, Singapore has a lower rate of obesity and a lower rate of
hypertension. However, it is important to understand and enhance the reduction in those
areas. On the other hand, Singapore has a higher risk of these factors, that is cancer, and low
birth weights of infants, diabetes, along with asthma. Health leaders and governance must
understand these critical areas and improve in these priority areas. These priority areas need
to be addressed on an urgent basis and need to overcome it.
The management of quality and safety towards health is very much crucial. Many
health leaders and ministries of health have taken multiple steps in order to meet the
requirement and set the quality as well as the level of safety as a priority. Ministries of health
in Singapore works with multiple healthcare institutions to improve the quality and deliver a
high range of quality care (moh.gov, 2020). They provide the best facility in order to
maintain the safety of the patients and to ensure that it will remain sustainable for the
population. Singapore works with multiple approaches to ensure the effectiveness of quality
as well as the safety of the health system. With the help of enabling the provision of best
practices from the exploration of causes that contributed to severe adverse measures across
institutions. This is to stimulate learning as well as the prevention of the occurrence of similar
incidents across the healthcare system. Management of quality and safety is done with the
help of programming that maintains the initiative towards a large scale as well as a systematic
range of quality development initiatives inside the healthcare system. The management and
administration of the health system in Finland consists of different levels that are state, a
province along with municipality (Trade.gov, 2020). The management is very fine in Finland.

8HEALTH SYSTEM IN SINGAPORE AND FINLAND
They have cost-effective deliveries for the system. The system is qualitative and safe as they
have efficient numbers of available scientists as well as engineers and effective numbers of
healthcare professionals. The management of R&D professionals is efficient and the number
of such professionals is increasing (Keskimäki et al., 2018). The efficient management
increases the quality and safety with the primary preventions, by getting better in a priority
area, with effective system design and policy.
From the above discussion, the priority area of Singapore and Finland is clearly
understood. Both countries have major different governance of the health system. Finland is a
decentralised health system and Singapore is a joint health system including government as
well as an individual. The funding and GDP of both countries are different. Population health
indicators and health system indicators have been addressed. Both the countries are working
towards bringing more efficient quality as well as safety to the health system. Governments
are playing a significant role in achieving the quality of care. However, the priority area in
the respective country must be addressed and the steps towards monitoring those areas are
necessary. All the professionals of healthcare system need to be well informed as well as
worried about the quality of care.

9HEALTH SYSTEM IN SINGAPORE AND FINLAND
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