Page 1 of 4 1234 LastLast
Results 1 to 30 of 101

Thread: Why Singapore's health-care system works

  1. #1
    Join Date
    Mar 2009
    Posts
    6,134

    Default Why Singapore's health-care system works

    Why Singapore's health-care system works Think | Updated today at 01:28 AM By Gillian Tett

    A decade ago, I had an experience that left me profoundly grateful to Singapore's health-care system. During a work trip to the island state, I was suddenly taken ill and succumbed to a rare variety of meningitis.

    In many countries, I would have died, but two extraordinary things occurred.

    First, a colleague had a strange premonition that something was wrong and came to my hotel room, where she found me sliding into a coma.

    Second, the colleague then had me rushed to a local hospital, where Singaporean doctors identified the problem with astonishing efficiency and then took a bold medical gamble to save my life. (Essentially, they injected every type of antibiotic they possessed directly into my heart because they did not have any tailored way of treating the rare strain of meningitis I had.)

    When that gamble pulled me out of the coma, the staff set me on the path to rehabilitation, with further efficiency and grace.

    A few months later, I stumbled on some paperwork between the hospital and my insurance group and noticed that the bill for the intervention was not that large.

    "If this had happened in America, it would be many times that size," a colleague later grimly remarked in New York. To which I retorted that if the incident had happened in America, I might not have survived at all since litigation risk might have deterred the doctors from engaging in that antibiotic gamble.

    Was this just a piece of random good luck? Yes, in part. But that may not tell the whole tale. Recently I have been flicking through a fascinating e-book, Affordable Excellence, that a scientist friend, Professor William Haseltine, has written about Singaporean medicine for the Brookings Institution. And this leaves me convinced that I have even more reasons to say "thank you" to Singapore than I realised at the time.

    Professor Haseltine believes that Singapore's health-care system is not just low-cost but also very effective in terms of saving lives; so much so, in fact, that this might offer lessons to the US, which is embarking on health reform.

    The statistics are striking. At present, the US spends about 18 per cent of its gross domestic product on health care, more than any other Western nation. But while this produces fantastic results in some niches (such as cancer treatment), the metrics for infant mortality, adult deaths, life expectancy and other health issues are worse.

    Singapore's health-care costs, by contrast, are just about 4 per cent of its GDP; and while the system is based on insurance programmes, premiums per capita are just 2 per cent of those paid by Americans. But on issues such as life expectancy, infant mortality, premature adult death and emergency care, Singapore produces much better outcomes than the US.

    Why? One reason, Prof Haseltine suggests, is that Singapore created a health-care system from scratch a few decades ago and was able to adopt a rational plan that focuses on the total health experience of the population. America, by contrast, is marred by competing, wasteful silos.

    But another weapon for lowering costs in Singapore is consumer pressure: Hospitals are forced to publish prices for medical procedures and outcomes so that consumers can compare them. Patients are also forced to co-pay for treatment, alongside insurance groups, to create incentives to scrutinise their bill.

    Now, it would be impossible to replicate some of this in a vast, fragmented system such as the US'. After all, most Americans hate the idea of state meddling, but there is one aspect of Prof Haseltine's report that is relevant: accountability. If Americans could compare the price of treatments as easily as they can in Singapore, that might lower treatment prices - doubly so if the use of co-payments was as widespread among the rich as among the poor.

    The good news is that the US is moving that way since there is growing support within the medical world for co-payments and price transparency. But the bad news is that any changes are slow and patchy because the system is so fragmented. For the foreseeable future, in other words, those statistics from Singapore are likely to keep putting the US and other nations to shame.

    It is a sobering thought, given that behind those statistics stand millions of human stories, many of which were not as blessed with as much good fortune as mine.

    Financial Times
    “Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity.”
    ― Martin Luther King, Jr.

    OUT WITH THE SHIT TRASH

    https://www.facebook.com/shutdowntrs

  2. #2
    Join Date
    Oct 2012
    Posts
    34

    Default

    I think Minority is PAP's Internet Brigade. Mainly to post positive things about the govt. Am i right, Minority?

