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      Affordable Excellence:

       The Singapore Healthcare Story

       How to Create and Manage Sustainable Healthcare Systems

       William A. Haseltine

      Ridge Books

       Singapore

      Brookings Institution Press

       Washington, D.C.

      ABOUT BROOKINGS

      The Brookings Institution is a private nonprofit organization devoted to research, education, and publication on important issues of domestic and foreign policy. Its principal purpose is to bring the highest quality independent research and analysis to bear on current and emerging policy problems. Interpretations or conclusions in Brookings publications should be understood to be solely those of the authors.

      Copyright © 2013

       William A. Haseltine

      All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means without permission in writing from the Brookings Institution Press, except in the case of brief quotations embodied in news articles, critical articles, or reviews.

      Copublished by Ridge Books, an imprint of National University

       of Singapore Press, and by Brookings Institution Press

      Affordable Excellence: The Singapore Healthcare Story may be ordered from: Brookings Institution Press 1775 Massachusetts Avenue, N.W. Washington, D.C. 20036 Telephone: 1-800/537-5487 or 410/516-6956 E-mail: [email protected]; www.brookings.edu/press

      Library of Congress Cataloging-in-Publication data is available ISBN: 978-0-8157-2416-2 (pbk. : alk. paper)

      9 8 7 6 5 4 3 2 1

      Printed on acid-free paper

      Composition by Forum

       Kuala Lumpur, Malaysia

      Printed by Versa Press

       East Peoria, Illinois

      Contents

       List of Illustrations

       Acknowledgements

       Introduction

       Chapter 1 The Singapore Healthcare System: An Overview

       Chapter 2 High Quality, Low Cost

       Chapter 3 Helping Patients Pay

       Chapter 4 Controlling Costs

       Chapter 5 Financing

       Chapter 6 Design and Infrastructure

       Chapter 7 Investing in the Future through Medical Education and Research

       Chapter 8 Facing the Future

       Appendix

       Notes

       Bibliography

       Index

      List of Illustrations

      Tables

       Chapter 2

       Table 2.1 Health Indicators, Singapore

       Table 2.2 Life Expectancy at Birth (years)

       Table 2.3 Infant Mortality Rate (probability of dying by age 1 per 1,000 live births)

       Table 2.4 Under-Five Mortality Rate (probability of dying by age 5 per 1,000 live births)

       Table 2.5 Adult Mortality Rate (probability of dying between 15 and 60 years per 1,000 population)

       Table 2.6 Physician Density 2000–2010 (per 10,000 population) and Hospital Beds 2000–2009 (per 10,000 population)

       Table 2.6a Cost Comparisons of Some Major Procedures between the United States and 3 Medical Travel Destination Countries

       Table 2.7 Healthcare Costs, Singapore

       Table 2.8 Expenditures, 2000 and 2008

       Table 2.8a Expenditures, 2000 and 2008

       Chapter 3

       Table 3.1 CPF Contribution and Allocation Rates for the Various Types of Employees

       Table 3.1a CPF Contribution and Allocation Rates for the Various Types of Employees

       Table 3.2 Medisave Withdrawal Limits

       Table 3.3 Top Up for CPF Medisave Account

       Table 3.4 Tax Benefits for Voluntary Contributions by Companies to Self-Employed Persons’ Medisave Account

       Table 3.5 MediShield Yearly Premiums

       Table 3.6 Deductible and Co-Insurance

       Table 3.7 Premiums for ElderShield400

       Chapter 4

       Table 4.1 Annual Premiums for Basic Health Insurance around the World

       Table 4.2 Appendix Surgery (Appendicectomy)

       Table 4.3 Public Hospitals: Medical Specialties

       Chapter 5

       Table 5.1 Subsidies at Public Hospitals

      

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