Healthcare in Singapore is mainly under the responsibility of the Singapore Government's Ministry of Health. Singapore generally has an efficient and widespread system of healthcare. Singapore was ranked 6th in the World Health Organization's ranking of the world's health systems in the year 2000.[1]
Singapore has a modified universal healthcare system where the government ensures affordability of healthcare within the public health system, largely through a system of compulsory savings, subsidies and price controls. Singapore's system uses a combination of compulsory savings from payroll deductions (funded by both employers and workers) to provide subsidies within a nationalized health insurance plan known as Medisave. Within Medisave, each citizen accumulates funds that are individually tracked, and such funds can be pooled within and across an entire extended family. The vast majority of Singapore citizens have substantial savings in this scheme. One of three levels of subsidy is chosen by the patient at the time of the healthcare episode.
A key principle of Singapore's national health scheme is that no medical service is provided free of charge, regardless of the level of subsidy, even within the public healthcare system. This mechanism is intended to reduce the overutilisation of healthcare services, a phenomenon sometimes seen in fully subsidised universal health insurance systems. Out-of-pocket charges vary considerably for each service and level of subsidy. At the highest level of subsidy, although each out-of-pocket expense is typically small, costs can accumulate and become substantial for patients and families. At the lowest level, the subsidy is in effect nonexistent, and patients are treated like private patients, even within the public system.
The increasingly large private sector provides care to those who are privately insured, foreign patients, or public patients who are able to afford what often amount to very large out-of-pocket payments above the levels provided by government subsidies.
Approximately 70-80% of Singaporeans obtain their medical care within the public health system. Overall government spending on healthcare amounts to only 3-4% of annual GDP, partly because government expenditure on healthcare in the private system is extremely low.
Singapore currently has the lowest infant mortality rate in the world (equaled only by Iceland) and among the highest life expectancies from birth, according to the World Health Organization.[2]
Singapore has "one of the most successful healthcare systems in the world, in terms of both efficiency in financing and the results achieved in community health outcomes," according to an analysis by global consulting firm Watson Wyatt.[3] The government regularly adjusts policies to active regulate "the supply and prices of healthcare services in the country" in an attempt to keep costs in check. However, for the most part the government does not directly regulate the costs of private medical care. These costs are largely subject to market forces, and vary enormously within the private sector, depending on the medical specialty and service provided.
The specific features of the Singapore healthcare system are unique, and have been described as a "very difficult system to replicate in many other countries." Many Singaporeans also have supplemental private health insurance (often provided by employers) for services not covered by the government's programs.[3]
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Singapore’s well-established healthcare system comprises a total of 13 private hospitals, 10 public (government) hospitals and several specialist clinics, each specializing in and catering to different patient needs, at varying costs.
Patients are free to choose the providers within the government or private healthcare delivery system and can walk in for a consultation at any private clinic or any government polyclinic. For emergency services, patients can go at any time to the 24-hour Accident & Emergency Departments located in the government hospitals.
Singapore's medical facilities are among the finest in the world, with well qualified doctors and dentists, many trained overseas.
Singapore has a medical savings account system known as Medisave.
The Singapore General Hospital is the largest and oldest hospital in Singapore, of which the foundation of its first building was laid in 1821.
The Tan Tock Seng Hospital is the second largest hospital in Singapore after the Singapore General Hospital, but its accident and emergency department is the busiest in the country largely due to its geographically centralised location. Set up in 1844 by an entrepreneur and philanthropist, Tan Tock Seng, the hospital came into the international spotlight when it was designated as the sole treatment centre for the SARS epidemic which struck the country in 2003.
In the 1990s, all public hospitals were "restructured" which means that they have been operated as government-owned corporations rather than the typical model of public hospitals in other countries. There are two major healthcare groups operating restructured hospitals: SingHealth and the National Healthcare Group (NHG). There is also a smaller group linked to the National University of Singapore called the National University Health System (NUHS).
There is one psychiatric hospital in Singapore, the Institute of Mental Health, previously known as Woodbridge Hospital after its old location near a wooden bridge in Yio Chu Kang. It is now located in Hougang.
Patients warded in B2 and C class wards in public hospitals with effect from 1 January 2009 will be means-tested to determine the level of subsidy they will be entitled.
| Means testing in public hospitals as of 1 January 2009 [4] | ||||
|---|---|---|---|---|
| Average Monthly Income of Patient (SGD) |
Citizens Subsidy | Permanent residents Subsidy | ||
| Class C | Class B2 | Class C | Class B2 | |
| $3,200 and below1 | 80% | 65% | 70% | 55% |
| $3,201 - $3,350 | 79% | 64% | 69% | 54% |
| $3,351 - $3,500 | 78% | 63% | 68% | 53% |
| $3,501 - $3,650 | 77% | 62% | 67% | 52% |
| $3,651 - $3,800 | 76% | 61% | 66% | 51% |
| $3,801 - $3,950 | 75% | 60% | 65% | 50% |
| $3,951 - $4,100 | 74% | 59% | 64% | 49% |
| $4,101 - $4,250 | 73% | 58% | 63% | 48% |
| $4,251 - $4,400 | 72% | 57% | 62% | 47% |
| $4,401 - $4,550 | 71% | 56% | 61% | 46% |
| $4,551 - $4,700 | 70% | 55% | 60% | 45% |
| $4,701 - $4,850 | 69% | 54% | 59% | 44% |
| $4,851 - $5,000 | 68% | 53% | 58% | 43% |
| $5,001 - $5,100 | 67% | 52% | 57% | 42% |
| $5,101 - $5,200 | 66% | 51% | 56% | 41% |
| $5,201 and above2 | 65% | 50% | 55% | 40% |
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1. No income declare and property with AV below $11,000. |
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