Singapore - Commonwealth Fund

1 Ministry of Health Singapore, “Update on the Number of People Using Their MediSave to Pay for Their Parents’ Healthcare Cost,” (Jan. 15, 2019), https://www.moh.gov.sg/news-highlights/details/update-on-the-number-of-people-using-their-medisave-to-pay-for-their-parents'-healthcare-cost.

2 Ministry of Health Singapore, Singapore’s Healthcare System, www.moh.gov.sg/our-healthcare-system.

3 Ministry of Health Singapore, Affordable Healthcare (1993).

4 J. Lim, “Sustainable Health Care Financing: The Singapore Experience,” Global Policy 8, suppl. 2 (April 12, 2017): 103–107.

5 E. Quah and N.B. Siong, “Evolving the Governance of Public Healthcare Institutions – A Continuous Improvement Journey,” in Singapore's Health Care System: What 50 Years Have Achieved, eds. L.C. Earn and K. Satku (World Scientific Publishing, 2016).

6 AIC’s origin dates from 1992, when the MoH set up the Care Liaison Services (CLS) to coordinate and facilitate the placement of elderly sick people in nursing homes and chronic sick units. Its role grew and it was renamed AIC in 2008.

7 World Bank, “Current Health Expenditure (% of GDP),” https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS.

8 World Health Organization, “Global Health Expenditure Database,” http://apps.who.int/nha/database/; accessed Oct. 6, 2019.

9 Ministry of Health Singapore, “Healthcare Inflation,” (Nov. 19, 2018), https://www.moh.gov.sg/news-highlights/details/healthcare-inflation.

10 Please note that, throughout this profile, all figures in Singapore dollars (SGD) were converted to U.S. dollars (USD) at a rate of about SGD $1.00 to USD $0.73, based on the rate from www.xe.com on Nov. 14, 2019.

11 Ministry of Health Singapore, “MediShield Life,” https://www.moh.gov.sg/cost-financing/healthcare-schemes-subsidies/medishield-life.

12 Ministry of Health Singapore, “Government Accepts Recommendations of Medishield Life Review Committee; Announces 4 Billion in Subsidies and Support for Medishield Life Premiums,” press release, June27, 2014, https://www.moh.gov.sg/news-highlights/details/government-accepts-recommendations-of-medishield-life-review-committee-announces-4-billion-in-subsidies-and-support-for-medishield-life-premiums.

13 Ministry of Health Singapore, “Healthcare Schemes and Subsidies,” https://www.moh.gov.sg/cost-financing/healthcare-schemes-subsidies.

14 Ministry of Health Singapore, “Healthcare Schemes and Subsidies.”

15 The CHAS was enhanced in November 2019 with a new tier that extends coverage to all Singaporeans for chronic conditions, regardless of income.

16 Ministry of Health Singapore, “Keeping Healthcare Sustainable and Affordable,” Committee of Supplies 2019 Factsheet, https://www.moh.gov.sg/docs/librariesprovider5/default-document-library/cos-factsheet-keeping-healthcare-sustainable-affordable.PDF.

17 Government of Singapore, “Workfare,” https://www.workfare.gov.sg/Pages/AboutWorkfare.aspx.

18 “Chart of the Day: How Much Are Singaporeans Covered by Public Health Insurance?” Singapore Business Review (June 13, 2019), https://sbr.com.sg/healthcare/news/chart-day-how-much-are-singaporeans-covered-public-health-insurance.

19 Central Provident Fund Board, “Private Medical Insurance Scheme,” https://www.cpf.gov.sg/Members/Schemes/schemes/healthcare/private-medical-insurance-scheme.

20 Twenty-nine percent of Singapore residents have full riders and pay nothing regardless of bill size, as of March 2018. Ministry of Health Singapore, “Inflation in Premiums for Private Hospitalisation Insurance Plans” (July 8, 2019), https://www.moh.gov.sg/news-highlights/details/inflation-in-premiums-for-private-hospitalisation-insurance-plans.

21 Speech by Chee Hong Tat, Senior Minister of State for Health, at the MOH Committee of Supply Debate 2018, March 7, 2018, https://www.moh.gov.sg/news-highlights/details/speech-by-mr-chee-hong-tat-senior-minister-of-state-for-health-at-the-moh-committee-of-supply-debate-2018.

