Let me start by saying this is not actually an explanation of the Singapore healthcare system. You can find tons of information online at the Ministry of Health (MOH) (http://www.moh.gov.sg/content/moh_web/home/our_healthcare_system.html) or a number of other locations. This is a few of my thoughts and observations that I find interesting about Singapore healthcare in general.
It’s important and cost less here than in the U.S. If you do not know, healthcare in the US is almost 19% of the country’s GDP therefore it is a huge burden and it is not changing soon. Singapore healthcare costs significantly less and is about 4% of the GDP here. We use an expatriate physician from the U.S. East Coast but he has been here for well over a decade (maybe two) and is settled in. There is a difference between Western and Eastern medicine and how you can talk to your doctor, therefore we (me!) chose Western.
It is much easier to see a physician here. I have made new consult appointments in as little as 2 days prior without a problem. Many work Saturday mornings, since the work week here is M-F and ½ Saturday (44 worked hours until overtime!). Our Cigna expat insurance covers the majority of fees.
Prescriptions are an interesting thing here. To date, any medicine prescribed by the doctor has been handed out in the office during the same appointment. It seems they keep on-hand the frequent medicines they prescribe. The fees are low – about $25 most times – and this has to be one of the best parts of the physician visit. There is no trip to the local pharmacy for the majority of your prescription needs. No laziness to delay you getting your medicine from a local Watson’s (cool huh? I own a chain of drugstores in Asia apparently).
Public health. Singapore is not shy when it comes to voicing public health concerns and putting them out for the public to be made aware. When walking to the nearby MRT station, I was passing a billboard of three Asian women dressed like Marilyn Monroe in the white dress with their skirts being lifted up by a breeze. “That is an interesting ad”, I thought. On closer inspection, it is healthcare message aimed at women to remind them to schedule Pap smears for the early detection of Cervical Cancer.
Although not a government-sponsored advertisement, another one that caught my eye was the recent pamphlet in one of the local women’s magazines my wife is fond of. The cover of the pamphlet mentions “The convenient and discreet treatment of vaginal yeast infection a.k.a. Thrush” Interesting. It must be a serious concern over here. Or because the pamphlet is sponsored by Bayer drugs for their Canesten drug, maybe it is just a new level of marketing evolved from the old one page ad seen only in a few magazines.
One thing I do know is we do not see drug commercials on TV here. That is a relief.
Hospitals are interesting or maybe I am just spoiled having worked for a Newport Beach California hospital for four years before moving here. In Newport Beach, none of the rooms were shared, all had a TV and, the hospital is air-conditioned. Of course, we were in a climate that changed and temperature regulation was more difficult. Here in Singapore, the climate is pretty much 85 degrees with 80%+ humidity on average, all day, every day, all year long. This does allow for some creative architecture in Singapore. In California, we used to talk about things such as open lobby designs we knew would be somewhat difficult given the actual winter weather in Southern California. No, I know it does not snow like the East Coast but you still could not have this open lobby design where air conditioning and heat are needed at different times during the year.
Some of the newer designs here in Singapore are very much like a resort in Bali or Hawaii. Recently a friend from the old hospital was in town and wanted to see one of the newest Singapore hospitals. Through some friends, we arranged for an insiders tour. Since we had both worked with the construction teams, our interest was the design and the patient flow.
The first thing I noticed when we arrived was the lobby. It was outdoors! The main reception area and information booth was like walking into a Hawaiian or Balinese resort. The area was covered to protect from the rain but the seating and desks were outside. Luckily there is a breeze most times.
As you wander through the lobby, you may notice some life-sized yet flat people plastered on the wall next to the stairs. I like the posters telling people to take the stairs versus the elevator when at all possible. It is a light-hearted poster instead of the ones you see reminding you to always wash your hands or die of infection! Of course it is important to wash or gel but I like the take the stairs reminder.
There were a number of interesting things during the tour. One was the education area for the nursing and hospital staff that was full of Toyota Lean training and examples. My previous three years in the States were all focused on Lean in my hospital and I thought it was great to see it. This local hospital was so much ahead of what we had ever done as far as training and the posting of projects. They had a wall that had holders containing large sheets of all the past projects you could pull out and review. If I were still trying to implement Lean, it would have been something I ‘copied’ to use at home!
The next thing interesting was the ‘wards’. In the US we typical call them units or floors but the idea is the same. A certain area may focus on cardiac care while another looks after cancer patients, etc. There are two types of wards/rooms here. One is the “I have good insurance, therefore I’d like privacy and air-con please“(air-conditioning for those of you not using the local dialect). The second type is really just the opposite. If your insurance or your funds from your mandatory health-savings account (one nice thing about government policies here) are not enough, you will be in the shared room with about 7 other beds and patients. Several ceiling fans overhead circulate the air from the nearby no-glass windows. Yes, these rooms are open to the air, shared by a number of other sick people, and there is never any air-con. It is all a breeze. I am sure there are many thoughts around this but I do know the amount of clean, fresh air circulating here is likely better than the re-circulated air-con air you usually get indoors even when it runs through the huge filters hospitals use as part of their HVAC system. Think of the cost savings for these buildings that have no constant air conditioning! No filter changes! Lower electricity cost!
The final thing I’ll mention seen during the multi-stop tour was the Chairman’s suite. This was a patient room with state-of-the-art controls accessed from a screen next to the patient’s bed. There was a full sitting room with a big screen TV and small table. It was larger than most hotel rooms I have stayed in and bigger than any private hospital room I had seen previously. I believe this modern Singaporean hospital has two such rooms. I understand as new hospitals are built there are at least a few of these in each now to attract those wealthy families who want the best treatment and privacy available.
Singapore healthcare is quote good and I have been pleased with the physicians we have worked with in the 11 months we have been living here. Statistics will show it is better, and less expensive, for almost all treatments when compared to the United States. I don’t know that it will last. Just like the U.S., I am starting to see more and more news items about the aging population and the lack of sufficient retirement funds or healthcare savings to get them through the golden years. For Singaporeans, the majority of their wealth is tied up in their home. Many have retirement funds of approximately $100,000. This does not bode well when the expected number of years left to live after retirement is at least 20. Time will tell but both Singapore, the U.S., and most major nations are now starting to see this burden of elderly healthcare hitting their systems. Add in the growing obesity problem, I am sure the 24/7 McDonalds delivery doesn’t help, and the next 5-10 years will be very, very interesting.
Best of luck Singapore. I am rooting for you!
Just in case – here was my previous ocean view…… 
More photos from our tours…
