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Affordable Excellence

The Singapore Healthcare Story

William A. Haseltine

Publication Year: 2013

This is the story of the Singapore healthcare system: how it works, how it is financed, its history, where it is going, and what lessons it may hold for national health systems around the world. Singapore ranks sixth in the world in healthcare outcomes, yet spends proportionally less on healthcare than any other high-income country. This is the first book to set out a comprehensive system-level description of healthcare in Singapore, with a view to understanding what can be learned from its unique system design and development path.

The lessons from Singapore will be of interest to those currently planning the future of healthcare in emerging economies, as well as those engaged in the urgent debates on healthcare in the wealthier countries faced with serious long-term challenges in healthcare financing. Policymakers, legislators, public health officials responsible for healthcare systems planning, finance and operations, as well as those working on healthcare issues in universities and think tanks should understand how the Singapore system works to achieve affordable excellence.

Published by: Brookings Institution Press

Title Page, Copyright

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pp. i-iv


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p. v-v

List of Illustrations

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pp. vi-viii


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pp. ix-xi

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pp. xii-xiv

Why this book? Affordable Excellence tells the story of the Singapore healthcare system, how it works, how it is financed, its history, and where it is going.
Today Singapore ranks sixth in the world in healthcare outcomes well ahead of many developed countries, including the United States. The results are all the more significant as Singapore spends less on healthcare ...

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The Singapore Healthcare System: An Overview

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pp. 1-15

Singapore has achieved extraordinary results both in the high quality of its healthcare system and in controlling the cost of care. In per capita terms and as a percentage of Gross Domestic Product (GDP), its healthcare expenditures are the lowest of all the high-income countries in the world....

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High Quality, Low Cost

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pp. 16-37

Lee Kuan Yew wanted Singapore to achieve excellence—“first world standards” as he put it in his memoirs. Only then, he believed, would his young country survive and thrive. ere is no doubt in my mind that the standards he desired for his city-state have indeed been met, and healthcare is one good example. Singapore now has a First-World healthcare system,...

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Helping Patients Pay

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pp. 38-63

The success of healthcare in Singapore today is largely due to the government’s creative use of the Central Provident Fund. The CPF’s medical savings component, called Medisave, makes it possible for Singaporeans to pay for much of their own medical care. Medisave is, in essence, a compulsory savings account. The government sets contribution rates for workers and their...

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Controlling Costs

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pp. 64-82

Once a healthcare system is built, it is much more difficult to reduce fixed costs, and when those costs spiral out of control, national budgets are strained. When nations can no longer support the system they have produced, they may need to resort to unwelcome alternatives that can include long delays for appointments, testing, and treatment; rationing; limitations...

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pp. 83-92

The Government of Singapore contributes billions of dollars to building and maintaining the country’s healthcare system and subsidizing a major portion of the cost of patient care, based on the individual’s ability to pay. As discussed earlier, the country does all this and achieves world-class outcomes while spending far less than most developed nations....

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Design and Infrastructure

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pp. 93-105

Primary care, where ill patients make first contact with care professionals, is largely issued by private rather than public care providers. There are approximately 2,000 private general practitioners in Singapore, located mainly in housing estates, and they deliver 80 percent of primary care.1 Several private general practitioner chains serve the public, including Raffles...

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Investing in the Future through Medical Education and Research

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pp. 106-127

Education, research, innovation, and continual improvement are fundamental to the success of the Singapore healthcare system. The government has two broad goals in mind as it directs investment into healthcare knowledge and medical research. One is to better serve the people of Singapore, making certain the healthcare system is staffed with highly-competent, highly-trained...

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Facing the Future

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pp. 128-142

In many developed countries, the proportion of elderly people in country populations is increasing rapidly. This trend is also true in Singapore, which has for years been experiencing a birth rate substantially below replacement. At the same time that fertility rates have declined, life expectancy has increased—due to the high quality of healthcare and rising ...


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pp. 143-147


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pp. 148-161


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pp. 162-173


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pp. 174-182

Back Cover

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p. BC-BC

E-ISBN-13: 9780815725268
E-ISBN-10: 0815725264
Print-ISBN-13: 9780815724162

Page Count: 182
Publication Year: 2013