Tuesday, March 20, 2012

SDP's Healthcare Proposal....

You can find the 87 page report here. The proposal is for a single payer universal healthcare system and contains suggestions on how it can be financed. I will leave you to read the report and go through the details yourself. I want to just highlight a few interest ones from the proposal.

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.

As Singapore became more developed, the PAP govt shifted more and more of the financial burden to the sick and their families. The cost of healthcare rose faster than wages and the inflation rate. At the same time the income gap rose and the PAP approach to shift the financial burden to the sick and their families increased the strain on the finances of families in the middle class and below. Today Singapore hospitals hire debt collectors to go after those who cannot afford to pay. About 21 per cent of Singaporeans who sought financial counselling from Credit Counselling Singapore had to do so due to medical bills. Today families are at risk from rising healthcare cost because many are uninsured [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.
 

41 comments:

Ng Eng Hou said...

The SDP Plan is a good start, but unfortunately this is not the plan from PAP.

When I looking at those reports or news about Singapore achieving world ranking in this or that. All these sound hollow or meaningless to most of us.

A lot of things are not working. Flooding happens often, SMRT breakdowns getting more often, we have not enough hospital beds, not enough doctors and nurses, most of us heavily worried about our medical costs.

Is This The Singapore That 60% Of The People Voted For?

Anonymous said...

a question for you - what is your current nationality ?

Anonymous said...

"The SDP has put forth a bold plan to move our healthcare system forward and leave decades of misdirected PAP healthcare policies behind."
Lucky Tan

But the problem is the SDP cannot win elections! Not even a single seat, let alone become govt to implement their bold proposal.

And Lucky Tan wasn't a opposition candidate in GE 2011, let alone 87 Lucky Tans.

Like that how?

Veritas said...

Israel has around S17 billion defence spending while we have 12 billion.

But look at what Israel did with this monies? Israel has managed to develop nuke, merkeva tanks, phalcon...etc

At least Israel get back some value for its monies spent. What we get? We only have fat salary for regulars, useless ST DSO DSTA where everyone despises.

In short, MINDEF is the greatest parasite of Singapore.

Anonymous said...

"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."
Lucky Tan

But the PAP won every election in the past 3 decades with at least 90% seats!

And how come SDP from 3 seats won in GE 1991 become no seats since then?

And how come WP from 6 seats in GE 2011 become 5 seats after just only 9 months?

So opposition have good proposals and plans got use or not?

Why not enough Lucky Tans join SDP or other opposition party?

Or why don't they just have one party and accept one Lucky Tan as their leader?

Like how all the PAP MPs accept PM Lee as their leader?

If the opposition can change, then they can win 60% like the PAP.

But unlikely lah.

So like it or not, accept PAP's healthcare plan lah.

Anonymous said...

Lau chui nua (mouth watering only, delicious looking but no chance to eat)

Anonymous said...

When good money is paid but cannot get good talents and outcome, that's how parasites starts to grow.

Anonymous said...

Just wondering aloud. If a poor soul has fallen sick and is in dire need for medical treatment, will the public hospital reject this patient? After treatment and this poor soul has absolutely no money or whatsoever to pay back the treatment and any follow up cost, what are the public hospital going to do? Write off? Or force him to sell his flat? Need a court order to do that? Get an order to bankrupt him?

ser guan said...

"One example is France, the no. 1 healthcare system in the world, they do not have different class wards, luxury private hospitals "

I wonder whether it is possible for France not to have any luxury private hospital. So i google and under an entry in wikipedia called "Health Care in France", it state that 18% of hospital are for profit instutions. i.e. private hospital.

Anyway, page 44 of the SDP healthcare proposal state that Singapore will continue to have private hospital. Does Lucky Tan disagree with that?

If private healthcare is not available in Singapore, what is there to stop me from going to Johore Bahru, Thailand or Hong Kong for my medical care.

Unless a communist revolution happen and singapore close its borders, sick singaporeans will never have equal care. Similar to the airline industry, Singapore present healthcare system has budget class,economy, business and first class. The SDP proposal will lead to only 2 class, budget and first. Is that what we want?

Veritas said...

////
Unless a communist revolution happen and singapore close its borders, sick singaporeans will never have equal care. Similar to the airline industry, Singapore present healthcare system has budget class,economy, business and first class. The SDP proposal will lead to only 2 class, budget and first. Is that what we want?
////

The communist health model is even better that private ones. Cuba a poor country has even better infant mortality rate than USA despite of USA embargo. Cuba even export doctors to south America.

Why are we importing doctors? Singaporeans are clever and we should be exporting doctors.

