Crystal Chia

UCAE14 Assignment

8. What lessons can Singapore draw from the Taiwanese experience in providing healthcare to its
people?

Singapore and Taiwan are 2 countries with similar demographics. Both are very densely populated
first world countries in Asia, as well as both are being hailed as one of the 4 Asian Tigers. While
both their economic growth models have been widely compared, little comparison has been made
between the Singapore and the Taiwanese healthcare model. In this essay, I will discuss the 3 main
lessons Singapore can draw from the Taiwanese experience in providing healthcare to its people.

The Taiwanese National Health Insurance has been a successful healthcare model for other
developing countries to emulate. However, only in a utopia would there be a perfect model. There
exist inadequacies in the Taiwanese healthcare model that can serve as lessons for Singapore to
learn.

Firstly, Taiwan spends 3.8% per capita GDP on the National Health Insurance. While the United
States spending of 15% per capita GDP is too much, it is in Dr Huangs as well as my opinion that
3.8% per capita GDP is too little. Due to the governments low spending on healthcare, out-ofpocket healthcare payments for an average Taiwanese citizen is 37%, which is slightly more than
one-third. This amount is considered a lot, and is a huge sum for Taiwanese citizens living under the
poverty line. In Singapore, the spending is 4.8% per capita GDP. While this is of a higher
percentage than in Taiwan, more can be done on the governments part to reduce healthcare
spending for those who unable to afford the sum. Dr Huang suggests the ideal amount to be 7.5%. I

am of the opinion that although this should not be taken as a penicillin for all ailments nor a magic
number, it should be a number Singapore can work towards. Given that the Singapore government
spends only 1.6% of its annual Gross Domestic Product (GDP) on healthcare, the government can
definitely do more to increase subsidies on healthcare.

Secondly, it is mentioned by Dr Huang that there is low quality of care in Taiwanese health care. In
order to boost patient volume, undertrained medical staff spend little time on each patient. This
stems from the root problem that medical schools and hospitals are underfunded, resulting in
medical professionals aligning their work values to sales rather than to providing quality healthcare.
In Taiwan, the percentage of chronic illnesses is about 50-60%, many of which are attributed to a
wasteful behaviour during ones youth, and could have thus been prevented. As such, large amounts
of money are spent to treat rather than to prevent. This stems from the same problem as described
above, that the Taiwanese governments spending on preventative education is insufficient.
Learning from the Taiwanese experience, the Singapore government should spend more on
preventative education, as well as training and retraining healthcare professionals to provide quality
healthcare without compromising efficiency.

Lastly, at present, healthcare providers are paid according to the treatments being prescribed. This
provides a loophole and the possibility to exploit patients, prescribing medication or treatments that
are unnecessary. To this, Dr Huang has made a very interesting suggestion. He proposes a reform of
the healthcare system to one that is a performance-based payment. While this will improve
healthcare efficiency and challenge medical professionals to push their medical boundaries, it will
be extremely difficult for Singapore to emulate and implement. Implementation of such a payment
system would require hospitals and medical providers to observe and track patients for a long
periods of time before deciding if the treatment is effective and thus being able to advise healthcare

professionals on the suitable payment. It is thus my opinion that Dr Huangs suggestion is

unfeasible in Singapores present context.

In conclusion, there are many lessons to be learnt from the Taiwanese healthcare experience, with
many problems attributing to the fact that government subsidies are insufficient in the many areas preventive education, training of healthcare professionals, and decreasing out-of-pocket payments
of patients. Neither Singapore nor Taiwans healthcare model is perfect, but one thing both have in
common is the fact that much can be done on the governments part to create a better healthcare
system that is centred on the people.

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