SS1 - Sp healthcare Flashcards
(5 cards)
Community
The community supports the healthcare system by providing some healthcare services, particularly for ailments that are not acute and do not require urgent treatment:
-> 1. (a) Community hospitals - for patients who are discharged from hospitals and still need stay-in medical care and supervision, because their illness is prolonged. Run by voluntary welfare organisations linked to the community or religious groups eg. Ang Mo Kio Community Hospital, Ren Ci Hospital, St Andrew’s Community Hospital.
(b) Nursing homes - for elderly who do not need urgent healthcare in a hospital, yet do not have children, maids or private nurses to ensure their health and safety at home. Basic support such as healthy meals, nurses and doctors are on hand, to ensure residents take their medication, are diagnosed for minor ailments and are sent to hospitals if the need arises.
(c) Day rehabilitation centres - healthcare services such as physiotherapy or Chinese medicine treatments - ease pain, help patients get on their feet again.
(d) specific healthcare support services - eg. SATA (for tuberculosis control), Singapore Chung Hwa Medical Institution (for the poor)
-> 2. Govt gives grants to such voluntary welfare organisations to help fund their operations.
=> community healthcare service providers are crucial in providing services particularly for the needy and elderly sick in Sp. Many are charitable, non-profit organisations that rely on govt grants and public donations. They help to keep the needy and elderly in their best possible health, at low or subsidised rates -> minimise the chance of acute illness, that requires expensive medical treatment at govt or private hospitals.
Individual
- Self-reliance: Medisave (1984) with contributions from workers’ CPF (about 6-8% of salary) (CPF is a compulsory savings scheme for workers in Sp).
-> Used to pay hospital bills, certain medical treatment. Usage has since been extended to pay for more types of medical treatments, incl. chemotherapy and medication to control high blood pressure.
=> encourages Singaporeans to rely in themselves and save for their future medical needs. The people share the costs of healthcare with govt -> lightens govt’s burden of paying for healthcare services (shared responsibility) -> govt need not depend on raising taxes to pay for rising healthcare costs. - Encouraged to maintain good health: under NHP (1983), the aims include to ‘build a healthy and physically fit population’, and ‘encourage Singaporeans to stay well and reward those who do so’.
-> schools and workplaces have programmes to emphasise the need to maintain good health
-> HPB set up to encourage the public to maintain good health through physical exercises, well-balanced diets, etc. Organises activities to promote public health, (i) fitness activities for all the family, like mass aerobics, (ii) voluntary free health screening (eg. for high blood pressure and diabetes) at community places
-> HPB also encourages schools to offer healthy eating options in their canteens. Also, promotes healthy eating at hawker centres by encouraging customers to order more soup dishes that are lower in fat and calories than fried and oil-laden dishes, consume less sauce and gravy, and order more vegetables.
=> good health -> not need medical treatment -> person can save on medical expenses.
Thus, adopting a healthy lifestyle is a way to cope with the rising cost of healthcare, for both the govt and individuals.
Government (->)
Govt encourages self responsibility and community support, while keeping healthcare affordable ->
- Encouraging self-reliance: (a) Sets the policy requiring all workers to save for medical needs via Medisave. Encourages Sp’s to have money in their Medisave a/c. (b) For hospitalisation, MediShield (1990): national healthcare insurance scheme, premiums paid for through Medisave. A co-insurance system, with payment borne by both MediShield and the patient (Medisave use is possible) (80-20% sharing). Can be used to pay for large medical bills which Medisave does not cover eg. long-term hospitalisation or treatment of serious illnesses, such as dialysis treatment. Over the years, expanded according to people’s changing needs eg. Eldershield for people above 40 is an insurance for healthcare in case of disability. (c) Promoting a healthy lifestyle - through HPB, MOE etc., schools, communities and workplaces offer programmes that help the public to keep fit, eat healthily and thus maintain good health.
- Keeping healthcare affordable - (a) govt subsidies - direct subsidies to govt hospitals, polyclinics and some nursing homes for the elderly -> ensure basic healthcare services for all Sp’s. Substantial amount - one-quarter of govt healthcare spending in 2000. (b) Higher subsidy for lower-income group (determined through means-testing) staying in Class C wards of hospitals. (c) Medifund (1993) - for those who still cannot afford after other measures eg. low-income workers and families (insufficient funds in Medisave), self-employed (no CPF or Medisave) - patients can apply for financial assistance at the hospital where they are being treated. (d) Restructuring of hospitals (1990s): enabled hospitals to have more freedom to reorganise to become more efficient, meet the needs of Sp’s better -> better efficiency - lower cost -> govt able to reduce amount of subsidies to hospitals.
- Working with the community - grants for community hospitals, nursing homes, day rehab centres, run by VWOs and private organisations; grants for specific healthcare support services for the poor or for those afflicted by a particular illness (TB).
Government (=>)
- Individual financial self-reliance through Medisave, MediShield -> less burden on govt to fund healthcare through taxpayers’ money. The money saved can be used to improve public healthcare services and subsidise healthcare especially for the less fortunate in society. This helps to ensure all Sp’s are able to get access to quality healthcare. Furthermore, govt supplements this approach by promoting a healthy lifestyle, starting from a young age, with programmes and advice from HPB, MOE, etc. - equips the individual with the knowledge and practice of the importance of health and ways to stay healthy. This is good governance, as govt prepares for the future of rising healthcare costs, by arranging for ways that help citizens to help themselves, to keep the total healthcare burden down.
- Keeping healthcare affordable -> Sp’s will not feel that healthcare is a big burden on their finances. As illness is unpredictable, despite measures to stay healthy, one may still succumb to injury or serious illness. It is critical that Sp’s feel that they are able to obtain good quality healthcare for their medical needs, at an affordable cost that will not drain their Medisave excessively. By making healthcare affordable for even the low-income, the poor and the needy elderly, no one feels left behind. This inclusive approach is important for the morale of society, and keeps workers motivated to work hard, as they feel looked after.
- Working with the community: Govt recognises that it has limited resources and therefore the community needs to be involved in addressing such a big concern as healthcare, that affects everyone. By giving grants and encouraging such organisations, these organisations are able to plug the gaps in the public healthcare system, and provide quality services. Furthermore, those who can afford it will donate to these organisations, knowing that these are the ones that provide crucial healthcare for many poor and needy.
1 Individual
The best way for the country as a whole to cope with rising healthcare costs is for each individual to take responsibility for himself. No matter how the healthcare burden is divided between the government and citizens, it is paid out of the pockets of citizens, through taxes. The only way to keep a lid on this burden is not to incur the medical costs in the first place. This only happens when the individual takes charge of his own health and stays out of hospital. The government can put many measures in place, but if Sp’s do not maintain their health, the total health bill would rise and be a strain on the economy. Medical staff, resources and infrastructure would also be strained, and this may lead to inefficiency and poor quality. Taxes may also need to be raised, making Sp less attractive to work in. Community support is important but also needs to be financed by Sp’s themselves, through taxes and donations, so rising cost can become overwhelming. Sp is a small country and has limited resources, so if a healthy population means less resources need to be devoted to healthcare, the rest of the economy would benefit. (This approach has been successful as Sp govt spending on healthcare is only 3% of GDP (compared to 6%, 14% in UK, US respectively), yet health outcomes such as life expectancy and infant mortality rates are about the best in the world.)