  3. #3
    Join Date
    Jun 2009
    Location
    Southbank
    Posts
    9,531

    Default

    Can you offer something better.

  4. #4
    Join Date
    Aug 2009
    Posts
    376

    Default

    Quote Originally Posted by agentg
    I think Minority is PAP's Internet Brigade. Mainly to post positive things about the govt. Am i right, Minority?
    Triple confimed he is one.

  5. #5
    Join Date
    May 2011
    Posts
    616

    Default

    I supposed damage control is in order for things that is happening in the background that maybe looming on the horizon ...

  6. #6
    Join Date
    Nov 2008
    Posts
    8,013

    Default

    The writer said the bill was not that expensive? He was reading about just the cost of the therapist?

  7. #7
    Join Date
    May 2011
    Posts
    616

    Default

    Quote Originally Posted by ysyap
    The writer said the bill was not that expensive? He was reading about just the cost of the therapist?
    Time to look at a more equatiable cost for resident and non resident.

    I would imagine the one doing the gamble or expriment is not a houseman.

  8. #8
    Join Date
    Mar 2012
    Posts
    71

    Default

    ang moh get cheaper bill?

  9. #9
    Join Date
    Dec 2009
    Posts
    6,003

    Default

    Quote Originally Posted by regency321
    ang moh get cheaper bill?
    SGD8

  10. #10
    Join Date
    Mar 2009
    Posts
    6,134

    Default

    Quote Originally Posted by agentg
    I think Minority is PAP's Internet Brigade. Mainly to post positive things about the govt. Am i right, Minority?

    Its a article by Financial Times. Well unless all you like is to read how shitty everything is I can post shits like all the other people also.

    There are good there are things to improve. If feeling Shitty is what folks like to feel good. by all means.
    “Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity.”
    ― Martin Luther King, Jr.

    OUT WITH THE SHIT TRASH

    https://www.facebook.com/shutdowntrs

  11. #11
    Join Date
    Mar 2009
    Posts
    6,134

    Default

    Quote Originally Posted by samuelk
    Time to look at a more equatiable cost for resident and non resident.

    I would imagine the one doing the gamble or expriment is not a houseman.

    Try getting health care in US and you will know. even with a green card or citizen.
    “Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity.”
    ― Martin Luther King, Jr.

    OUT WITH THE SHIT TRASH

    https://www.facebook.com/shutdowntrs

  12. #12
    Join Date
    Mar 2009
    Posts
    6,134

    Default us-health-care-system-worst-in-the-world

    http://theweek.com/article/index/204...t-in-the-world

    U.S. health care system: Worst in the world? A Commonwealth Fund study concludes that American care ranks first in cost and last in performance among seven industrialized nations By The Week Staff


    The US health system: Worse than the rest? Getty Get ready for more heated debate about health care: A new study says the U.S. spends twice as much as six other industrialized nations on care, but gets the worst results. The U.S. health system, which cost $7,290 per person in 2007, ranked "last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives," according to the report by the Commonwealth Fund, a New York-based private foundation focused on health. The Netherlands, where the universal health care system spends $3,837 per person annually, had the best care. Does the U.S. really have the worst health system, or is the study biased in favor of socialized medicine?

    There's no denying America lags behind: "Years ago, the World Health Organization came out with a ranking of health systems that placed the US 37th," says Ezra Klein in The Washington Post. And while there's been much controversy over that ranking, it's pointless to refute the Commonwealth Fund's findings. This isn't a broadside from some outsider — the ratings come from our own patients and doctors. And, "here, too, the U.S. underperforms."
    "U.S. health-care system: Still bad"

    This study is biased in favor of socialized systems: Worldwide health-care comparisons are "apples and oranges," says Sue Lani Madsen in the Seattle Post-Intelligencer. The costs of socialized systems would be higher if they offered as broad a range of care as we have in the U.S. ("You can't buy what's not available"). And poor grades from American patients may be a measure of high expectations rather than low-quality care.
    "Health care spending: No such thing as non-biased"

    Face it. Our system's the worst, but there's hope yet: "Pretty much no matter how you measure it, our health care system stinks," says Julie Rovner at NPR. But there's hope yet. The winners in the Netherlands don't have the sort of government-run, socialized system that's so widely derided. They achieve "universal coverage with an individual insurance mandate, much like the one recently passed by the U.S. Congress."
    "U.S. spends the most on health care, yet gets least"
    “Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity.”
    ― Martin Luther King, Jr.