22 Ministry of Health Singapore, “MediShield Life Benefits,” https://www.cpf.gov.sg/Members/Schemes/schemes/healthcare/medishield-life.

23 Ministry of Health Singapore, “MediShield Life,” https://www.moh.gov.sg/cost-financing/healthcare-schemes-subsidies/medishield-life.

24 Ministry of Health Singapore, Affordable Health Care (1993).

25 Ministry of Health Singapore, “MediShield Life Coverage,” (Jan. 15, 2019), https://www.moh.gov.sg/news-highlights/details/medishield-life-coverage.

26 Ministry of Health Singapore, “Healthcare Financing,” https://www.moh.gov.sg/docs/librariesprovider5/default-document-library/health care-financing_esh-apr2019.xlsx.

27 Singapore General Hospital, “Outpatient Charges,” https://www.sgh.com.sg/patient-services/charges-payment/pages/outpatient-charges.aspx.

28 Ministry of Health Singapore, “Revision to List of Overseas Medical Schools for Registration to Practise in Singapore,” press release, April 18, 2019, https://www.moh.gov.sg/news-highlights/details/revision-to-list-of-overseas-medical-schools-for-registration-to-practise-in-singapore.

29 National University of Singapore, “Undergraduate Students Tuition Fees per Annum,” http://www.nus.edu.sg/registrar/info/ug/UGTuitionCurrent.pdf#page2.

30 National University of Singapore, “Fees for Undergraduate Programmes,” http://www.nus.edu.sg/registrar/education-at-nus/undergraduate-education/fees.html.

31 Ministry of Health Singapore, “Health Manpower,” https://www.moh.gov.sg/resources-statistics/singapore-health-facts/health-manpower.

32 Ministry of Health Singapore, “Health Facilities,” https://www.moh.gov.sg/resources-statistics/singapore-health-facts/health-facilities.

33 Ministry of Health Singapore, Primary Care Survey 2014, https://www.moh.gov.sg/docs/librariesprovider5/resources-statistics/reports/moh-primary-care-survey-2014-report.PDF.

34 Ministry of Health Singapore, “Developing Primary Care Networks for Better Care in the Community,” press release, March 29, 2019, https://www.moh.gov.sg/news-highlights/details/developing-primary-care-networks-for-better-care-in-the-community.

35 Manpower Research & Statistics Department, Ministry of Manpower Singapore, “Occupational Wage Survey,” https://stats.mom.gov.sg/iMAS_Tables1/Wages/Wages_2018/mrsd_2018Wages_table4.xlsx.

36 Singapore has six national centers that serve as national tertiary centers for cancer, dental, eye, heart, neurosciences, and skin.

37 Ministry of Health Singapore, “Health Facilities,” https://www.moh.gov.sg/resources-statistics/singapore-health-facts/health-facilities.

38 M. Ramesh, “Reasserting the Role of the State in the Health Care Sector: Lessons from Asia,” Policy and Society, 27, no. 2 (2008): 129–136.

39 M. Ramesh and S.B. Azad, “The Healthcare system in Singapore,” Global-is-Asian (Lee Kuan Yew School of Public Policy), https://lkyspp.nus.edu.sg/docs/default-source/gia-documents/the-healthcare-system-in-singapore-with-graphics.pdf?sfvrsn=f0446c0a_2.

40 Public hospitals also receive above-the-block funding for new initiatives and programs such as new service development, research, and education.

41 Ministry of Health Singapore, “Health Facilities,” https://www.moh.gov.sg/resources-statistics/singapore-health-facts/health-facilities.

42 Speech by Dr. Amy Khor, Senior Minister of State for Health, at the Ministry of Health Committee of Supply Debate 2019, March 6, 2019, https://www.moh.gov.sg/news-highlights/details/speech-by-dr-amy-khor-senior-minister-of-state-for-health-at-the-ministry-of-health-committee-of-supply-debate-2019-on-wednesday-6-march-2019.

43 Ministry of Health Singapore, “Health Facilities,” https://www.moh.gov.sg/resources-statistics/singapore-health-facts/health-facilities. These data refer to providers who are funded by the MoH and/or are receiving referrals from AIC. Data on non-MoH-funded services are not available as these services do not need to be licensed by the MoH. These providers are governed by their respective professional licensing bodies.

