Introduction
Singapore is an Asian country that has a population of approximately five million people. The country has one of the most efficient healthcare systems in the world. Since its independence in 1965, the country has taken several steps that have led to significant improvements in its healthcare system. In 1983, the government developed the National Healthcare Plan.
The aim of the plan was to provide a roadmap for the development of the healthcare system for the next 20 years (Meng-Kin 17). During this period, the government introduced several programs that targeted various groups of people. In 2002, the government introduced the ElderShield plan. The aim of this program was to improve the healthcare of the elderly and disabled. On the other hand, the US healthcare industry is more than two centuries old.
The US government spends vast sums of money on healthcare provision. Medicaid and Medicare account for the lion’s share of government expenditure on healthcare provision. This necessitates the US government to formulate strategies that would help in reducing the cost of healthcare provision.
Increase in the proportion of the elderly to the total population necessitates the US government to take urgent steps to prevent further escalation of the healthcare budget. The US government should formulate a strategy that would help in replicating the strengths of the healthcare system of Singapore in the US healthcare system.
Healthcare Regulation
Singapore’s healthcare system has three pillars. The healthcare system strives to improve the general health of the population through various preventive healthcare programs. In addition, the healthcare system puts great emphasis on the personal responsibility of individuals towards their healthcare. The government strives to reduce the cost of healthcare services by subsidising healthcare in public health institutions.
The Ministry of Health (MOH), Monetary Authority of Singapore (MAS) and the Central Provident Fund (CPF) are the main health regulators. CPF is a social security savings plan that enables Singapore nationals to support themselves in their old age (Ho 95).
On the other hand, the US has one of the most complex healthcare regulations in the world. Numerous agencies help in regulation of healthcare. Healthcare agencies may regulate healthcare at the state or federal level. In addition, the regulators may be private or public.
The United States Department of Health and Human Services and the National Institutes of Health (NIH) are the major bodies that cater for the healthcare needs of all American citizens. The American Medical Association (AMA) is one of the vital private organisations that help in the oversight of healthcare industry (Field 608). In the US, different states may have different agencies that help in regulation of healthcare.
Healthcare Delivery
Singapore’s healthcare system helps in the delivery of various types of healthcare to the population. Approximately 2000 private hospitals provide 80% of the primary healthcare needs of the population. This shows that the government’s efforts to provide primary healthcare services to the population have been unsuccessful. However, the government provides the bulk of hospital care services.
Government healthcare facilities provide approximately 80% of hospital care services. In 2010, there were 8,881 hospital beds in government healthcare facilities (Ministry of Health Singapore para 1). Public health facilities had slightly less than thirteen thousand nurses and approximately 1800 nurses. On the other hand, private healthcare facilities had 2,268 hospital beds.
The number of doctors and nurses in the private healthcare facilities was approximately 3,300 and 5,100 respectively (Ministry of Health Singapore para 2). These statistics show that the government is the dominant player in the provision of hospital care. However, a close analysis of the number of doctors and nurses shows that there are less hospital beds for every healthcare practitioner.
The number of hospital beds per healthcare practitioner has a significant effect on the quality of healthcare. This may imply that the quality of healthcare services in private healthcare facilities is higher than in government healthcare facilities.
Community hospitals play a key role in healthcare delivery in the US. Community hospitals may be state-owned or investor-owned. Community hospitals are the major healthcare facilities that provide primary and intermediate healthcare services. Most community hospitals tailor their services to meet the healthcare needs of the community (Purves 88).
This improves the efficiency of healthcare services of community hospitals. There are 4,973 community hospitals. The total capacity of these community hospitals is 797,403 beds. On the other hand, there are slightly more than 200 federal government hospitals.
The total capacity of these hospitals is slightly more 100,000 beds. Therefore, community hospitals are vital in designing various preventive health programs. Most community hospitals have adequate staffing levels that enable them to meet the healthcare needs of the community.
