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| Khoo Teck Puat Hospital - Singapore |
With Obamacare repeal talks ebbing and flowing in the States, conservatives mention Singapore ( as well as Scandinavian countries) as a role model for well-managed healthcare systems. But is the Singapore model really that good? The thing is: Singapore is a really weird country, and generally its model will be difficult to apply to other countries -- especially one as massive and complex as the United States'.
Singapore is an island city-state, with 5 major hospitals which are largely government-owned
Singapore healthcare system is centralized and mostly government-run, albeit with some private sector support. Drug prices are controlled, as are doctors -- not entirely sure how it is compatible with conservative pro-business, free-market economics world view. Hospitals also make non-trivial income from medical tourism: visitors from Indonesia, Malaysia, and China come to Singapore for medical care and vacation at the same time, and the hospitals charge them premium over the subsidized prices set for local citizens.
Unique location
Because of its geographic position in Southeast Asia, strategically located as a major trade hub surrounded by developing countries, hospitals in Singapore can source drugs relatively cheaply.
Singapore culture is also totally weird
People don't drive that much, due to affordable high-quality public transport in the city state (also, a friend told me it cost him nearly $3k to run his family car, including road tax, parking, and maintenance -- leading him to give up the car in exchange for GrabTaxi). People walk everywhere, making obesity a non-issue. There is no drug problem, as drug trafficking is punishable by death, a rule which is strictly enforced. There is no guns whatsoever, despite the mandatory draft into the Singapore armed forces. The young population is very health-conscious, and weekend biking is popular culture. There are health problems: air pollution can be an issue at times, mostly due to smog from forest fires in neighboring Malaysia and Indonesia.
Economics also matter
The median Singaporean is also wealthier than the American. In terms of GDP per capita, both countries are at about US$50k, but because of Singapore's small population (5.6m in 2016), there's just less poverty to deal with.
Main lesson: things are easier when costs are lower
Singapore historians highlight their young, immigrant-welcoming demographics, and well-educated population. Some also point to the country's sustainable healthcare financing system. But the main point is that all of the factors above reduce healthcare costs. And managing a healthcare system is that much easier when costs are lower, and buying powers higher.
