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January 27, 2009
Singapore’s health system saves money and lives

The U.S. spends nearly 17 percent of its gross domestic product on health care, while Singapore spends about 4 percent of its own GDP. According to the World Health Organization, Singapore has one of the best health care systems. The country’s 4 million people are required to save a portion of each paycheck, which then goes into an interest-bearing savings account used to pay future medical bills.

Worldfocus special correspondent Daljit Dahliwal and producers Mary Lockhart and Ara Ayer report from Singapore’s hospitals.

Watch an extended interview with Singapore’s Minister of Health on the fundamentals of Singapore’s world-renowned health care system.

Below, bloggers compare Singapore’s health care to other global systems.

An American blogger at “Everday Singapore” compares her experience going to the doctor in the U.S. and Singapore, saying that she receives more attention in Singapore because there are less patients.

The “Health Beat” blog writes that Singapore’s health system is a valuable example for other nations, though such a system might not be sustainable were it transported to the United States for economic reasons.

Blogger “Bryan Caplan” examines the statistics and concludes that Singapore has achieved American health outcomes for about a quarter of the cost.

Blogger “cbernard” analyzes the Medisave system’s effectiveness.

A blogger at “Dissidia” describes her stay at Singapore General Hospital and posts images.

The “Singapore Life and Times” blog writes that locals feel hospital charges are too high, and that the hospitals seem to be purchasing overly-expensive items.




As a doctor currently working in a Singaporean hospital (having recently returned from working in the Australian health care system) – I can definitely attest the system in Singapore, for all its meeting perfomance targets, is certainly not patient-oriented or in the best interest of the average patient unless you happen to be middle-class & have family and sufficient CPF/Medisave. Patients in Singapore have access to little, if any, support at all from the state).
In the hospital system’s daily workflow, discharging patients is a priority (often at the expense of ensuring the individual patient’s well being before discharge). I have seen countless patients’ initial medical issues being inadequently investigated or treated due to the greater priority on patient discharge rate to ensure turnover rate (hence “key perfomance indicators” are met for economic analyses).
And make no mistake – unless you have family or savings to support you, there’s only paltry (if any) support for critical illnesses (e.g. cancer, etc) from the government due to their strict anti-welfare state mentality.
In short, despite the widespread claims and shiny new buildings – Singapore’s health care system is definitely NOT anywhere near that of a first world standard. At least not to the average patient in the public health system – those in the lower income earning strata- whose needs are very marginalised and largely ignored.


I can’t believe the crap i hear about Singapore’s healthcare. Lets start with the fact that our system is ranked 6th by WHO whereas USA’s is like 37th.

To say that our healthcare system is only available to the rich is hocus pocus bullcrap. The fundamental belief of our system is to provide affordable,reliable,quality and service where healthcare is concerned to Singaporeans. As an asian, there is this common saying “Health is Wealth”. The govt invests our taxations into healthcare is also for the fact that they understand we are a nation with limited resource other than its population (people)… to ensure a reliable healthcare system is to ‘invest’ in the well-being of the Singapore work-force.

No, we’re not paying cheap to get more. Cost is low is coz we’re maximizing every dollar that is spent wisely on investments. Basically we cut waste. Our administration is fully computerised, something that Americans reject coz they feel ‘oh god…govt got control of me’ paranoid. The key to our system is not ‘cut cost’….rather its ‘cut stupid wastage’ with common sense applied.

For many years, we have people from abroad who do come over for specialised treatment packages. People from as far as the US, Middle East, Europe and Asia. Ofcourse they pay a higher than norm rate coz they aren’t citizens to being with.

I can confidently say, noone has been turned away from treatments…specialised, general or exmergency if they can’t afford it. You don’t have to fight it out with insurance companies about what you’re allowed for. Private Insurance are supplements to the basic medicare-like programmes here hence that keeps costs to a very very reasonable minimum with regulations preventing exploitation or descrimination. Yes, we have laws protecting us.

And please… lets not get into which country got the best doctors. Thats a different topic altogether. We have some of the best in cardiological, nerological, cancer research centres on the world-stage and that just to name a few. No country single-handedly has everything! Each healthsystem and the availability of its specialised care is setup uniquely based on individual country’s needs….for example, whatever is a common ‘killer’ illness to Singaporeans, we have all that is needed preped up.

And about doctors pay here. Put it this way. If these docs think what they get here sucks and that money is more divine than the services they render to save people’s lives… they can jolly-well head to the US to earn their big-bucks. We would have a mass exodus of doctors a long time ago had your claims stand true. We don’t take the belief like those of a typical american that thinks healthcare is a commodity like that of a hamburger restaurant. Healthcare is NOT a privilledge or just a mere product to us.

As a citizen, i have my gripe about certain things in our healthcare system…. and we will always complain about it even if it improves. Coz having it good doesn’t mean we just stop as is…. it can and will must always be even better.

A rank of 6th in the world isn’t good enough. Even if its 1st. We will go on and on demanding for more improvements.


A note I wrote to Sen. Cantwell, based in part on this segment:
I have made some terrible choices in life. Recently, I’ve chosen to work in the nonprofit sector, working to help people with even less than I have to survive and thrive despite living with HIV or chronic hepatitis.