    OUT WITH THE SHIT TRASH

    https://www.facebook.com/shutdowntrs

  13. #13
    Join Date
    Mar 2009
    Posts
    6,134

    Default

    http://www.businessinsider.com/us-he...d-world-2013-1

    CHARTS: The US Has Some Of The Worst Health Statistics In The Developed World

    In their efforts to block health care reform, politicians often claim that the U.S. has the best health care system in the world. As such, we shouldn't tinker with it.
    The evidence, however, points to a different conclusion: the U.S. health care system provides less quality and less value compared to its international counterparts.
    The New York Times recently published an article that discusses the results of a comprehensive study convened by the Institute of Medicine and the National Research Council on mortality rates and other measures of health care.
    The expert panel concluded that there is a ‘U.S. health disadvantage,’ according to Sabrina Tavernise at the Times:
    The panel called the pattern of higher rates of disease and shorter lives “the U.S. health disadvantage,” and said it was responsible for dragging the country to the bottom in terms of life expectancy over the past 30 years. American men ranked last in life expectancy among the 17 countries in the study, and American women ranked second to last.
    Aaron Carroll of The Incidental Economist points us to the report, U.S. Health in International Perspectives: Shorter Lives, Poorer Health, which has plenty of charts that confirm these findings. For instance, when it comes to the health of a pregnant mother or her soon-to-be/newborn child, the U.S. has the highest mortality rate among all developed nations:

    The U.S. is also home to the third-worst mortality rate by nutritional deficiencies, the second-worst rate of death through respiratory disease, and the highest absolute age-adjusted mortality rate amongst all developed nations:

    National Research Council and Institute of Medicine
    So, what does the U.S. pay for this degree of service?
    Short answer: more than any other country on the planet, as indicated by these charts:


    Nearly all these advanced countries, which provide better health care outcomes at a lower per capita cost, have a system of universal health care in place.


    Read more: http://www.businessinsider.com/us-he...#ixzz2VmC1tdhP
    “Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity.”
    ― Martin Luther King, Jr.

    OUT WITH THE SHIT TRASH

    https://www.facebook.com/shutdowntrs

  14. #14
    Join Date
    Mar 2009
    Posts
    6,134

    Default

    “Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity.”
    ― Martin Luther King, Jr.

    OUT WITH THE SHIT TRASH

    https://www.facebook.com/shutdowntrs

  15. #15
    Join Date
    Oct 2012
    Posts
    34

    Default

    Quote Originally Posted by minority
    Its a article by Financial Times. Well unless all you like is to read how shitty everything is I can post shits like all the other people also.

    There are good there are things to improve. If feeling Shitty is what folks like to feel good. by all means.

    Are you paid to make postings?

  16. #16
    Join Date
    Dec 2009
    Posts
    6,003

    Default

    Quote Originally Posted by minority
    Your impressive statistics give little condolence to this poor boy who waited 5 hrs at TTSH and died from dengue. Better to look at ground issues than be a desktop warrior.

    http://singaporeseen.stomp.com.sg/st...s_at_ttsh.html

  17. #17
    Join Date
    May 2009
    Posts
    3,677

    Default

    the second death is even worse - diagnosed with skin inflammation and given antibotics, without blood tests being ordered!!!!

    the clinical symptoms were fever, shortness of breath, vomitting and rash on the leg. how can these be typical of skin inflammation?!?!?!?!?!?!?

    if it's my dad, i would surely sue the hospital for malpractice and misdiagnosis.

