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Singapore is known for its cleanliness, commitment to sustainability, and its unique blend of natural and modern design. Recently, it’s been calling more attention in its direction for being dubbed the “6th blue zone”. This refers to a place where people are living longer than the average.

However, the other blue zones are benchmarked against longevity criteria rooted in their history and cultures. So, how exactly does Singapore (a land of futuristic, well, everything) operate in the same league as the more tradition-inclined nations? Well, in contrast, Singapore earned its rank by way of engineered changes applied over time.

Sure, the state became more walkable and mandated healthier food choice labels, among other things. However, we want to spotlight their advanced healthcare that is on par with other innovative countries. What did they do differently – unlike the rest – to up someone’s chances of living longer?

A longer lifespan seems like a pipe dream when our healthcare systems are unsustainable

Singapore has a population with an astounding average life expectancy of 85.2 years (5.2 years more than the U.S.). If this does not call for a lesson in Singapore’s longevity classroom, then we don’t know what will. The nation wholeheartedly applies universal health coverage (UHC) to its system, much like most countries (despite varying standards). But they go about achieving it without breaking the bank.

Firstly, universal health coverage aims to keep disease burdens to a minimum by allocating enough funds toward medical care. It has been shown that investing in this area can improve productivity levels, protect household incomes, and keep poverty at bay.

Accordingly, the UHC system seems like a well-oiled machine and it has served well for the last few decades. Only, inevitable industrial progress may threaten to derail. It is forecasted that expensive medical devices, testing, etc. will create long-term economic setbacks.

How can the essence of universal health coverage remain intact with the impending costs of technological advancements?

World-class healthcare at bargain-basement costs? Singapore says it’s not too good to be true

Certainly, healthcare exhibits a sensitive interplay with the overall stability of a country and its people. With that in mind, it’s rather baffling that Singapore spends only 3% of its gross domestic product (GDP) on its (impressive) healthcare. That is relatively low compared to the rest of the world. For example, the UK’s expenditure sits at 8%, while the USA’s is at a whopping 16%.

Hence, how on earth are Singaporeans accessing superior quality health outcomes (for cheaper) and living longer? According to a published journal on Science Direct, policymakers have been advised to adopt more of a mixed financing system for health care to ensure economic sustainability in the future. But there’s a chance that Singapore inspired this solution.

Instead of reinventing the UHC concept, Singapore tweaked its delivery 

A UHC healthcare system (like the NHS in Britain, for example) makes its services accessible on the grounds of need as opposed to being able to pay for it. In other words, a tightened bank account should not impede a person’s admission into a doctor’s office. It sounds like a righteous tenet to us.

Arguably, healthcare appears as “free” to citizens in countries that have adopted this medical infrastructure. However, Singapore’s politicians observed a fatal flaw in this outwardly “free” healthcare (which, in any case, people pay for indirectly through high taxes).

“Free” anything tends to blur demand limitations and tempt overuse, which is unsustainable. This well-intentioned welfare model is left with no choice but to enforce price controls and rationing, which in turn leads to other disruptions.

Naturally, Singapore’s skepticism begs the question: do they have a better solution? Possibly. The stats mentioned earlier compel our inquiry. The nation encouraged individual responsibility and free market input. This steered the creation of both private- and government-subsidized hospitals. However, the former (individual responsibility) is the real backbone of their medical care model.

Your taxes go into your own healthcare savings account

In one sense, Singapore is similar to the other countries that provide UHC. Most hospitals are government-owned, and you pay a tax to receive healthcare. Only living in Singapore means your taxes go into your medical-focused savings account to be spent by you, as needed. How do they do this, though?

The government achieves UHC with a mixed national medical insurance system. The Singaporean public and the state itself have combined accountability for the nation’s healthcare.

The state funds only about a quarter of the total healthcare expenses. Each resident pays for the remainder – via their contributions to the national life insurance programs and schemes. These are known as the 3M’s (Medisave, MediShield, and Medifund).

