This video interview of Leong Sze Hian highlights a number of problems with healthcare, housing and transport faced by ordinary Singaporeans. If you have been reading my blog for the past few years, these problems have been highlighted here many times with the hope that the PAP govt will do something to improve the lives of ordinary Singaporeans. However, little has been done and it is not where we have gone but where we continue to head that worries me most. Why isn't the PAP govt motivated to solves these problems? Why is it so hard for the PAP govt to solve these problems? It is not possible for the PAP govt to be unaware of these problems ...then why have things been allowed to deteriorated so badly in the past 10 years...? Lets go through the root cause of each of these problems and I will show you a consistent pattern behavior and thought of on the part of this govt.
Housing. HDB continues to insist that housing is affordable even as more people default on their HDB loans. Among the solutions being explored to make housing "more affordable" is to put Singaporeans in no-frills housing or downgrade to smaller flats. If HDB flats are truly affordable, how did we get here? Rightfully, the rise of HDB prices has to be kept in line with the household income and the sustainability of this income but this is hardly the case as the rise in HDB flat prices have outstripped the rise of median income. HDB claims that it merely priced its new flats relative to the resale market. But how did the price of flats escalate to such levels? Is market price simply the reflection of demand and supply? There were 2 things that resulted in the escalation of housing prices - the 1st is the liberalisation of CPF for housing[research paper : Link] which caused a large jump in housing prices sometimes termed euphemistically by the PAP govt as 'asset enhancement'. The 2nd is the lengthening loan tenure and expansion of household debt to keep the property price rising - HDB flats used to be paid up in 7-8 years now they take 30 years to pay up. The end result is insufficient funds for retirement and a high household debts that make Singaporean households vulnerable during recession. But who are the prime beneficiaries of high housing prices? Housing loans are wildly profitable for banks, our govt land sales to HDB rake in billions which go into Temasek Holdings for investments and big developers. Our housing market is hardly healthy due to the high levels of debt incurred by Singaporeans for a roof over their heads. During the boom times, people who need a home have to take on huge debts as prices go up and when recession comes, defaults mount and a large number of people get into trouble with the bank.....and Singaporeans have to go through these gyrations 3 times in the past 10 years.
Healthcare. If you're asked to design a healthcare system for Singapore, would you learn from the number 1 healthcare system or the number 20 healthcare system in the world? Before I answer that question lets take a look at the rising cost of healthcare in Singapore. We have been told that cost of healthcare will rise and keep on rising fast so we have to purchase insurance to cover ourselves and set aside sufficient funds should we get sick. Have you asked why healthcare costs have gone from highly affordable to barely affordable -read about the case of the cancer patient needing to raise hundreds of thousands[link] because her insurance only covers $30K of her $400K treatment. Some people who have not had relatives or close ones who got sick still thinks that serious illness can be treated for around $50K- that is just not the case. You sometimes wonder what happens to people who cannot afford to pay up - the hospital will hire debt collectors to chase after these people for payment - some have to take up bank loans or sell their homes to pay for treatment.
Singapore aims to be a medical hub and the goal is to attract 1 million medical tourists by 2012 [link][Link]. This ambition to be a medical hub for rich arabs and millionaire Indonesians have strained our resource tremendously because it caused private hospitals to expand to serve these medical tourists and the pay packets of specialists and surgeons to escalate. There is a case being fought today involving healthcare provider Parkway and one its ex-employees whose job was to market medical services in middle-east and Europe [Link to be provided] - he is suing for $2.2M in commissions for bring patients to Singapore. When it comes to medical services, Singaporeans now have to compete with pocket books of millionaires from around the world. The govt remedy to all this is to make us buy insurance. However, if you listened to Leong Sze Hian's interview carefully, an insurance based approach leaves out hundreds thousands of Singaporeans who cannot be covered or cannot afford the insurance. To find out where we will be in a few years we just have to look at the US which has a similar system. Such a system is prone to cost spirals in which medical costs go up causing insurance premiums to go up. Such a system has also left millions Americans uninsured and the cost of healthcare per American has escalated to be among the highest in the world as the profits for insurance companies and hospitals went up. What we are beginning to adopt is a healthcare system that promises to generate higher and higher profits for various businesses and passes the cost to Singaporeans who become sick.
Now to the question...why did the PAP copy the healthcare system from a country that is ranked 20th (USA) instead of the country that is ranked No. 1 (France)? ....The answer is simple - the French system results in a healthcare cost that is among the lowest per person in the society in developed countries but generate little or no profits for insurance companies, hospitals (which are mostly govt owned).....the choice is obvious for the PAP....
Public Transport. Our main public transport companies (SMRT, SBS) are public listed companies with shareholders who have invested in these companies for profits. If I'm a SMRT shareholder, I would be concerned if the trains are not packed like sardines every morning and the human beings in the train actually have space to swing their arms. I will demand SMRT lower its costs by reducing its frequency so that the utilisation per train goes up and profit goes up. If I were an SMRT shareholder, for the past 5 years I would be smiling because SMRT pays out good dividends and its profits increases year after year[Link]. Last quarter they reported rising profits apparently the recession that is hurting Singaporeans does not hurt SMRT's profits.Singapore being an island state means that there is no place to run to when cost of living escalates. Yes, our concerned govt encourages us to put our old parents in Johor so save money and they are considering the use of Medisave for overseas medical treatment because many cannot afford to be treated locally anymore. However, what the PAP will not do is change the system to lessen the financial burden on Singaporeans because our debts translate to profits for many business entities and our govt with its complex interests in GLCs and its pro-business ideology simply cannot work solely for the benefit ordinary Singaporeans. So their message to Singaporeans is work harder, work longer and never retire.