  18. #18
    Join Date
    Mar 2009
    Posts
    705

    Default

    Quote Originally Posted by eng81157
    the second death is even worse - diagnosed with skin inflammation and given antibotics, without blood tests being ordered!!!!

    the clinical symptoms were fever, shortness of breath, vomitting and rash on the leg. how can these be typical of skin inflammation?!?!?!?!?!?!?

    if it's my dad, i would surely sue the hospital for malpractice and misdiagnosis.
    Indeed .. when I first read this I thought that MO muz be damn stupid (wonder how he/she passed her medical exams)! Some more already got precedent case, plus this is an old man with other health conditions, shouldn't there be more care? Nvr heard of skin inflammation can have such symptoms, sounds like a malpractice

  19. #19
    Join Date
    Dec 2009
    Posts
    6,003

    Default

    Our health care system has been overwhelmed. With the new NTU medical school recently started and new hospitals being built, the system may only start to recover in 6-7 years' time. However real expertise takes many more years to build up and it will take a lot of tax-payers' money to ramp up the training and facilities.

  20. #20
    Join Date
    May 2009
    Posts
    3,677

    Default

    Quote Originally Posted by hyenergix
    Our health care system has been overwhelmed. With the new NTU medical school recently started and new hospitals being built, the system may only start to recover in 6-7 years' time. However real expertise takes many more years to build up and it will take a lot of tax-payers' money to ramp up the training and facilities.
    our healthcare manpower resources lagged since the day when Lim Hng Kiang became health minister.

    doesn't help when the NUS med school selection panels have an unspoken 'reserved' lots for the well-connected

  21. #21
    Join Date
    Dec 2009
    Posts
    6,003

    Default

    Quote Originally Posted by eng81157
    our healthcare manpower resources lagged since the day when Lim Hng Kiang became health minister.

    doesn't help when the NUS med school selection panels have an unspoken 'reserved' lots for the well-connected
    What flavor of coffee do you want to drink

  22. #22
    Join Date
    Mar 2011
    Posts
    2,065

    Default

    Quote Originally Posted by cheerful
    Indeed .. when I first read this I thought that MO muz be damn stupid (wonder how he/she passed her medical exams)! Some more already got precedent case, plus this is an old man with other health conditions, shouldn't there be more care? Nvr heard of skin inflammation can have such symptoms, sounds like a malpractice
    Some MOs are difficult to fathom. Especially Foreign Talent.

    My own personal experience here.

    I was prescribed with a drug (antibiotic) from an affiliated clinic to TTSH. After one week of taking the drug, I started feeling unwell with stomach pains, loss of appetite...took my blood test at a private lab...found my blood count was low including platelet count (could be an early sign of dengue). Did the Dengue test - negative. I suspected drug allergy. I even broke out in a rash. Went to see the MO. They said....maybe...stop the drug and see. I stopped the drug for a few days. I repeated the Dengue test (on my own expense) which was negative again. I felt better. The rash went away. My platelet count went back towards normal level. I also had pins and needles which were a known side effect of the drug and they stopped when I stopped the drug. I went back to see the MO. He said that my case had been reviewed by their team and they concluded that I did not have a drug allergy. Asked me to restart the drug. I was horrified as I feared that I could develop a severe and life threatening drug reaction. They were indifferent to my concerns and stuck to their recommendation to restart the drug.

    I felt that I had a strong case for it being a drug reaction and had already proved it was not Dengue (by 2 sets of tests) and still they refused to accept that it could be a drug reaction.

    If they cannot put the signs and blood tests together for a relatively simple case like mine, I don't have much confidence that they could have put together the signs and symptoms of the more complicated cases of infectious diseases that come their way.


  23. #23
    Join Date
    May 2009
    Posts
    3,677

    Default

    Quote Originally Posted by chiaberry
    Some MOs are difficult to fathom. Especially Foreign Talent.

    My own personal experience here.

    I was prescribed with a drug (antibiotic) from an affiliated clinic to TTSH. After one week of taking the drug, I started feeling unwell with stomach pains, loss of appetite...took my blood test at a private lab...found my blood count was low including platelet count (could be an early sign of dengue). Did the Dengue test - negative. I suspected drug allergy. I even broke out in a rash. Went to see the MO. They said....maybe...stop the drug and see. I stopped the drug for a few days. I repeated the Dengue test (on my own expense) which was negative again. I felt better. The rash went away. My platelet count went back towards normal level. I also had pins and needles which were a known side effect of the drug and they stopped when I stopped the drug. I went back to see the MO. He said that my case had been reviewed by their team and they concluded that I did not have a drug allergy. Asked me to restart the drug. I was horrified as I feared that I could develop a severe and life threatening drug reaction. They were indifferent to my concerns and stuck to their recommendation to restart the drug.