  • Medisave is a mandatory medical savings account, which typically covers routine medical appointments.
  • MediShield is an affordable opt-out financial security plan against catastrophic illnesses that may deplete a Medisave account.
  • Lastly, those who cannot afford to pay their medical expenses have the Medifund to turn to. The government set it up to endow medical funds for individuals who do not have the means.

Receive medical care without fearing the financial burden

According to a journal in The National Library of Medicine, a rise in chronic diseases has led to the phenomenon of multi-morbidity. This is when two or more lifelong diseases are present in an individual. Multimorbidity has raised concern over the high medical fees to treat multiple ailments. Therefore, if we want people to live longer (and well), then they need to be able to seek care without the dread of footing the bill.

Singapore’s medical insurance programs seem to spare people of a hefty financial load. The Medisave program provides assurance and rewards individuals for looking after their health. It prepares citizens for those health-related things that are going to happen (think blood tests and vaccinations). Every employee sets aside 8-10.5% of their monthly salary (under obligation) into this savings account. Of course, coverage can be extended to the individual’s spouse, children, and parents. Additionally, Medisave is tax-exempt and any unspent funds remain in the account. The account holder’s heir can also inherit it.

Moreover, MediShield provides insurance. It acts as a security net in case you experience those less likely (but still possible) threats to your health. A devastating car crash or undergoing cancer treatment may completely wipe out your resources. Fortunately, MediShield liberates you from carrying the full financial weight alone.

We can certainly learn from Singapore’s remarkable healthcare system

Most places could probably take note of Singapore’s ostensibly bulletproof modus operandi. For example, the U.S. healthcare model could strike up more of a private-public balance. Canada’s Medicare could put an end to limiting the supply of physicians (which means fewer long waits for certain services). Overall, people should not have to forgo hospital visits to avoid the knock of possible financial hardship.

Certainly, there are actions individuals can take for themselves to look after their health. However, a concerted effort to make medical care more accessible and affordable may bring about extra beneficial outcomes.

Main Photo image credit by Coleen Rivas on Unsplash

References

Bloom, D; Canning, D. (2010, August 3). The Health and Poverty of Nations: From theory to practice. Taylor and Francis Online. https://www.tandfonline.com/doi/abs/10.1080/1464988032000051487.
Chen, L.C.; Phua, K.H. (2013, September 14). Transferring lessons from Singapore: an art or a science?. The Lancet. https://www.thelancet.com/article/S0140-6736(13)61921-2/fulltext.
Hruza, G.J. (MD). (2020, September-October). A Prescription for World Class Healthcare at Rock Bottom Cost!. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723141/.
Larkin, J.; Foley, L.; et al. (2020, March 26). The experience of financial burden for patients with multimorbidity: A protocol for a systematic review of qualitative research. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309055/.
Lim, J.M.E. (1998, July 4). The importance of social context. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1113455/.
Ministry of Health Singapore. (n.d). Achieving more with less – Singapore’s Healthcare Expenditure. Ministry of Health Singapore. https://www.moh.gov.sg/resources-statistics/educational-resources/achieving-more-with-less—singapore%27s-healthcare-expenditure#:~:text=Singapore%20is%20achieving%20similar%20outcomes,comparable%20with%20many%20developed%20countries.
World Health Organization. (2023, October 5). Universal health coverage (UHC). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc).
Caela Bennett

Caela Bennett

Caela Bennett is a wellness content writer and holistic health coach. She hopes to enlighten people through powerful storytelling and offer clarity when navigating the noise within the realm of health. In addition, she guides others in awakening their self-discovery journey and embodying the best version of themselves. Her work is rooted in the philosophy of alchemy: turning metal into gold, i.e., transforming one thing into something better. While she is a maximalist in expressing herself through words, she is a minimalist in lifestyle pursuits.

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