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Singapore Has Universal Health Care Without Government Control

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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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