Many absurd things happening here because of a crazy medical cartel.

Years of experience has shown that private healthcare model like those of US failed miserably. The system is just for wicked medical cartel, big pharma to extract rent from helpless people.

Anonymous said...

Good article by Lucky! 60.1% is the tipping point. Internet has level the playground and will continue to influence the electorate..

Lucky Tan said...

Ser Guan,

I did not say abolish private hospitals. In france a large number of these private hospitals are non-profit and administered the same way as as public hospitals. The for profit private hospitals have to price their treatment under a pricing mechanism known as the DRG. That is why I said no "luxury private hospitals" rather than private hospitals. You have to properly regulate the private sector care otherwise it can "go wild" and devour resources of public sector.

Anonymous said...

http://www.straitstimes.com/BreakingNews/Singapore/Story/STIStory_779531.html

Singapore's is the 5th biggest arms importer in the whole wide world!!!

The Opposition team has to drill them more.
This is one single BIGGEST ticket item and they cannot continue to hide behind opacity and expect people to believe there is no waste,mismanagement of any kinds with such scale and spend.

We would rathe spend on upgrading hardwares than upgrading our human talent software - health.
This is utter shameless..what kind of govt do that?

Anonymous said...

There is no doubt whatsoever that the SDP Health Proposal is much more superior than the current pap system.
Any sane Singaporeans without vested interests will vote for the SDP Proposal.
It is really amazing how the pap has complicated and mess up the Singapore Health System and yet they have the audacity to champion it on the world stage. Those countries should find out from the ordinary Singaporeans before they adopt this pap shitty health system. I hope Communist China is not so stupid. If they adopt it, there will be another revolution in the future.

yk said...

Hi Lucky, SDP proposes to cut the defence budget by $5.7 billion, which is close to 50% of the defence budget for the year - $12 bil+. While my gut feel is that our defence budget is excessive, i don't think a cut of close to 50% of our defence budget is in our best interest. Although we are not in the middle east, we are also not, at the same time, in a pleasant neighbourhood.

Veritas said...

////
i don't think a cut of close to 50% of our defence budget is in our best interest. Although we are not in the middle east, we are also not, at the same time, in a pleasant neighbourhood.
////

We are having a peaceful relationship with Malaysia and Indonesia for more than 40 years.

And besides, I am increasingly seeing no injury when we are invaded by Malaysia and Indonesia. Quite the contrary, as times goes by, the advantage of being conquered by Malaysia and Indonesia gets ever attractive.

First, we must ask what are we defending. Obviously we are defending the property of rich and FTs.

PAP has created phoney wealth and illusion that Singaporeans has better material well-being. The reality may be far from that. In fact, we are slaves subjected to heavy stealth taxed.

Our children are deprived of a grass patch because of greedy PAP and their FT policy.

When we get absorb into Malaysia or Indonesia, we will have plenty of living space. We can have a dog. Not a bad deal.

Next we need to ask ourselves who is worth for us to shed our blood. For me, I will only give away my life so that our children have a better future.

But now, this is no longer relevant. PAP make use of FT to sterilize us to TFR of 1. In short, within 5 generations, we will drop to 8% of our population today.

So to defend Singapore is equivalent to defending the children of FT.

And why so stupid of die of others sons.

Singapore is increasingly no longer worth defending. In current trend persist, the best thing to do is not to resist people like Mahathir, but we should invite them to throw their divisions into Singapore to get rid of PAP.

When we are absorb into Malaysia or Indonesia, I bet 100% our fertility will recover to 2.

We will then have children that is worth defending.

PAP uses FT to force us into shoebox that in the near future, PAP may be jacking up land price to a level that we may need to pay 30 years mortgages for a space as big as toilet bowl.

Lye Khuen Way said...

What I like about the SDP's proposal is that it was a concerted effort by some 9 professional doctors who volunteered their time and except for one, they were NOT from the SDP !

We now await the response from the Health Ministry and many concerned stake holders from the Defence camp.

As Lucky pointed out, the more a country progresses, almost ALL will embark on some form of universal Healthcare for its citizens, rich or poor.
Then again, we are NOT a country, as one SC/Minister x2 always remind us.
But wait, a citizen surely belongs to a City-State, no ?

Anonymous said...

Flooding happens often, SMRT breakdowns getting more often.

But the ERP never break down leh.

Anonymous said...

What do you want?

With more healthcare spending, there will be less defend spending.

With less defend spending, ST Group will have difficulty to survive.

Without ST Group, retired generals and rear admirals and resigned officers will be unemployed.

