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252 Prescribing New Economic Medicine for Healthcare PHUA KAI HONG Bornin1941toahumblebackground,GohChokTongexperiencedadifficultearlychildhood during the years of the Japanese occupation. In a parliamentary speech, he recalled growing up in the Pasir Panjang area in a rustic house without modern sanitation that was home to many families, and admitted that his two children were much better off than he was when he was young.1 Goh’s father died when he was very young and his mother worked as a teacher in a Chinese school to support him and his sister. He was raised by his mother with the help of a grandmother, an uncle and an aunt. This early experience gave him a good appreciation of the importance of public health and its links with socioeconomic development. Goh was educated at Raffles Institution where he excelled in his studies and sports. He was active in scouting and swimming, ending as Troop Leader and Captain of the school swim team, where he developed close friendships with prominent doctors-to-be among his classmates. These included Dr Tan Cheng Bock, Founder-President of the Association of Private Medical Practitioners, ex-Member of Parliament, outspoken back-bencher and Chairman of various Government Parliamentary Committees during Goh’s tenure; and Dr Cheng Heng Kock, former Deputy Director of Medical Services, Ministry of Health (MOH) and Chairman of the Medical Board, KK Women’s and Children’s Hospital. Goh’s son, Jin Hian, is a medical doctor who was Executive Director of Parkway Shenton, the General Practitioner (GP) division within the Parkway Healthcare Group, one of the largest hospital groups in Asia with their head office based in Singapore. Thus he was not short of access to medical advice and feedback on health affairs from both the private and public sectors. Goh spent three years at the University of Singapore and topped his class by obtaining a Bachelor of Arts (First Class Honours) in economics in 1964. As part of his degree, he wrote a 108-page thesis on“A Statistical Analysis of the Production Response of Malayan Fishermen to Price Changes”. The study was conducted in a Malay kampung in Bedok, which included a detailed estimation of household income and expenditure within an 22 PRESCRIBING NEW ECONOMIC MEDICINE FOR HEALTHCARE 253 impoverished minority community.His early exposure to understanding the socioeconomic conditions of the poor and disadvantaged gave him a social perspective that balanced the hard-nosed economic policies of Singapore. Goh entered politics in the December 1976 general election as the People’s Action Party (PAP) candidate for the electoral constituency of Marine Parade, where he had strong emotional ties and had spent many happy hours as a Boy Scout playing and swimming at the seaside home of a classmate. He won his seat with a convincing majority and captured 76.8 per cent of the vote. He was appointed Senior Minister of State in the Ministry of Finance in September 1977. He held that post until March 1979, when he was promoted to the position of Minister forTrade and Industry.His well-rounded exposure and experiences in the economics-related portfolios of finance, trade and industry were to have considerable influence on his future health policies. Goh’s HealthyVision for Healthcare Singapore inherited a strong British-type National Health Service system, with the government playing a dominant role in the public provision of health services financed by central taxation. Over the past 25 years, the government has actively embarked on a systematic series of health sector reforms to restructure the healthcare delivery system and to diversify the sources of financing. The foundations of these reforms were laid throughout the period of Goh’s tenure as Minister for Health (1981–1982), Second Minister for Health (1982– 1984), First Deputy Prime Minister (1985–1990) and Prime Minister (1990–2004) (see Figure 1 for a chronology of these healthcare reforms). Goh’s imprint on Singapore’s healthcare system is spelt out in the National Health Plan, which he introduced in 1983 as Second Minister for Health, that emphasises building a healthy population through disease prevention and the promotion of healthy living.2 Individuals are encouraged to take responsibility for their own health by saving for expected future medical expenses. To reinforce this sense of personal responsibility, the healthcare system is built upon three healthcare financing programmes that help people pay for medical expenses: Medisave, Medishield, and Medifund. The so-called 3M system was designed to create a largely self-funded healthcare...

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