Prognosis excellent for Singapore's
health care By Simon Parker
SINGAPORE - Singapore has one of the most
advanced health care sectors in the Asian region.
This point is partly supported by the
country's health care indicators. As of 2004, the
Department of Health said life expectancy was 79.3
years and the infant mortality rate per 1,000
live-births was 1.9.
It is also backed by
the government's investment in the sector, which
in the year 2004 was an estimated 5.9% of total
government expenditure. Recurrent health
expenditure topped about S$1.61 billion (US$950
million) in the same year, while development
health spending touched S$97 million. There are
about 11,840 hospital beds in
29 hospitals and specialty centers in Singapore.
This is a ratio of about 3.7 beds per 1,000
residents. While there are private medical
facilities available, the government remains the
dominant health care provider, allowing it to
control the supply of hospital beds, the
introduction of high-tech medical equipment and
the rate at which costs rise, which in turn helps
set the bench mark for how much the private sector
charges.
The cost of running the country's
health sector is borne both by the government and
the public, under the guiding philosophy of
individual responsibility and community support.
Patients pay for part of their treatment, an
amount that varies depending on the level of
service they demand. The remaining funds come from
government subsidies, which aim to keep health
care affordable for all members of the general
public.
An extensive health care financing
framework for individuals also exists.
Singaporeans can help defray potentially high
medical costs by investing regularly in one of the
nation's health care savings plans, which include
Medisave, MediShield and ElderShield. Medifund,
targeted to those individuals unable to pay for
their medical treatment, buttresses the system.
The country also boasts a strong
biomedical-sciences sector. In 2004 manufacturing
output from this sector surged by 33% on-year to
S$15.8 billion, a figure that looks set to grow as
an increasing number of multinational
pharmaceutical and medical equipment firms set up
operations in Singapore.
Numerous leading
pharmaceutical firms have also set up their
regional clinical trial centers in the city-state,
including AstraZeneca, Aventis, GlaxoSmithKline,
Merck & Co, Novartis and Novo Nordisk.
Outlook According to the
government, demand for a strong regional health
center in Singapore should surge in the coming
decades. Asia's population is expected to grow
from 3.2 billion in 2002 to 5.6 billion in 2050,
and with it will come an increasingly affluent and
demanding class of people who will want the type
of quality health care being offered in Singapore.
The burgeoning middle classes of India and
China are two such target markets.
In
2003, about 230,000 foreign patients sought
treatment in Singapore, and the country's Economic
Review Committee has set a target of serving 1
million foreign patients each year by 2012.
The government's aim of developing a
top-class regional health care center is evident
through the recent opening of the "Biopolis", a
center that will house a full complement of
research and development (R&D) activities,
including medical research, drug-discovery efforts
and medical-technology research.
Work on
phase two of the Biopolis has already commenced, a
pointer to the success of the project.
"The overwhelming demand for spaces at
Biopolis leading to the accelerated Phase II
development, signals the exponential growth of the
biomedical sciences R&D community in
Singapore," Yeoh Keat Chuan, deputy director of
the Biomedical Sciences Group of the Singapore
Economic Development Board, said in June.
"It bears testimony to Singapore's success
in building a world-class R&D environment."
It is expected that the center will
eventually encompass about 2,000 researchers.
The move to develop the nation's
biomedical sector appears to be on track,
highlighted by the decision of the European drug
major, Novartis, to set up a US$180 million
pharmaceutical-production center in Singapore.
Work on the new plant and distribution center
commenced in March, and once completed it is
expected to employ more than 150 people.
Yet like many industrialized nations,
Singapore's health sector is endeavoring to find
ways to cope with the increasing proportion of the
population aged more than 60 years. While in 1999
only 11% of the population was more than 60, by
2030 this group is expected to account for 27% of
the nation's population.
The spiraling
cost of medical technology, combined with rising
expectations from a more demanding public are also
key challenges confronting the nation's health
system.
"All over the world, medical
inflation exceeds the general CPI (consumer price
index)," Health Minister Khaw Boon said in May.
"If there is no transformation in the way health
care is delivered, health care must eventually
bankrupt all economies. We need to find creative
ways to deliver more with less, maintain if not
raise standards, while cutting out wastages and
squeezing out inefficiency."
Government
policy Apart from providing a world-class
health system for Singaporeans, the government
continues to focus on attracting foreigners to the
city-state, whether as patients or investors.
As part of the drive to attract more
foreign patients, the government is continuing to
position Singapore as a regional hub for medical
treatment and research.
The government,
partly through the Singapore Economic Development
Board, is also looking to enhance the country's
clinical-research base and biomedical-sciences
industry. The continuing development of the
Biopolis illustrates this.
Moreover, in
light of the recent SARS (severe acute respiratory
syndrome) epidemic and bird flu outbreak, the
government is also setting up a Regional Emerging
Disease Intervention Center as part of the
Biopolis. This institution will endeavor to better
monitor, treat and prevent critical
infectious-disease threats in the region as well
as government efforts to differentiate Singapore's
health system from those in neighboring countries,
helping to attract additional investment.
