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Chapter3:

ManagingHealthcare

CasestudiesofSingaporeandBritain

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LessonObjec=ves

In this chapter, you will learn about:Challenges that governments face in managing

healthcareHealthcare in Singapore and Britain in the 60s

and 70s

Approaches to manage Healthcare since 80s

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Onusisonselftopayforservices.Self

employersclaimmedicalfeesfrominsurancecompanieswhenmedicalservicesusedbyemployees.

Employerpaidinsurance

insuranceplansboughtforpersonalcoveragein=mesnecessity

Personal

Insurance

taxcollectedisusedfortheneedyci=zens.GovernmentTaxes

How is healthcare paid for in Singapore?

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ChallengesinSingapore Toprovidequalityhealthcareandmanaginghealthcareexpenditure

1960s self-governmentin1959 rapidurbanisa?onledtopollu?on indiscriminateli@ering improperdisposalofrubbish healthcareimportantforna?onbuilding

1970s wealthierandbe@er-educatedpeople demandforbe@er-qualitymedicalservices needforspecialisa?onofmedicalservices

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GoalsoftheNa=onalHealthPlan

Ensureahealthyandphysicallyfitpopula=on

EncourageandrewardSingaporeansforleadingahealthylifestyle.

Encourageindividualstoaccumulatefinancialresourcestopayfortheir

medicalexpenses.

Individual

Providesomehealthcareservicesandsupportservice.

Community

Keephealthcareaffordable

Government

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introducedin1984;CPFcontribu=onthatcanbeusedto

payforhospitalbillsandcertainmedicaltreatmentswhenneeded.

Medisave

Na=onalHealthcareInsuranceScheme

SomeclaimsthatcannotbemadeusingMediSavecanbemadeusingMedishield.

Especiallyforpeoplewhorequirelong-termtreatmentillnesses.

Medishield

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WhatisMedifundandWhywasit

ini=ated? Establishedin1993.Primarilycaterstotheneedywhocannotpayfortheirhospitalbillsandself-

employedpeoplewhodonotmakeCPFcontribu=onsandwhoaccordinglyhaveno

Medisave.

Thegovernmentini=atedafundwithsome$200millionandtheaccumulatedinterestwasu=lized

toprovideforneedypa=ents.

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Medifund

MedifundcanbeusedtopayforHIVtreatmentandmaybecancerinfuture

Applica=onstoMedifundaremeanstestedtoensuretaxpayers'moneyonlysubsidisesthosewhoaremostinneed.

Everyyear,MedifunddistributessomeS$60mtoS$70mtopa=entstohelptowardsinpa=entandoutpa=entcosts.

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GovernmentPoliciestokeep

Healthcareaffordable

Governmentsubsidies Medifund Restructuringofhospitals Meanstes=ng

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RestructuringofHospitals

Governmentsway

ofcopingwithrisingmedicalcost

Hospitalshavegreaterfreedomtoreorganizetocatertothehealthcare

demandsofSingaporeans

enabledthegovernmentto

reducesubsidiestohospitals.

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Promo=ngHealthyLifestyleAdoptahealthylifestyle.Ideally,apersonofgoodhealthislesslikelytorequiremedicaltreatment.

HealthPromo=onBoardcarriesoutvariousprogrammestoeducatethegeneralpublic.

Schoolsandworkplacesalsoemphasizehealthyhabits>

exercising,healthydiet.

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LASTLYWorkingwithorganisa=on

Taponthecommunitytoprovidesomehealthcaresupport.Voluntarywelfare

organiza=onsandsomeprivateorganiza=onsaregivengrantstoruncommunityhospitals

andnursinghomes.

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Hospitalsrunbyvoluntarywelfare

organisa9ons

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Organisa9onsthatprovidespecifichealthcare

orsupportservices

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Thereares=llsomegroupsofpeoplewhocannot

payforhealthcareservices.

They have to depend on the government for

their healthcare needs.

Theelderlywhodo

nothavetheopportunitytosave

forhealthcare.Thosewhoareunableto

work.

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Healthcare in Britain

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PostWWIIBritainwitnessedpoverty,massiveunemployment,and

diseaseswerewidespread.

SirWilliamBeveridgestudiedthesitua=onand

deliveredTheBeveridge

Report.

CradletograveSir William Beveridge

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NHS

Establishedin1948.

Everyci=zenconsentsand

contributestoana=onalfundthathelpstheneedy

peopleofBritain.

FreemedicalservicestoallBri=shci=zens,

i.ehealthcarebecameapublic

good.

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Ini=allytheNHSwashighlypopular,howeverin1951theNHSwasunableto

meetthedemandsofthepeople.Why?

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Why?

Risingcost Overwhelmingdemand Morehealthcareneeds.e.gdentures,spectacles,hearingaids

Medicaltreatmentwithoutconsidera=on

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SincehealthcarewasfundedbytheBri=shgovernmentitshealthcareexpenditurewasraised.Thismeantthatthe

governmenthadtocollectmoretaxesfromthepeopleto

managetherisinghealthcarecosts.

Budget set aside for the NHS

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Inthe1980sMargaretThatchersgovernment

soughttoreduce

governmentspendingon

healthcarebypriva=za=on.

Margaret Thatcher, Prime

Minister of Britain (1979 - 1990)

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NHSplan(2000)calledforanincreaseintheamountofgovernmentspending=ll2004.

NHSImprovementplan(2004).Improvinghealthcareservices.Pa=entscanchoosefrom4healthcareserviceproviderswhilstNHSpays

fortheirtreatment.

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LASTLY..

HaveBri=shhealthcarepoliciesmettheneedsofthepeople?