While ordinary Singaporeans are discriminated in job applications and are suffered with depressed salaries due to the tsunami of foreigners,

these retired generals and rear admirals and resigned officers, being cream of the crop, must hold high positions, earn high incomes, work in stable environments and protected from the impact of the tsunami of foreigners.

In essence, retired generals, rear admirals and officers are different from ordinary Singaporeans and therefore they must receive privilege Very Important Person treatments.

Anonymous said...

//Flooding happens often, SMRT breakdowns getting more often.

But the ERP never break down leh.//

ERP is a cash cow so how can it breakdown.

Flooding & SMART breadowns also can be cash cow also because it will be a good reason or excuse to charge you more for better infrastructure & improvement.

When it comes to smart-alec scholars, head they win tail you lose. Either way, you will be painted black and they will be painted white. they are so smart that they begin to forget the word SMART is written on their foreheads.

Veritas said...

We have to ask ourselves what are we defending?

We are defending a government which take away our gardens, grass patch, and uses these to build lodging for foreigners.

We are defending a government which uses land scarcity as a excuse to implement COEs, but uses all these land to build lodging for foreigners.

We are defending a government who give foreigners that cannot get 1st class under full scholarship while our sons go into debt for paying tuition.

We are defending a government that force poor citizen at least 40% of overt or stealth tax while the rich pay 0% tax.

We are defending a government which jail our sons for 1 day of AWOL while rich man son Melvin the pianist draft dodger are invited back to perform on red carpet.

We are defending a government which ever crank up property hoping that Singaporeans fertility drop to zero.

We are defending a corrupt government whereby all holders important positions are relative to one another. Tony Tan is relative of LKY. Tony is CEO former GIC, Loong is now CEO GIC, Ho Ching CEO Temasek. Kuan Yew now is special advisor GIC.

We are defending a family of fanatic gambler who rather lost all our monies in wall streets rather than invest in health care.

We are defending a government that give jobs to foreigners.

.... more
.... more

The crimes of PAP are numerous. I am increasingly believe that it would be better living under the racist Malay Bumi policy than PAP's phoney meritocracy.

Anonymous said...

When Potong Pasir voted Opposition, they got abalone from PAP.

When Hougang voted Opposition, they got teochew porridge from PAP.

When Holland-Bukit Timah GRC voted PAP, what did they get?
- A demeaning question;
What do you want? 3 meals in a hawker centre, food court or restaurant?


CONCLUSION
----------
You get more goodies when you vote Opposition.

Anonymous said...

I hope people give SDP a chance to prove themselves in 2016

Anonymous said...

" Taiwan - has a strong free market economy - decided to create a new health care system in the mid 1990s, it studied every existing model. It too chose a model of universal access and universal insurance but decided against having several private insurers, as Switzerland and the US do. Instead it created a single insurer, basically a version of Medicare (US). The result : universal access and high quality care at stunningly low costs. Taiwan spends only 7% of its GDP on healthcare."

An excerpt from TIME magazine by Fareed Zakaria "Health Insurance Is for Everyone". It compares the Swiss and Taiwan standard.

http://www.time.com/time/magazine/article/0,9171,2109128,00.html

It should put Singapore into Hall of Shame for spending so little in this area for its citizens when cost of living, inflation and deterioration of globalization have all resulted in the diminishing care of our people. All these while we spend 25% on hardware and sustaining operationals in defense.

Anonymous said...

"I hope people give SDP a chance to prove themselves in 2016."
Anon 21/3/12 12:38

They even got Tan Jee Say to contest GE 2011, but SDP still lost what.

So how to win in 2016? Get Lucky Tan to join SDP?

Anonymous said...

"It should put Singapore into Hall of Shame for spending so little in this area for its citizens when cost of living, inflation and deterioration of globalization have all resulted in the diminishing care of our people. All these while we spend 25% on hardware and sustaining operationals in defense."
Anon 21/3/12 12:55

But 60% think it is no shame to vote PAP what.

Or maybe more shame to vote opposition.

Anonymous said...

If you feel so strongly about this issue, then vote Opposition in GE 2016.

Convince your friends & family to vote Opposition in GE 2016.

Convert ONE PAP voter to vote Opposition in GE 2016.

Talk no use.
Opposition politics is the cure for bad government policies.

Anonymous said...

Even with so much spending in defence, we are overrun by Foreigners. Singaporean are having a bad deal despite, everybodies need to paid so much tax. Our babies and old citizen are not even spared to be taxed. (Gst 7%).