    I felt that I had a strong case for it being a drug reaction and had already proved it was not Dengue (by 2 sets of tests) and still they refused to accept that it could be a drug reaction.

    If they cannot put the signs and blood tests together for a relatively simple case like mine, I don't have much confidence that they could have put together the signs and symptoms of the more complicated cases of infectious diseases that come their way.

    did they explain the rationale for continuing the drug? were u still having a fever then?

  24. #24
    Join Date
    Mar 2011
    Posts
    2,065

    Default

    Quote Originally Posted by eng81157
    did they explain the rationale for continuing the drug? were u still having a fever then?
    They said it was not a drug reaction because the symptoms started after I had been on the drug for a week rather than straight away. The drug was for prevention of infection as I had been exposed to someone who was infected. I had no fever or symptoms of illness before then. They did not consider that I could have a delayed reaction to the drug (not all drugs cause immediate reactions). And they were not at all concerned that I could develop a severe life-threatening reaction if I started the drug again after stopping it.
    Last edited by chiaberry; 10-06-13 at 15:37.

  25. #25
    Join Date
    May 2009
    Posts
    3,677

    Default

    Quote Originally Posted by chiaberry
    They said it was not a drug reaction because the symptoms started after I had been on the drug for a week rather than straight away. The drug was for prevention of infection as I had been exposed to someone who was infected. I had no fever or symptoms of illness before then. They did not consider that I could have a delayed reaction to the drug (not all drugs cause immediate reactions). And they were not at all concerned that I could develop a severe life-threatening reaction if I started the drug again after stopping it.
    depending on how the drug is metabolized and if there is any adverse reactions, they should pop up within 24 hours usually.

    since they did a dengue blood test, did they run a bacteria culture test too? the bacteria culture would rule out if you have the bug. if you were not febrile, there is no real reason to continue the course of antibiotics, especially since there was a break of a couple of days.

  26. #26
    Join Date
    Mar 2011
    Posts
    2,065

    Default

    Quote Originally Posted by eng81157
    depending on how the drug is metabolized and if there is any adverse reactions, they should pop up within 24 hours usually.

    since they did a dengue blood test, did they run a bacteria culture test too? the bacteria culture would rule out if you have the bug. if you were not febrile, there is no real reason to continue the course of antibiotics, especially since there was a break of a couple of days.
    No my white cell count was normal. No good reason to do a blood culture. When I stopped the drug, the symptoms went away, mostly within a day, the rash took 3 days, the pins and needles took a bit longer.

    I had to continue taking antibiotics as it was for TB prevention.

    I decided not to go back on the original drug. I saw a senior doctor who offered me an alternative drug which I took without any side effects.

    The original drug was Isoniazid. I had stomach pains, loss of appetite, my platelet count dropped, my liver function tests were affected, I had a red rash all over my body, I had pins and needles (meaning my nerves were affected - but it did not respond to high doses of vitamin B6 which I self administered). I don't think that most doctors can ignore the possibility that I had a reaction to Isoniazid and to ask me to go back on it was in my opinion risky on the part of the MO. It was over the Christmas holiday period. If I had a severe reaction, I think I might become an unfortunate stastistic as I would have to wait 5 hours or more to see a doc.

    Oh yeah, I also had mouth ulcers, so my airway swelling could have become a problem if I restarted on the same drug.


  27. #27
    Join Date
    May 2009
    Posts
    3,677

    Default

    Quote Originally Posted by chiaberry
    No my white cell count was normal. No good reason to do a blood culture. When I stopped the drug, the symptoms went away, mostly within a day, the rash took 3 days, the pins and needles took a bit longer.

    I had to continue taking antibiotics as it was for TB prevention.

