Individual

The individual can manage healthcare in Singapore using Medisave and Medishield.

Self-reliance can be encouraged through Medisave and Medishield. Medisave is a
savings scheme that was introduced in 1984. About 7% to 9% from workers Central
Provident Fund (CPF) contributions every month is channeled into their Medisave
accounts. It can be used to pay hospital bills and medical treatment such as
chemotherapy and medication to control high blood pressure. By encouraging
Singaporeans to have money in their Medisave accounts, they are better able to pay for
healthcare.

There is also MediShield, a national healthcare insurance scheme which Singaporeans
purchase with their Medisave. Patients can make claims from MediShield to pay for
large medical bills which Medisave does not cover. For example, a patient can use
Medishield to pay for more long term hospitalization or treatment of serious illnesses
such as dialysis. Over the years, the use of MediShield has been expanded to meet the
specific needs of the people. For example, by paying premiums for ElderShield, people
above 40 years old would be able to pay for healthcare in case of disability.

In this way, healthcare becomes a shared responsibility. Medisave and Medishield
lighten the governments burden of paying for healthcare services. The individual has a
role to play in managing healthcare in Singapore by sharing the cost of healthcare with
the government. The government hence need not depend on raising taxes to pay for
rising healthcare costs. Hence, the individual is able to contribute to the management of
healthcare in Singapore.





Government

The government is responsible for managing healthcare in Singapore and it keeps
healthcare affordable by giving subsidies. Direct subsidies are given to government
hospitals, polyclinics and some nursing homes for the elderly to ensure that basic
healthcare services are available for all Singaporeans. In 2000, government spending on
healthcare increased. To ensure that healthcare remains affordable for most
Singaporeans, especially the lower-income group, the government gives different rates
of subsidies to the different classes of wards in hospitals. For example, Class C wards
receive the most in subsidies. The government also introduced means testing to make
sure subsidies are proportionately channeled to those who need them.

To help needy Singaporeans, Medifund was introduced in 1993 for those who still
cannot afford to pay for their medical expenses. For example, low-income workers and
self-employed people do not have Medisave or sufficient cash. The government started
with a fund of $200 million and the interest earned from the fund is given to public
hospitals to provide help for needy patients. Patients who need help apply for the fund
at the hospital where they are being treated.

Another way to manage rising healthcare costs was through restructuring the hospitals
in the 1990s. Restructuring meant that hospitals would have more freedom to
reorganize to meet the needs of Singaporeans. The government would also be able to
reduce the amount of subsidies to hospitals.

Through these measures, the healthcare cost remains in check and the government
manages healthcare in Singapore by continuing to use the limited resources to provide
these services to meet the needs of the people.



Community

The community is also responsible for managing healthcare in Singapore. Working with
community involves cooperating with organizations. For example, some patients who
are discharged from hospitals may still need medical care. Voluntary welfare
organizations are given grants to run community hospitals, nursing homes and day
rehabilitation centres. An example will be the Home Nursing Foundation which provides
quality and affordable home nursing services for the needy and elderly sick.

It is not practical for the government to provide all types of healthcare including long-
term rehabilitation centres as it will demand a huge amount of resources. Thus,
community support helps complement the government in providing specific areas of
healthcare. It also ensures that everyone regardless of their financial or severity of their
health condition is given affordable healthcare.