Singapore's Universal Healthcare System: An Overview

This report provides an overview of Singapore's healthcare system, focusing on its universal healthcare model. It examines the various policies and principles implemented by the Singaporean government to ensure accessible and affordable healthcare for its citizens. The report details key schemes such as Medisave, Medishield Life, Medifund, and ElderShield, highlighting their roles in financing healthcare and providing financial support to individuals. It also discusses the role of the government, including the Ministry of Health, Central Provident Fund, and Monetary Authority of Singapore, in regulating and managing the healthcare system. Furthermore, the report emphasizes the concept of "Health for All" and the significance of primary healthcare centers in achieving universal health coverage. The report concludes by discussing the fairness of the health system and the measures taken to promote it, with a focus on ensuring equal access to healthcare services for all residents. This report is a valuable resource for students seeking to understand the complexities and successes of Singapore's healthcare system.

INTRODUCTION TO HEALTH SYSTEMS 1
Title-Introduction to Health Systems
Assignment Name
Student Name
Course Name and Number
Professor
Date

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Contents
Purpose........................................................................................................................................3
Introduction..................................................................................................................................3
Policies and Principles.................................................................................................................4
Health for all................................................................................................................................6
Role of Government....................................................................................................................8
Fairness in health system.............................................................................................................9
Conclusion.................................................................................................................................10
References..................................................................................................................................11

INTRODUCTION TO HEALTH SYSTEMS 3
Purpose
The purpose of this project is to through some light on the Universal Healthcare systems
in country like Singapore. The purpose of Universal healthcare system is to provide the equal
and essential health services to all individual. Both private and public health care centers are
running which has the responsibility for assessing the health needs and providing equal service to
public. Various policies and principles are laid down and followed by people to make this system
stronger.
Introduction
Universal Health system simply means that people should have easy access to healthcare
centers and to the health care services they require without any financial hardship. In other
words, it ensures that everyone in the society can make use of the health services available to
them at the time they need they most.
Health care in country like Singapore is mainly under the Singapore Government and
Ministry of health and is one of the most successful healthcare systems in the world, in term of
both financial efficiency and the good percentage of result achieved in the health outcomes
services. Singapore, in contrast to most countries in the world, spends an average of 3.7 percent
of its GDP on healthcare; as a result it has impressive outcomes. Health care system in Singapore
is one of the most efficient and widespread system of health services. Singapore is the country
where the government ensures the public affordability through a system of compulsory savings,
policies and subsidies. Some of the common schemes and subsidies include :- Medifund,
Medishield life, Eldershield and many more.

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Policies and Principles
According to World Health Organization (WHO), Singapore’s health care is ranks sixth
in the world and also stands fourth in the best healthcare infrastructure in the world. Singapore is
known as the repudiated healthcare hub worldwide and center for healthcare excellence as it
offers first class healthcare services, facilities and systems to both its resident population as well
to the international patient also.
Ministry of health under Singapore’s Government is responsible for the formulation and
implementation of all the policies and programs for development and regulation of all health care
product and services. They aim to provide one high quality health services to its patient focusing
on the strong clinical facilities and cost effective services. From the past ten years, health sector
here has seen a recommendable growth with more health facilities and technique and the use of
latest technology and clinical equipments (Mitchell, 2015). Same in policies formulation has also
changes in the span of ten years accordingly, formulated to provide the best healthcare and
financial support to the patient at the time of an illness.
The Singapore Government plans built and formulate and maintain the nation health care
services(Lim, 2017). Both the public and the private health industries are maintained by
government. Some of the important policies and schemes are discussed below framed and
implemented in the last ten years:-
Medisave :- It is the compulsory individual medical scheme. It is a national medical scheme
which uses a combination of compulsory savings from payroll deductions, which helps the
person to put aside a part of the salary into their Medisave account to meet future medical needs
for hospitalization for themselves or for their immediate family members. It covers many

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diseases and also some chronicle diseases. Medisave use for chronicle disease was launched in
Oct 2006.In this scheme, for bill patient will pay 15% in cash and the rest amount will be paid
using Medisave. Amount can be claimed only of the patient is admitted for at least 8 hours in a
hospital.
Medishield life :- This policy was implemented on 1st November 2015. It is a health insurance
scheme that helps the policy holder to meet the medical expense for major and prolonged illness,
that the medisave balance would not be sufficient to cover. It covers the people of all age groups
and the premium is paid by insured through medisave. Residents of Singapore are automatically
covered in this for whole life. The Government of Singapore supports the cost of extending
Medishield life coverage to those patients who suffer from serious pre-existing condition. These
patient needs to pay only 30% Additional premiums for 10 years. If the medical condition
prevails after the start of individual’s Medishield cover that is not covered under pre-existing
condition and is not subjected to additional premiums.
Medifund :- It is a type of Government endowment fund set up to help the residents of
Singapore. This fund was set up to provide financial aid to the patient who has received a
treatment from Medifund approved hospital or institution but face difficulties in affording the
remaining medical expense after receiving Government subsidies and schemes and drawing on
the other means of payments like Medishield life, Medisave and cash or any other private
policies.
In Short, Medishield, Medisave and Medifund work together to reduce the out of pocket
payments for an Individual.

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ElderShield :-All the Singapore’s residents with Medisave accounts are automatically enrolled
in this ElderShield program once they are 40 in their age. There is no exclusions of pre-existing
coverage if the individual in auto-covered in this. It can be opted out also. It is basically an
insurance scheme which aims to provide financial protection and support to the patient who
needs long term treatment and care mostly when they attain seniority in age .This scheme was
launched in year 2005. Under this, in the case of severe disability policyholder can also receive
the monthly payout in form of cash for a particular period of time depending upon the
ElderShield plan they have opted.
IDAPE: - Known as Interim Disability Assistance Program for Elderly. It was launched in
2005.It is a Government assistance scheme that provides financial help to needy and disabled
senior citizens, who are not eligible to join the Eldershield program due to maximum age entry
or have pre-existing disabilities.
Community Health Assist Scheme:- It was introduced by the Ministry of health in Singapore in
year 2012. This scheme was meant for Lower to middle class individuals. Various income slabs
are fixed by department to include the people under this program .Individual whose income was
higher than the slab was not included in this CHAS scheme.
Health for all
The health care system in Singapore is considered as the world class .Over the past, in the
span of ten years Government of Singapore has put quality and best health services in place,
making them affordable to the general public for the best health services at all age level and
supporting them at the time of financial hardships and old age. Ministry of health in Singapore is
working on the twin philosophies in their country i.e. to make healthcare affordable to all and

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taking the individual responsibility (Tan, Tan, Bilger & Ho, 2014). In other words, making the
health care policies and schemes more transparent to the public and at the same time making
proper us of funds collected for best adoption of technologies to improve the delivery of the
healthcare services.
Singapore have evolved a mixed financing system, offering the best protection to its
residents with healthcare schemes and subsidies to ensure that no resident can deny any access to
health care because of financial hardships and affordable issues. These schemes and policies are
planned in such a way that even the major illness and treatment at every age level is made
affordable to the patient in best hospitals and healthcare centers covered under the policies
(Tonsing, 2017).
The concept of Primary health care centers has helped the Singapore’s Government attain
that level where they stand today as per World Health Organization (WHO).International
Conference on Primary health care was held 30 years ago in Alma-Ata in a conference on 1978
headed by Dr. Halfdan Mahler, WHO director-general at that time. Their approach behind this
was simple i.e. to achieve the goal of “Health for all”. This conference was held by the health
organization of the Leagues of the nation-World Health Organization (WHO), recommended that
the primary centers will be the greatest benefit to people specially in rural areas and low class
people as the healthcare services will be made available to patient at the small cost. Primary
health care is all about providing the essential heath care treatment which is easily accessible by
the patient and the family members in the community or the area where they work or resides.
Therefore, Primary health care centers are opened by local government and the health
department in the smaller areas or villages and even in the near about places in the city and

INTRODUCTION TO HEALTH SYSTEMS 8
societies. As per the World Health Organization (WHO), health report in 2008, Primary health
care approach is the most efficient, fair and cost effective way to organize the health care system.
The World Health Organization (WHO), defines Universal Health coverage as a means
where the patient gets the health services, without any thought and without any financial thought.
Timely access to health services is crucial and important in promoting and sustaining good
health(Temkin, 2014). At the same time, health care system is linked to financial system and
support provided by the government comprising medical saving, insurance and government
subsidies to offer protection against unpredictable high expenditures and hospitals bills.
Role of Government
The three main regulators in Singapore that have made it possible in period of last five to
ten years are Ministry of health (MOH), Central Provident Fund (CPF), and Monetary Authority
of Singapore (MAS). Ministry of health is in charge of the regulation and the provision of the
health care services. Its works on promoting the education on health among the people, to make
people more aware about the health care system and services available to them. MOH also works
on monitoring the accessibility and the quality of healthcare services. It also regulates the
allocation of the resources and administrating the licenses required for more health care units.
CPF i.e. Central provident fund is a compulsory saving plan enrolled by the government
for its residents to support them financially and in old age at the time they need the health
treatment and guidance the most. Workers and Employers in Singapore are required to make
compulsory monthly contributions from their income into three CPF’s account, ordinary
accounts, special accounts and Medisave accounts.

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MAS i.e. Monetary Authority of Singapore is like a central bank, which regulates the
insurance sector and plans(The Lancet, 2012). The Insurance department of MAS works under
Insurance Act that regulates various schemes and activities including registration and providing
the required license.
Government at the center plays an important role in regulating the health schemes and
polices(Saxena, 2009):-
Government strategy:- It aims to nurture a healthy nation. Government and local government
conduct various seminars and counseling programmes to educate about the health and the
benefits of the policies.
Good and affordable medical services:- Government has many specialized centers and
hospitals as per the schemes and subsidies ,that provide health care and funds are backed by
the government.
Good practitioners and doctors should be available at the health care centers and hospitals.
Governments to support this make the best techniques and doctors available from around the
world so that patient gets the best treatment and diagnosis (Courtemanche & Zapata, 2013).
Fairness in health system
Universal Health care aims to provide the best health services the patient need at the time
of illness and end to end care especially to senior citizens (Santos, 2015). Promoting the Universal
Health coverage has always been the important part of Singapore’s overall development. Some
steps to promote and keep the health system fair in Singapore are:-

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Increase in the use of appropriate copayments methods in healthcare. In case where the funds
are to be used from various public schemes and subsidies proper method should be
implemented so that the patient and the other family members does not face the financial
hardship(Su-Yen, Horn & Mong, 2015).
Focus on preventable disease. Although policies like Medisave, Medishield and IDAPE
cover the pre-existing illness and chronicle diseases (Boerma, AbouZahr, Evans & Evans, 2014).
Government should focus to cover more and more diseases under the schemes so that the
patient gets the appropriate heath treatment under the same schemes.
Monitoring and evaluating UHC. Government on timely basis should monitor the universal
health care systems and schemes (Mohan, 2010). As well as keep a check on the areas of
intervention which could help in improving the health of the patients and timely improves the
health schemes and system.
Conclusion
The country like Singapore is blessed with a strong foundation in health system and its
development. Singapore has a range of policies and schemes that support good health care
system. In future, focus will be on strengthening the primary health care networks, and an
increasing collaborations with partners and other insurance providers company so that the health
care system will be able to provide better care for the patients need. If Singapore is successful in
ensuring that these health benefits will grow and provide a reliable health solution to the public
at large, this aspect of Singapore’s health financing system will be instructive and a guiding tool
for other countries as well.

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References
Boerma, T., AbouZahr, C., Evans, D. and Evans, T. (2014). Monitoring Intervention
Coverage in the Context of Universal Health Coverage. PLoS Medicine, 11(9),
p.e1001728.
Courtemanche, C. and Zapata, D. (2013). Does Universal Coverage Improve Health?
The Massachusetts Experience. Journal of Policy Analysis and Management, 33(1),
pp.36-69.
Lim, J. (2017). Sustainable Health Care Financing: The Singapore Experience. Global
Policy, 8, pp.103-109.
Mitchell, P. (2015). Nursing and universal health coverage. International Nursing
Review, 62(3), pp.283-284.
Mitka, M. (2007). Universal Health Coverage. JAMA, 297(6), p.581.
Mohan, M. (2010). Singapore and the Universal Periodic Review: An Unprecedented
Human Rights Assessment. Journal of East Asia and International Law, 3(2), pp.5-5.
Mohan, M. (2010). Singapore and the Universal Periodic Review: An Unprecedented
Human Rights Assessment. Journal of East Asia and International Law, 3(2), pp.5-5.
Santos, L. (2015). Universal Health Care Systems: Universal Access or Universal
Coverage?. Journal of Business & Financial Affairs, 04(03).
Saxena, A. (2009). Transforming Singapore's healthcare delivery system: health care
integration in Singapore. International Journal of Integrated Care, 9(6).
Singapore - Grandparents key to nurturing healthy habits in children.
(2013). International Journal of Health Care Quality Assurance, 26(4).
Singapore - Singapores one patient/one record plans on track. (2010).’ International
Journal of Health Care Quality Assurance, 23(1).
Su-Yen, G., Horn, L. and Mong, B. (2015). Diabetes Care in Singapore. Journal of
the ASEAN Federation of Endocrine Societies, 30(2), pp.95-99.
Tan, K., Tan, W., Bilger, M. and Ho, C. (2014). Monitoring and Evaluating Progress
towards Universal Health Coverage in Singapore. PLoS Medicine, 11(9), p.e1001695.
Temkin, L. (2014). Universal Health Coverage: Solution or Siren? Some Preliminary
Thoughts. Journal of Applied Philosophy, 31(1), pp.1-22.

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The Lancet (2012). The struggle for universal health coverage. The Lancet,
380(9845), p.859.
Tonsing, K. (2017). A review of mental health literacy in Singapore. Social Work in
Health Care, pp.1-21.