When countries become wealthy, one of the first thing the govt does is to ensure that people have good universal healthcare. It is one way to mitigate the negative effects of income inequality. The belief in many countries is that no matter how poor you are, you will be taken care of when you're sick. Not just taken care of but receive equal care. One example is France, the no. 1 healthcare system in the world, they do not have different class wards, luxury private hospitals - when you're sick, you receive the same high quality care as the person 10 times richer than you. That is also the same philosophy that shape the healthcare systems of developed East Asian countries like Taiwan and Japan. Having universality and equality of access to healthcare is one of the main advantage of being born in a developed country ....unless that country is Singapore.
[Research Paper]or under-insured. There are healthcare cracks such as the lack of coverage for children with congenital illnesses and old folks (over 60s) who simply cannot afford the high insurance premiums. Quality of care over the last 2 decades has become more differentiated with private hospitals forming a medical hub for the rich Singaporeans and medical tourists drawing down the limited healthcare resources such as experienced surgeons, specialists and nurses leaving public hospitals with insufficient beds[Link] and capacity[Link]. In 2010, former Health Minister Khaw allowed the use of Medisave for Malaysian hospitals for those who can no longer afford healthcare in Singapore[Medisave can be used in 12 Malaysian hospitals]-the solution for these people is to get treatment in a developing country.
While there is extreme parsimony in healthcare spending which is now the lowest among developed countries as a % of GDP, the PAP govt increased defense spending over the last 2 decades relative to our neighbors and we now have the 4th highest defense spending per capita in the world and our defense spending exceeds that of Malaysia and Indonesia combined - countries with land area hundreds (or thousands) of times the size of Singapore. About one quarter of our budget is spent on defense and this is even higher than Israel which spends 18% of its budget on defense. You might think that such high defense spending will lead to better security in the long run. Think again. Such an imbalance in budget allocation was only possible because Singapore has been run as a semi-authoritarian state in which the PAP has the support of the mainstream media - which allows the PAP to play up the "vulnerability narrative"- and win elections using various uniquely Singapore means such as upgrading carrots and GRCs. The power to spend our budget in an such unbalanced manner will be reduced as Singapore makes political progress. This excessive defense expenditure just cannot be maintained and planners are better off if they start preparing for a more realistic level of spending instead of depending on an excessive unsustainable spending to secure the country.
The SDP suggestion to fund the new healthcare plan:
We propose several sources of revenue to make up for the extra $6.5 billion in government spending on healthcare:
1. Spending on defence should be reduced to those nearer that of other small developed nations ($5.75 billion).
2. Because the burden of spending on healthcare under the plan has shifted from private enterprise to the government, we proposed a slight increase in the corporate tax rate ($1 billion).
3. A luxury tax on luxury items ($1.85 billion).
4. A tax on foreign buyers of local properties ($200 million).
5. Spending from the revenue of the Tote Board will be recalibrated to focus more on healthcare and other social welfare programmes as priority areas.
6. A larger dividend payment from earnings from our past reserves should be made available for use on social programmes including healthcare.
The bulk of funding comes from cutting the defense budget to a less excessive and more sustainable level. Unfortunately, there is a lot of secrecy surrounding our defense spending and information asymmetry exists between those who have a vested interest to maintain this excessive level of spending and those who want a better outcome for Singaporeans. The defense spending supports a number of govt linked companies such as the ST Group that is also a major employer of high ranking officers leaving the SAF. The SAF is also closely linked to the PAP leadership - just count the number of former SAF generals and rear admirals in the cabinet. With this network of vested interest, it is hard to change the system to benefit ordinary Singaporeans who just want a healthcare system worthy of a developed nation and does not burden them so heavily when they get sick. If Singaporeans want a better outcome, they are left with very little choice - they can wait forever for the PAP to shift from its ideological extreme or select representatives who will put the public interest ahead of special interests.
The SDP has put forth a bold plan to move our healthcare system forward and leave decades of misdirected PAP healthcare policies behind. The PAP spent the past 3 decades shifting the healthcare financial burden from govt to the sick and their families and commercializing healthcare resources for profit by promoting Singapore as a medical hub for the rich from other countries. What the PAP govt has done has hurt ordinary Singaporeans and it is time to reform the system and do what is right.