    I decided not to go back on the original drug. I saw a senior doctor who offered me an alternative drug which I took without any side effects.

    The original drug was Isoniazid. I had stomach pains, loss of appetite, my platelet count dropped, my liver function tests were affected, I had a red rash all over my body, I had pins and needles (meaning my nerves were affected - but it did not respond to high doses of vitamin B6 which I self administered). I don't think that most doctors can ignore the possibility that I had a reaction to Isoniazid and to ask me to go back on it was in my opinion risky on the part of the MO. It was over the Christmas holiday period. If I had a severe reaction, I think I might become an unfortunate stastistic as I would have to wait 5 hours or more to see a doc.

    Oh yeah, I also had mouth ulcers, so my airway swelling could have become a problem if I restarted on the same drug.


    yup, they should have switched you to another regime, just to be safe. i suspected that you would have TB or septicimia, but the latter would have required you to be warded.

    the mouth ulcers outbreak should have been an easy tell-tale sign of reaction to a drug.

  28. #28
    Join Date
    Nov 2008
    Posts
    8,013

    Default

    Quote Originally Posted by chiaberry
    Some MOs are difficult to fathom. Especially Foreign Talent.

    My own personal experience here.
    I went back to see the MO. He said that my case had been reviewed by their team and they concluded that I did not have a drug allergy. Asked me to restart the drug. I was horrified as I feared that I could develop a severe and life threatening drug reaction. They were indifferent to my concerns and stuck to their recommendation to restart the drug.

    What team did the analysis for you? Doesn't sound professional, not to mention coming from a hospital. Even a GP has the good mind to tell me to change medication when my body does not respond positively to the course of antibiotics after a week, not to mention rashes and negative responses...

  29. #29
    Join Date
    Mar 2009
    Posts
    6,134

    Default

    Quote Originally Posted by hyenergix
    Your impressive statistics give little condolence to this poor boy who waited 5 hrs at TTSH and died from dengue. Better to look at ground issues than be a desktop warrior.

    http://singaporeseen.stomp.com.sg/st...s_at_ttsh.html

    have u tried Brunei wait in public hospital? yes its subsided at $1. but have u tried it? as well as wait?

    Have u tried china hospitals or even vietnam?

    Yes US hospital are more efficient but A&E wait are also crazy? Have u seen the bill? it take a PHD to decipherer it. And becoz of the insurance model the quality of the health care is crap. An who benefit from this? the lawyers and the docs.

    so see for urself experience it before u go thinking we have the worst.
    “Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity.”
    ― Martin Luther King, Jr.

    OUT WITH THE SHIT TRASH

    https://www.facebook.com/shutdowntrs

  30. #30
    Join Date
    Mar 2009
    Posts
    6,134

    Default

    Quote Originally Posted by agentg
    Are you paid to make postings?

    Well there are positive news. is it in your nature to think that everything is shit? a article in Straits Time pple like you will scream its goverment mouth piece bullshit.

    A article from the bbc or international media u will say its ang mor view and start getting xenophobic. ignoring

    but when some one publish bullshit bad news u will agree without checking facts.

    Well the article is comparing US health care which is now working . If u choose to look at the worst of all things I guess u are really sad. Nothing will truly make u happy but see bad news. and think u are in shit.
    “Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity.”
    ― Martin Luther King, Jr.

    OUT WITH THE SHIT TRASH

    https://www.facebook.com/shutdowntrs

Similar Threads

  1. Replies: 0
    -: 03-10-21, 16:44
  2. How Singapore's monetary policy works : Business Times
    By princess_morbucks in forum Coffeeshop Talk
    Replies: 18
    -: 10-04-14, 01:56
  3. Massive health-care complex by 2030 (will this be positive for the area?)
    By vboy in forum Singapore Private Condominium Property Discussion and News
    Replies: 9
    -: 09-09-13, 15:40
  4. Replies: 144
    -: 14-02-13, 12:18
  5. Singapore system is in a mess
    By hyenergix in forum Coffeeshop Talk
    Replies: 52
    -: 26-01-12, 13:23

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •