, Singapore

Managing healthcare inflation in Singapore

By Andrew Merrilees

At the official opening of Farrer Park Hospital on March 16, Health Minister Gan Kim Yong said that as Singapore's population increases in age, the private healthcare sector must offer services at a lower cost to meet their needs. He called on private hospitals to upgrade their IT systems in order to provide improved services.

Singapore can be proud of its reputation for quality healthcare – ranked sixth in the World Health Organisation's analysis of international healthcare systems in 2000 and third by the Political and Economic Risk Consultancy (PERC) in 2003 – but times are changing, and rapidly.

No one is questioning the quality of care, but the question that needs to be asked is could the system be more efficient?

The private sector in Singapore is predominantly used by those with well above average incomes, but as the population ages, so will demand on the healthcare system as a whole, meaning the private system must match what the public sector has to offer.

Private insurers and hospitals have a big role to play in working with government in reducing healthcare inflation. For many years insurers have blamed premium increases on the rapid rise of technology driving up the cost of delivering service. In most industries technology is helping create efficiencies.

Perhaps all hospitals, not just private institutions, should take a look at how efficiently they are running. How many administrative functions are cumbersome and not running to world's best practice? No one would advocate any drop in clinical care – the fact that Singapore has one of the world's best clinical outcomes is something we should all be proud of. The aim is to refine the system to the point where care is top quality but at a fair price to those who need it, and that means creating efficiency, as well as selecting medication for its function and not its brand name.

With health inflation somewhere between 7 and 13 percent, depending on who you speak to, the whole sector needs to look to be run more efficiently. The hospitals have a role to play, the insurers need to start adopting more of the US best practices around wellness and prevention, the networks of doctors need to think about cost containment, the whole process of making a claim needs to be more automated than it is in Singapore.

The system isn't going to be sustainable for a relatively small and ageing population like Singapore unless radical changes are looked at.

The key to the solution could be public and private institutions working together to increase efficiency and lower the cost of healthcare to an ageing and money-sensitive population – people whose needs will vary across a range of healthcare needs.

The private sector has been urged to upgrade their information technology and join the National Electronic Health Record (NEHR) – doing so would be a step in the right direction. As elderly people go to facility to facility for various healthcare needs, doesn't it just make sense to have their records easily accessible at each facility?

Back in 2015 in a press release from the Ministry of Health, constituency MP Gerald Giam Yean Song said the NEHR's IT systems would be constantly reviewed and updated, and the Health IT Master Plan was developed for this purpose. Song also encouraged the private sector to get on board with the "one patient, one health record" vision. It is this sort of approach that will be a key to managing healthcare cost in the future.

There is no doubt that both the private and public sectors will take these statistics into account and will develop the same endgame – better technology, service, efficiency, and treatment – and we can look forward to a more integrated and cooperative healthcare system in Singapore. Our lives depend on it.

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