Publication: Financing Health Care : Singapore’s Innovative Approach

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Taylor, Rob
Blair, Simon
Health care costs are escalating rapidly in many countries. While many factors contribute to rising costs, health insurance plays a part by shielding patients and physicians from the real cost. In an effort to contain costs, governments, employers, and insurers have modified payment schemes and coverage, often leading to rationing and restricted consumer choice and in some cases to denial of care. Singapore is unique among developed countries in achieving excellent health outcomes at a low economic cost. Part of its success may be attributable to its health financing system, which combines individual responsibility with targeted subsidies. Despite Singapore's small size, with only 3.2 million residents in a land area of 660 square kilometers, the country has been a stellar economic performer, rising from impoverishment only 40 years ago. Its per capita GDP, US$427 in 1960, rose to US$24,740 in 2000, one of the highest in the world. Singapore's health indicators are equally impressive. Its average life expectancy increased by 15 years from 1960 (63 years) to 2001 (78) and is now one of the world's longest. Its infant mortality rate is the world's lowest, at 2.2 per 1,000 live births, much improved from 6.6 in 1990 (and 34.9 in 1960) and far lower than rates in most other countries. Both the public and the private sector provide health care in Singapore. The public sector provides 20 percent of primary care and 80 percent of hospital care through two integrated care networks. The private sector dominates primary health care, providing 80 percent through its 1,900 clinics. The 13 private hospitals account for 20 percent of inpatient admissions. Singapore has 11,800 hospital beds (3.7 per 1,000 people).
Taylor, Rob; Blair, Simon. 2003. Financing Health Care : Singapore’s Innovative Approach. Viewpoint. © World Bank, Washington, DC. License: CC BY 3.0 IGO.
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