Just say a family of monthly income of $1,000, if they spent all the money, the Gst payable will be $840 annually. $1,000, nowaday can't go very far, as the government don't imposed annual tax. But now, this family are taxed nstantly when they consume necessities. Somebody said that there is Gst rebate. But why pay tax first or whether the rebate is adequate to offset, a big queston mark?

fed up with stupid 60.1 said...

SDP plan is good, but most voters could not care less.

They are religiously programmed to worship LKY and his army of white-dressed clerics who worship money and greed.

Even the poorest PAP diehard from AMK or Tanjong Pagar will vociferously defend the right of FTs to take his job and enjoy scholarships funded by his taxes and then to turn around and call him a dog.

This PAP diehard demonstrates his love and loyalty for his god by voting PAP every election.

Until SDP can persuade these religious people, there's no point in coming up with any theoretically sound plans for the nation which will never be implemented by the greedy MIWs.

Anonymous said...

"Until SDP can persuade these religious people ..."
ANON: 21/3/12 17:33

I respectfully disagree.

It is not SDP's job to persuade.
It is my job as a loyal Singaporean to defend my country and family from such people.

If you are committed to Singapore;
vote Opposition.

If you are VERY committed to Singapore;
Persuade your friends & family to vote Opposition.

If you are a die-hard Singaporean;
Persuade a PAP supporter to vote Opposition.

Go out and win votes for the Opposition.

Anonymous said...

I go through SDP Healthcare Proposal already.

Very professional and well written.

But in GE 2011, SDP scored "kosong" leh. Very "sayang" hoh?

Anonymous said...

多干实事, 少说空话.
-已故邓小平

Anonymous said...

Run the country like a company and your
- hospitals must make a profit
- buses must make a profit
- MRT must make a profit
- HDB must make a profit
- LTA must make a profit
- URA must make a profit
- everything must make a profit

And you're expecting an easier and better life?

Anonymous said...

For an easier life, just vote Opposition.

Hougang voted Opposition.
And now they get free Teochew porridge.

Potong Pasir used to get abalone porridge when they voted Opposition.
Now? No more until GE 2016.

Vote wisely in GE 2016.

Voting for the Opposition is like making love.
It gets easier with practice.

Anonymous said...

"What the PAP govt has done has hurt ordinary Singaporeans and it is time to reform the system and do what is right."
Lucky Tan

But ordinary Singaporeans are the majority of people what, right?

So they are also majority of voters, right?

So you mean PAP govt hurt majority of voters and yet can get 60% majority votes?

So where's the logic?

Anonymous said...

Considering the backlash against the SDP on yahoo.com and that silly article written by an unknown Miss Jeanette Tan who claimed that "some" Singaporean readers do not want universal healthcare and do mind paying extra for people who are out of a job, I am wondering how this plan of universal healthcare will ever be made possible. Some Singaporeans actually think that people who do not work are in that state because they are lazy and entitled, and actually refuse to pay any taxes or endorse universal healthcare for the unemployed! What a mistaken lot of self-righteous people!

Anonymous said...

//But ordinary Singaporeans are the majority of people what, right?

So they are also majority of voters, right?

So you mean PAP govt hurt majority of voters and yet can get 60% majority votes?

So where's the logic?//


It is common sense! A ruling party with absolute control of almost everything should have no problem to obtain more than 60% of votes.

Anonymous said...

What has the PAP government done for singaporeans these past 10 years?

Nothing but incompetence and overcrowding.

The moneyy they get from us every month for the quality of work they've been doing lately is a sin.

ANd we have Heng Swee Keat talking about paying money to students in the name of values education? Stupid 60.1%.

Anonymous said...

Interesting post. I must contend though that,t whilst you've made the point about equality of access in countries like France, where access is irrespective of personal income, if you dig a little deeper into WHO reports, you will find that no system can guarantee equality of access. Their research have shown that the rich, irrespective of country, will always be better off because they are usually more informed about how to access services. It goes beyond having services available to actually removing barriers to access, which one may not consider a barrier.

Anonymous said...

Kind of misleading.. You really need to get out of this country to see if the grass is greener on the other side.. Comfort and safely was taken for granted and abusied over the years. Imported tax 17%for Uk and whole of Europe is 29% same thing as what we call gst here. Income tax 35% and above. Country like Denmark 50% per year. A decent meal cost bout $20 and above per head count. Some family can only afford to eat out once a month. Lets not forget since land is not a issues and even if the house is cheap. The loan and interest given from the banks there is much higher. And you will not gain anything even after you hold it for more than 10 yrs. now think medical, edu etc all cover for 50% of your income taken per year. Choose a first world country to compare and get your facts right.. Read on why English was being use as our first language.!

Anonymous said...

Just because other countries and their system has flaws does not make ours right