Singapore's Health Care Model

Today's New York Times has an article about the good outcomes of the health care system in Singapore, where lifespans are 2-3 years longer than in Britain or the U.S.

There are private and public hospitals, as well as a number of tiers of care. There are five classes: A, B1, B2+, B2 and C. “A” gets you a private room, your own bathroom, air-conditioning and your choice of doctor. “C” gets you an open ward with seven or eight other patients, a shared bathroom and whatever doctor is assigned to you.

But choosing “A” means you pay for it all. Choosing “C” means the government pays up to 80 percent of the costs.

The most frustrating part about Singapore is that, as an example, it’s easily misused by those who want to see their own health care systems change. Conservatives will point to the Medisave accounts and the emphasis on individual contributions, but ignore the heavy government involvement and regulation. Liberals will point to the public’s ability to hold down costs and achieve quality, but ignore the class system or the system’s reliance on individual decision-making.

Like many things in Singapore governance, it reflects the ruthless application of intellect to daily life. Singapore is a de facto one party state notorious for its lack of a soft heart, it rewards winners and penalizes losers. Unsurprisingly, this unambiguous reward structure produces in Singapore more winners and fewer losers.