My salary is small–and the organization too small to provide coverage. A terrible choice, eh? So I have no insurance and am living with Hepatitis C.

In my work, I’ve worked with hundreds, perhaps thousands. I have watched so many suffer and die–and far too often, needlessly.

We need HR 676–like every other industrialized nation. HR 676 is clear, concise and makes sense.

Insurance companies and pharma have charged “what the market will bear” for far too long, resulting in what some of us think of as a “soft” form of economic genocide. The effects ripple around the world–it’s not just Americans who suffer!

It is time for change, for courage, for evolution. We have very few opportunities left to make a credible and powerful difference in the way our species looks at this world.

Health care is one piece of that–and our health is dependent on our environment. Global warming warns us that the waste, greed and frivolity of the very wealthy, of the big corporations, represent an old way of thinking. One that is extraordinarily dangerous.

Providing a choice for a robust and vigorous public option as outlined in HR 676 reflects a piece of that shift in thinking.

We no longer have a choice about this. We MUST grow up, swiftly, as a species. We must learn to care for each other and our world.

Or we are on our way to our own self-inflicted extinction.


One thing that is not mentioned is that costs are capped by the government. The lower prices given for the named surgeries is because they are set by government. Doctors income is kept much lower than here, drugs are purchased without the huge markups that pharmaceuticals here get, and all hospitals and other services are non-profit. There are no managed care organizations (HMOs) adding cost as there are in the US.

Taking the profit and more importantly excessive administrative costs out of medical care will reduce our costs immediately.

We can have good health care here in the US if we wanted. We have great care by the VA but they are strapped for funding so there are long delays and inadequate care for brain and mental disorders because of poor planning and budget cutting. The VA pays very low prices for medications and medical devices because they have great purchasing power as a very large group.

Incidentally, the VA is true socialized medicine. Medicare is a true single payer plan with no restrictions on Doctors, etc, BUT the fancy costly Medicare Advantage Plans are all for profit HMOs which limit the choice to that plans Doctors and hospitals.

Advantage Medicare plans cost the government (that’s us, folks) 14% to 18% more plus what they rake in from their client base. There is that profit and absurd administrative costs (which include multi-million dollar salaries for top executives).

We can do a lot better than the Singapore health care system.


As someone who has lived in both the US and Singapore, I must say the reporters did not do a good job of reporting the true situation in both countries. For basic medical treatment, a Singaporean goes to a polyclinic. There, you can wait for hours to see a doctor who rushes through your case because of the patient backload. In the US, such occurs only for the very poor. If you have medical insurance, the wait in the US is long, but not comparable to the wait in Singapore.

Our hospital wards are divided into different categories, where the poor can stay in a place with 8 beds in a room, all separated by thin screens. When we were warded in an American hospital, we had a private room, even though our income at the time was much less than in Singapore.

There are arcane rules governing how you can use the government sponsored insurance. A relative of mine could claim nothing for a prostate cancer operation because he was discharged from hospital after a short-period of time (two days)- even though the bill ran to tens of thousands of dollars. In the US, our child was fully covered for everything including special immunizations, because the state of Atlanta had a law mandating insurance companies provide comprehensive coverage for children.

Our local insurance is in no way as comprehensive as in the US. Insurers here only cover the “36 major illnesses.” If you have some other illness, it’s not claimable.

The poster who described the different treatment between rich and poor was right. I would invite the reporters to (for example) visit the Kallang Kerbau Hospital (KKH), where the divide is very stark. This GOVERNMENT RUN HOSPITAL has two gynecological waiting areas. One for the poor, which is crowded, and where waiting times are long, and one for the rich which is comfortably decorated, with short queues, and many more nurses.

My experience with US vs. Singaporean medical care is American medical practice is much better than Singaporean. For example, American nurses are better trained than Singaporean ones. Indeed, an American gynecological nurse in many ways is as skilled as a Singaporean gynecological doctor. Both, for example, take advanced degrees to become licensed for their practice. An American medical degree is an advanced degree. A Singaporean one is equivalent to a bachelor’s- the degree of a nurse. Both perform similar roles- delivering babies. The caveat is that American medical practice is more cautious. One receives a whole battery of useless tests, basically to absolve the medical practice from liability.


It is possible to spend less to get more? Obviously not. The truth is that Singapore’s good healthcare is only accessible to those with the money. Medical tourists will find the healthcare excellent.

For the locals, the norm is to have one room to 8 patients, and the wait to be examined by a specialist doctor take months. There is the local saying that it is better die than to fall sick in Singapore.


the devil is in the details. taking thing in face values is foolish


Singapore only take care of the rich. The compulsory saving mention is this article fail to comment that most singaporean could not afford the medical care in the island and the buzz here among locals is that it is cheaper to died in singapore than to fall sick !


Thank you for the story. We cannot underestimate the negative impact the healthcare and pharmaceutical lobbyist’s have on our system.


Good story. I passed a link to this story on to the Obama administration.


Singaporians may have greater access to health care; but do their doctors live in exhorbitant homes like American doctors? According to the Hippocratic Oath, medical doctors must drive expensive German cars, play golf in exclusive country clubs, take mandatory winter vacations in Hawaii, and have box seats at Yankee Stadium.

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