44 Ministry of Health Singapore, “Beds in Inpatient Facilities and Places in Non-Residential Long-Term Care Facilities,” https://www.moh.gov.sg/resources-statistics/singapore-health-facts/beds-in-inpatient-facilities-and-places-in-non-residential-long-term-care-facilities.

45 From 2020 onward, MediSave long-term care allows the monthly withdrawal of up to $200 dollars to assist with long-term care costs, which can be used to pay for nursing home services.

46 L. Lai, “Eldershield Review Committee Proposes Severe Disability Insurance Scheme Be Made Compulsory for Future Cohorts,” Straits Times, Jan. 30, 2018, https://www.straitstimes.com/singapore/health/eldershield-review-committee-wants-scheme-made-compulsory.

47 Central Provident Fund Board, “ElderShield,” https://www.cpf.gov.sg/Members/Schemes/schemes/health care/eldershield.

48 K.B. Tan and C.E. Lee, “Integration of Primary Care with Hospital Services for Sustainable Universal Health Coverage in Singapore,” Health Systems & Reform 5, no. 1 (2019): 18–23.

49 Primary Care Pages, “Chronic Disease Management Programme (CDMP),” https://www.primarycarepages.sg/practice-management/moh-national-schemes/chronic-disease-management-programme-(cdmp).

50 Those born before December 31, 1930, or age 65 and above in 2014.

51 Pioneer Generation, https://www.pioneers.sg/en-sg/Pages/Home.aspx.

52 Singaporeans born between January 1, 1950, and December 31, 1959, and who became Singapore citizens on or before December 31, 1996.

53 Merdeka Generation, “Merdeka Generation Package: Benefits,” https://www.merdekageneration.sg/en/benefits.

54 Information stored in the national EHR includes discharge summaries, laboratory test and radiology results, medication history of surgeries or procedures, allergies and adverse drug reactions, and immunizations.

55 Ministry of Health Singapore, “Institutions participating in the National Electronic Health Records System (NEHR),” https://www.moh.gov.sg/institutions-participating-in-the-national-electronic-health-records-system-(nehr); accessed Aug. 15, 2019.

56 Ministry of Health Singapore, Health Hub, https://www.healthhub.sg/myhealth#PersonalHealth.

57 J.W. Thomas and S.G. Lim, Using Markets to Govern Better in Singapore, Harvard University faculty research working paper (2001), https://research.hks.harvard.edu/publications/workingpapers/citation.aspx?PubId=7993.

58 Ramesh et al., “The Healthcare System in Singapore.”

59 Ministry of Health Singapore, “Hospital Services,” https://www.moh.gov.sg/our-health care-system/health care-services-and-facilities/hospital-services.

60 W. Haseltine, Affordable Excellence: The Singapore Healthcare Story (Brookings Institution Press, 2013).

61 Lai, “Paying for Healthcare.”

62 B.K.H. Png, “Singapore’s Approach to the Challenge of High-Cost Medical Interventions,” Asia-Pacific Biotech News 19, nos. 04–05 (April–May 2015), https://www.asiabiotech.com/19/1904n05/1904n050042x.html.

63 Ministry of Health Singapore, “Fee Benchmarks Provide Stakeholders a Reasonable Range of Fees for Common Surgical Procedures,” press release, Jan. 15, 2019, https://www.moh.gov.sg/news-highlights/details/fee-benchmarks-provide-stakeholders-a-reasonable-range-of-fees-for-common-surgical-procedures.

64 S. Khalik, “The '3 Beyonds': Singapore's Strategy to Sustain Quality Healthcare as Demand Rises,” Straits Times, Nov. 30, 2017, https://www.straitstimes.com/singapore/health/the-3-beyonds-singapores-strategy-to-sustain-quality-healthcare-as-demand-rises.

65 Ministry of Health Singapore, “Licensing Experimentation and Adaptation Programme (LEAP) – Aa MoH Regulatory Sandbox,” https://www.moh.gov.sg/our-healthcare-system/licensing-experimentation-and-adaptation-programme-(leap)---a-moh-regulatory-sandbox.

66 Ministry of Health Singapore, “CareShield Life,” https://www.moh.gov.sg/careshieldlife/about-careshield-life.