Singapore Has Universal Health Care Without Government Control
In Singapore they already have universal health coverage. They also have world-class quality care at world-competitive prices. How do they do it, asks William McGurn, a Vice President at the News Corporation who writes speeches for CEO Rupert Murdoch?
The American health system depends on regulation and oversight to accomplish what Singapore tries to do with competition and choice, explains McGurn:
* At the high end of accommodation, a patient can choose the Victory suite at the Raffles Hospital, a leading private care facility in downtown Singapore; the cost is about $1,438 per night and that price includes a 24-hour private nurse, a refrigerator stocked with drinks, and an adjoining living room to entertain.
* At the other end of the scale, a bed in a six-person room goes for just $99.
* The actual care is the same whether a patient decides to stay in a deluxe suite or a dormitory-style room.
* But the choice is the patient's; the financial incentives encourage the patient to think about those choices; and the low-priced options help keep the overall costs down.
This is no accident, says Murdock. Like ours, Singapore's system is a mix of public and private care and financing. Unlike ours, Singapore's system is anchored, as the Ministry of Health puts it, on the twin philosophies of individual responsibility and affordable health care for all:
* All but the abjectly poor have to pay for some of their care, another downward pressure on prices.
* Almost all working Singaporeans are required to put money in a medical savings account that they use for out of pocket expenses.
* It's their money, and they control it; as a result, they are careful about spending it.
It seems to be working. According to a Raffles Hospital official:
* A knee replacement surgery runs between $12,000 and $14,000; spinal fusion runs between $10,500 and $14,000, and a heart bypass (coronary artery bypass graft) from $23,000 to $26,500.
* Conservatively speaking, these prices are less than a third of what the same procedure would cost in the United States -- that is, when you can even get the price.
Source: William McGurn, "What Singapore Can Teach the White House ," Wall Street Journal, October 20, 2009
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Singapore isn't a "free market" at all. They are more regulated than we are.
Does this sound like a free market system to anyone?
1 - Mandatory deductions from payroll to create a health savings account and services must be justified in front of a BUREAUCRATIC DEATH PANEL before you can deduct your own money .
2 - The government has a privately run insurance option which the government regulates costs and care (i.e. price fixing) and they compete with the private insurance option.
3 - In a government hospital, the government subsidizes 80% of the cost of care
4 - They offer a government-run insurance option in addition to price fixing a so-called "private" one.
5 - They offer a government safety net in certain cases
6 - Hospitals must publish prices for comparison shopping purposes
7 - It's been reported they do not approve the care from the deductions on their health savings account for the disabled and elderly that do not have life threatening situations.
It's really hard to keep prices down when the government fixes the price of an insurance option and then makes private insurers compete with it. People also do not seek treatment for basic illnesses that are not medically necessary to treat, because of the deduction from their account, actively discouraging people going for treatment for something like non-suicidal depression or ADHD or migraines.
And I wonder how they keep costs so low, even when compared to other government-run health care systems (except places like Sweden don't deny care to the disabled)?
I'm glad conservatives are on board for actual government rationing in the name of Social Darwinism; discouraging non-medically necessary treatment; price controls; a de facto public option ; government-subsidized care; and forcing you to hold a savings account.
So, this is free market health care? I think Adam Smith might disagree.
So, what's with the strawman?
The words used were "competition and choice".
You just don't like this article because it makes a liar out of Obama. Obama tries to tell us that his healthcare plan is about competition and choice, but it is actually about regulation and subsidy(price-fixing).
So, while you were busy scrambling to discredit another nation's healthcare program, you missed one important fact:
They are doing it better than Obama's plan would and it is working.
The plural of 'anecdote' is not 'data'.
nothing to do with Obama. It has to do with the fact the article has no idea what it's talking about. Singapore isn't a beacon of "choice and competition", it's a beacon of price fixing and strict government controls. The costs aren't low because of choice and competition, the costs are low because the government takes a private insurance company (it used to be officially public, but then they "privatized" it - so they could pretend it was more capitalistic than it is) sets the rate extremely low and tells the other insurance companies to compete with them. It's basically a public option , and a much stronger one than our Congress is considering given the price mechanism we have designed for it.
I can't say the system would be better or worse compared to Obama's model, considering we haven't tried Obama's model. From a cost perspective, it would be better; but because of more aggressive government regulation - not less. This is false choice and competition, surely you can see a government fixed private insurance is in every way just a public option (and they still cover 80% of basic care in gov. hospitals anyway).
What I can say though, is that this author is delusional if he thinks it's "choice and competition" that made it possible. It's price fixing that makes it so cheap. Oh, and denying disabled people services. Every Singaporean I've spoken with (I know 9 somehow ... not sure how that works given the population, maybe they like my university over there) will say they deny care to disabled and non-life threatening care to elderly people;a necdotal stories support that; and I can assure you it's not a coincidence the government doesn't reveal those statistics to the World Heath Organization. It's like those African countries that say they have a 0% AIDS rate but then won't produce the data or let anyone collect data.
I really have no problem with some "choice and competition" mechanisms in health care such as price shopping or health care savings account (I'd be iffy on deducting this forcibly) - but that isn't going to lower costs to the level Singapore has. I'd don't even want price fixing of that level, I'd be happy if we could just get insurance costs to rise at a rate at least comparable to inflation like most things.
Caelum just demonstrated that the Singapore Health Care system is tightly regulated and price-fixed. An excellent rebuttal of the OP. And you are saying that he just doesn't like the article because it claims Obama is a liar since they have a system built on based on "choice and competition" when he is pointing out that the Singapore system is not the "choice and competition" utopia the OP claims it is.
Sure they seem to have a great system set up for making informed choices for their care-providers, but it doesn't sound like they have a choice of how to pay for it at all, which is the ENTIRE republican argument of demanding "choice" in this legislative debate.
Is this just pure dissonance on your part or am I missing something?
caelum, the OP and I opined.
I saw no demonstration of anything except opinions. If you saw facts, perhaps you could point them out.
The plural of 'anecdote' is not 'data'.