Funding
Medisave, MediShield, Medifund, and ElderShield are the main medical schemes that help in financing public health in Singapore. Medisave is a social scheme that helps people to save for future healthcare expenses. Medisave caters for hospitalisation expenses and certain outpatient treatments of individuals and their immediate family members.
In addition, Medisave may help in paying the premiums of MediShield and Private Medical Insurance Scheme (PMIS). On the other hand, MediShield is primarily a medical insurance scheme that caters for severe health conditions. It caters for partial expenses of prolonged hospitalisation and outpatient treatment of various serious illnesses.
ElderShield is a health insurance scheme that caters for people who need long-term care. ElderShield mainly covers the elderly. Medifund is a government endowment fund that acts as a last resort source of funds if Medisave and MediShield are unable to cater for medical expenses.
The government replenishes the funds when there is a budget surplus. However, the government is not the only major player in the healthcare insurance industry. Several private health insurance companies provide health insurance to individuals and groups (Meng-Kin 19).
In the US, it is the duty of employers to ensure that their employees have medical cover. Medicare and Medicaid are the major medical schemes that help in financing public health. Medicare is a healthcare plan that covers the elderly and disabled. On the other hand, Medicaid covers people who have low incomes. Federal funds help in supporting Medicare while state and federal funds support Medicaid.
Patient Protection and Affordable Care Act (PPACA) is a healthcare regulation that ensures that all Americans have access to healthcare insurance. Access to healthcare insurance enables people to save huge sums of money that they would have used to cater for medical expenses (Pipes 107). People who would like to receive extended healthcare services may enrol in various private healthcare plans.
Healthcare Expenditure
Healthcare expenditure as a percentage of GDP is one of methods that help in determining the government’s commitment to improving the health status of the nation. In 2009, Singapore’s ratio of healthcare expenditure as a percentage of GDP was 3.9% (Ho 95). There is a gradual increase in the ratio of direct government expenditure on health through Medifund.
On the other, there is a gradual decrease in the social security expenditure on healthcare. In the private sector, out-of-pocket expenditure accounts for a sizeable percentage of healthcare payments (Ho 95). This necessitates the government and the private sector to formulate strategies that would improve access to healthcare insurance.
In 2008, the US had the highest healthcare expenditure as a percentage of GDP. The expenditure of the US on healthcare was 16% of its GDP. Medicare and Medicaid accounted for a sizeable percentage of the government spending on healthcare. In addition, out-of-pocket healthcare expenditure of the US was very high (Squires 2).
Conclusion
The US has one of the most efficient economic systems in the world. Very few economic systems can rival the US economic system. However, the healthcare system of the US has many flaws. Exponential increase in healthcare costs is one of the major problems that the healthcare system faces. On the hand, Singapore has been able to replicate the efficiency of its economic system to the healthcare system.
Despite having significantly lower expenditure on healthcare, Singaporeans are some of the healthiest people on the planet. Copying the healthcare structure of Singapore would enable America save huge sums of money. It would free up money for other activities that would lead to economic development. However, the healthcare systems of the countries face several problems that are unique to each country.
Works Cited
Field, Robert I. “Why is health care regulation so complex?” Pharmacy and Therapeutics. 33.10. (2008): 607–608. Print.
Ho, Lok-sang. Health policy and the public interest. Burlington, MA: Routledge, 2012. Print.
Meng-Kin, Lim. “Health care systems in transition ll. Singapore, part I.” Journal of Public Health Medicine. 20.1. (1998): 16-22. Print.
Ministry of Health Singapore. “Healthcare institution statistics.” Statistics. n.d. Web.
Pipes, Sally C. The truth about Obamacare. Washington DC: Regnery Gateway, 2010. Print.
Purves, Geoffrey. Primary care centres. Burlington, MA: Routledge, 2012. Print.
Squires, David A. “The U.S. health system in perspective: A comparison of twelve industrialized nations.” The Commonwealth Fund. 16.1. (2011): 1-13. Print.