Lessons for Singapore from the US?

Typically, a country’s health system reflects the political ideologies that it was founded upon. However, as countries become richer, concerns over access and equity tend to take on a greater role in shaping the healthcare system. Below is a comparison of the present healthcare systems in Singapore and the United States (US) the models used, results attained as well as a comparison of both countries’ recent healthcare reform efforts.

Historically, US society was founded on capitalism. During the post-world War II period, private employers found it difficult to attract and retain labour as money was scarce. Hence health insurance was used by private employers as a way to attract and retain workers. Gradually, the government found private health insurance useful as a way to attract and retain labour so they began to offer employers some benefits such as tax breaks if they provided health insurance to their employees and dependents.

Although this model proved to be advantageous in many ways, it ultimately made a large percentage of the US population susceptible to high medical costs; this included the elderly and the unemployed. The latter included many fresh college graduates, the self-employed and those who worked for small businesses which did not offer insurance. A private-sector solution proved to be futile because insurers were not willing or were not able to afford the high premiums that would insure these ‘high-risk’ individuals.

Thus, in 1965, the US government implemented the Medicare and Medicaid programmes that respectively provided public insurance for the elderly and the disabled, and for low-income households. Over the past 48 years, the government expanded these programmes such that coverage is near universal for those who are eligible.