Case studies of healthcare in singapore and britain
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Transcript of Case studies of healthcare in singapore and britain
How much responsibility should the government/ individual take for the
healthcare of an individual citizen?Britain
(90% govt, 10% ind)
v.s.Singapore
(50% ind, 40% govt, 10% community)
Managing Healthcare in Britain
British WelfareWelfare System• Recommended by
Beveridge Report (by Sir William Beveridge) to end poverty, diseases and unemployment after WWII
• Welfare system Welfare system to look after citizen from ‘cradle to grave’ started in 1948
Healthcare: National Health Service (NHS)
• Basic healthcare services are free for all citizens
• Healthcare system based on meeting the needs of the people, rather than focusing on the ability to pay
Healthcare: National Health Service (NHS)
Benefits:•Ensures that the people had a minimumminimum standard of welfare for a decent life•People were happy with the system and continued supporting the government
Main problem: Inability to handle
demand
• Methods to solve problems must
(In your explanation)(1)Reduce demand(2)Increase resources(3)Change the way the resources are used
so that patients who really need the services can access it
Main problem: Inability to handle
demand
Problems and Solutions
Over-expenditure on Healthcare
Low efficiency Low quality of service
ProblemsProblems
SolutionsSolutions
Encouraging self-responsibilityEncouraging self-responsibility
Increase efficiencyIncrease efficiency
Provide quality serviceProvide quality service
• Some services were no longer free
• Some services were no longer free
• Privitisation within NHS
• Privitisation within NHS • NHS Plan (2000)
• NHS Improvement Plan (2004) – Providing choices
• NHS Plan (2000)• NHS Improvement
Plan (2004) – Providing choices
1) Encouraging self-responsibility
• Managing spending by encouraging self-responsibility– Cutting back on
government spending on healthcare
– Create a system where the individual is more responsible for one own’s healthcare and welfare
Margaret Thatcher (1980s)
Problem: Over-expenditure on Healthcare
1) Encouraging self-responsibility
• Encourage responsibility for own health–Medicine, dental
treatment and optical services were no longer free except for some groups: e.g.• Expectant mothers• Students under 19
Helps to reduce demand and wastages!
1) Encouraging self-responsibility
• Managing spending by encouraging self-responsibility– Cutting back on
government spending on healthcare
– Create a system where the individual is more responsible for one own’s healthcare and welfare
Margaret Thatcher
British were
British were
unwilling to
unwilling to
accept this!!
accept this!!
1) Encouraging self-responsibility
Tony Blair (2000)
“..NHS remains the
symbol of social justice.. So that
every patient can access treatment
whenever they want and need
…”
1) Encouraging self-responsibility
Tony Blair (2000)
“..We decided to make a
historic commitment to
a sustained increase in NHS
spending. We would spend the
money if, but only if, we also
changed the inefficiency of
the NHS…”
1) Encouraging self-responsibility
Tony Blair (2000)
• Increasing taxes– Increases in
National Insurance contributions in 2003
– Spent £69 billion for NHS (15.8% of budget)
2) Privatization
• Policy of Privatization • Contract out non-medical
services – laundry, cleaning, catering– Private companies are
concerned with profit-making, thus they would try to remain competitive and efficient
• Hospitals can concentrate on medical services improve their own efficiency
Problem: Low efficiency
3) Increase quality of service
Focus:Focus:•Patients were given more information to make informed choices of treatment and care•Putting the needs of patients as top priority
Problem: Low quality service
3) Increase quality of service
NHS Improvement Plan (2004)
MoreMore choices: Patients could choose from four different healthcare providers and NHS would pay for the treatment
NHS Direct: provide medical advice over the phone to patients with minor illnesses saves time and money
Has the British Healthcare Policies met the needs of the
people?Many different opinions from the people….
• People of Britain identify themselves with and feel strongly about it
• British citizens are grateful for the system
• Many great improvements to the system
Has the British Healthcare Policies met the needs of the
people?Many different opinions from the people….
• No real improvements to the system – still low efficiency and quality of service
• Excessive government spending
• More reforms needed to meet the changing needs of the population
Problems and Solutions
Over-expenditure on Healthcare
Low efficiency Low quality of service
ProblemsProblems
SolutionsSolutions
Encouraging self-responsibilityEncouraging self-responsibility
Increase efficiencyIncrease efficiency
Provide quality serviceProvide quality service
• Some services were no longer free
• Some services were no longer free
• Privitisation within NHS
• Privitisation within NHS • NHS Improvement
Plan (2004) – Providing choices
• NHS Improvement Plan (2004) – Providing choices
Healthcare in Singapore
Healthcare in Singapore
• Challenges of managing healthcare
• Who pays for the healthcare services in Singapore?
• Singapore healthcare system – Individual, Government, Community
• Have Singapore’s healthcare policies met the needs of the people?
Healthcare in Singapore
• What are some complaints that you have about healthcare in Singapore?– Visiting a doctor?– Getting MCs?– Paying for the bills?
Healthcare in Singapore
• Providing basicbasic healthcare
• Providing quality quality healthcare
• Providing affordableaffordable healthcare
What are the challenges of managing healthcare in Singapore?
To ensure that all Singaporeans who need the healthcare service can afford it..
(In your explanation)
(1)Reduce demand(2)Increase resources(3)Change the way the resources are used(4)Make healthcare affordable
so that patients who really need the services can access it
Government’s approach to Healthcare in Singapore today.
What is the approach to healthcare in Singapore today?
Medisave• A certain amount of money
from people’s Central Provident Fund (CPF) is put into their Medisave account
• This money can be used to pay hospital bills and certain medical treatment when needed.
How is the Individual responsible for his own healthcare?
• Why Medisave?–Medisave encourages
Singaporeans to be responsible for their own health
– Government does not have to increase taxes, or take on the burden of healthcare in Singapore.
– Healthcare as a shared responsibility. How is the Individual responsible for his own healthcare?
• Brainstorm:
Is Medisave all good and sufficient?
How is the Individual responsible for his own healthcare?
• So.. Is Medisave enough?
Source A: A view by a heart specialist, Dr Charles Toh, on the medisave
scheme in 1983.
With Medisave, people would have to take care of themselves. Sometimes, the financial burden would be transferred to their children when a person cannot pay his hospital bill. Worse of all, what about the people who cannot pay their hospital bills?
Is Medisave all good?
Source B: A comment by the retired and former Health Minister, Dr Toh Chin Chye, on the Medisave Scheme in 1983.
Healthcare is the responsibility of the government. It is the duty of the government to find ways of using taxpayers’ money to meet different objectives. Moreover, smaller companies would find it hard to bear additional costs arising from Medisave.
Bad point: • Not all Singaporeans
make CPF contributions and therefore, do not have Medisave. –E.g. Tuition teachers,
self-employed Singaporeans.
How is the Individual responsible for his own healthcare?
MediShield • National healthcare insurance scheme• Medisave is used to pay for this scheme• Patients can make claims from
MediShield to pay for large hospital bills that Medisave does not cover.
How is the Individual responsible for his own healthcare?
MediSave STILL not enough..
Lucky got MediShield…
MediSave STILL not enough..
Lucky got MediShield…
Why MediShield? • To help people who
require long-term treatment of more serious illnesses but are unable to pay for their hospitalization
How is the Individual responsible for his own healthcare?
Is MediShield good?• Healthcare is made
more affordable• Needs of specific
groups of Singaporeans are catered to – Dependent on the
premiums you can pay
How is the Individual responsible for his own healthcare?
Maintaining Good Health
• Stay strong and healthy by doing more exercises and eating right
• Save possible expenses on healthcare
How is the Individual responsible for his own healthcare?
Summary• Medi-S2
–Medisave–MediShield
• Maintain good health
How is the Individual responsible for his own healthcare?
MS2
Government’s approach to Healthcare in Singapore today.
What is the approach to healthcare in Singapore today?
• Government provides monetary aid to organizations that provide healthcare support services
How is the Community responsible for healthcare?
• Why?– The community
can provide some healthcare support services for Singaporeans.
– It is not possible for the government to run all healthcare services
How is the Community responsible for healthcare?
• Examples: – Voluntary welfare
organisations and private organisations are given money to run community hospitals, nursing homes and day rehabilitation centres for patients
How is the Community responsible for healthcare?
Government’s approach to Healthcare in Singapore today.
What is the approach to healthcare in Singapore today?
Government subsidies • Direct subsidies are given to government
hospitals, polyclinics and some nursing homes for the elderly
• Subsidies to lower classes of wards in hospitals (Class C) to help the needy
Why such subsidies?
• To ensure that basic healthcare services are available for all Singaporeans
How is the Government responsible for healthcare?
Medifund• $200 million and the interest earned
from this fund, is given to public hospitals to provide help for needy patients
• Patients who need help can apply for this fund at the hospital
How is the Government responsible for healthcare?
Why Medifund?• For Singaporeans who are unable
to afford healthcare despite Medisave, Medishield and government subsidies. –E.g. low-income workers, or self-
employed people.
How is the Government responsible for healthcare?
So… Is Medifund good?• Ensures that basic healthcare is
affordable for Singaporeans
How is the Government responsible for healthcare?
HURRAY FOR Medifund!!! HURRAY FOR Medifund!!!
Through Medishield and Medisave
Note: Government’s role here is to encourage.
How is the Government responsible for healthcare?
Why?• A healthy person will
not require medical treatment and therefore, he can save on medical expenses.
How is the Government responsible for healthcare?
• How?–Schools and workplaces
have programmes to emphasise on the need to maintain good health• E.g. physical education
classes in schools• E.g. posters to encourage
healthy eating in canteens
How is the Government responsible for healthcare?
How is the Government responsible for healthcare?
Government’s approach to Healthcare in Singapore today.
What is the approach to healthcare in Singapore today?
Is healthcare in Singapore affordable?
•Medisave helped patients who have little savings afford healthcare•Medishield and Medisave helped patients pay for part of hospital’s bill
YES!
Is healthcare in Singapore affordable?
• Elderly who used to work but had no schemes to help them make compulsory savings – dependent on family members, community and government• People who are unable to work – dependent on government for their healthcare needs
NO!
Is healthcare in Singapore successful?
• High quality of healthcare services• Increased life expectancy• Low infant mortality• Used only less than 3% of National Income • People are more aware of the need to be responsible for
their own healthcare – Medishield/ Medisave• Medifund for the needy• Community help/ services for the needy
YES!
Is healthcare in Singapore successful?
•Old people without medisave/ insurance not able to afford healthcare services•Healthcare costs is continuing to rise• Still very much dependent on government subsidies
NO!
Government’s approach to Healthcare in Singapore today.
What is the approach to healthcare in Singapore today?