Chpt 3 Notes Sec 3

Chapter 3

1. Singapore Healthcare

Key Issue in Singapore healthcare: What are the best ways to manage Singapore’s Healthcare System and to keep it affordable and of high quality?

Key question
1. There are 3 ways to ensure that Singapore healthcare remains affordable and of high quality
a) Encouraging self-reliance 
b) Government support
c) Community Support
Explain how each approach ensures that healthcare remains affordable and of high quality and which is the best way.

2. The most effective/best way to manage the Singapore healthcare system is through government support. How far would you agree? Explain.

3. “Being self-reliant is the best way to keep healthcare in Singapore affordable.” How far do you agree? Explain.

Factor	Explain factor
Factor 1 Self-reliance/individual responsibility	One of the best ways to do so is through individuals being solely responsible meaning being self-reliant. Self-reliance is about being able to look after oneself by being able to pay one's healthcare bills. [How is this done?] This is done by saving enough money to meet cost of medical treatment through CPF Medisave. If enough money is saved, the person will always be able to afford medical care and meet his healthcare needs. [What is CPF Medisave?] For example, CPF Medisave is a compulsory savings program where 6% of a person's monthly salary is automatically saved in a CPF account which can be used to pay for medical bills only and thus the money will accumulate steadily at 4% interest to become a sizeable sum. Hence, employed Singaporeans will always have the money to pay for their medical needs and this ensures that healthcare always remains affordable for most Singaporeans. Another way in which the individual can help himself in meeting his healthcare needs is through Medishield. Medishield is a long-term medical insurance policy that will help pay for the large medical bills of Singaporeans. This is relying on ourselves because Medishield needs to be bought using one’s own cash and Medisave. With Medishield, a large part of the bill will be covered by the insurance and so it becomes more affordable for people to pay for their medical bills.
Factor 2 Government support	Government support is another way of keeping healthcare affordable for Singaporeans. Government support refers to the government policies that help make healthcare cost lower for Singaporeans. This is done when the government pays for part or a patient’s entire hospital bill. If the government pays for most of the bill, then Singaporeans would find it affordable since they pay less on their own/out of their own pockets. For instance, government subsidies to help Singaporeans pay for part of their hospital bill. A person staying in a C Class ward at a government or restructured hospital will pay only 20% of the bill as the government pays for the other 80%. Hence, Singaporeans pay less for their medical bills because of government support and so this makes Singaporeans' healthcare more affordable. The government also helps by restructuring hospitals to make them more efficient and hence this lowers the cost of medical bills since fewer resources are needed to offer good quality. Thus, the medical bills will be lower for Singaporeans and so healthcare becomes more affordable. The government also offers help in terms of Medifund which is a $200 million fund where the interest is used to help poor Singaporeans who have neither.  Medifund, the government also
Factor 3 Community support	Finally, yet another way to help keep healthcare affordable for Singaporeans is through Community support. Community support refers to medical services such as medical support services provided by voluntary welfare organisations. These voluntary welfare organisation receive government grants [money] and also collect public donations to provide medical services at a cheaper rate, making it more affordable since a smaller fee is charged. For example, the National Kidney Foundation(NKF) and the Ren Ci community hospital provide medical services like kidney dialysis and hospitalization for the aged sick at low cost. By charging less, more Singaporeans can afford such medical services and hence this is how community support makes healthcare more affordable for Singaporeans.
Weighing	In conclusion, Individuals are not solely responsible in keeping healthcare cost in Singapore affordable as the community and government play a key role in this as well since government and community support reduces the overall cost of healthcare to individuals. The individual may not have enough funds to look after oneself because he may be unemployed or has a long-term illness for which he has no savings due to the absence of employment. In such cases, government support like Medifund plays a major role in assisting these people pay for their Medical needs.  However, the individual still plays a significant and very important role because in the longer-term relying on oneself is critical in ensuring that people will always be able to afford healthcare. This is because government and community support are less sustainable approaches to keeping healthcare affordable in the longer-term. The amount of government support is dependent on its ability to increase taxes, however, this is not always possible since continuous tax increments will affect the citizens' incentive to work and live in Singapore. Similarly, it is not sustainable for Singaporeans to depend on the community since cheaper community medical services are dependent on government grants and public donations. Should the government be less able to provide large grants and of the public becomes less generous in donating, community support would not be sustainable in the long-term. Hence, the individual still plays a very important role in helping to keep healthcare affordable although it must be complemented by government and community support.

2. British healthcare

Q: The following are three approaches/methods used by the British Government to try to successfully manage the National Healthcare System (NHS) in Britain.

v  Improving efficiency = Use of privatization

v  Improving quality = government policies to improve quality of healthcare services

v  Managing expenditure = spending more or spending less.

Which is the most effective approach to ensuring the NHS is well managed? Explain.

Factor	Explanation	Comments
Explain factor 1 Increased efficiency	One way in which Britain tried to better manage healthcare its healthcare system is through increased efficiency. Increasing efficiency means being able to providing better healthcare service using fewer resources. This is done through privatization. Privatization means the government passes some or all of the management of a government hospital over to private companies. Private companies will be more efficient and lower wastage of resources as they are experts in some of these areas of service provision. With less wastage, healthcare expenditure by the British government can be reduced and so less government funds are needed to run the healthcare services and yet the quality remains high. Thus, with privatization, the British enjoy value for money healthcare services. For example, the British government let private companies run the non-medical related services in government hospitals like catering, cleaning ad laundry. These private companies are experts in these areas and so can give good quality service at a lower price. Hence, this leads the government spending less on healthcare but still being able offer good quality services. This is how an increase in efficiency through privatization helps the British government manage their healthcare system more effectively. Hence this is why…..	Point/Factor Describing factor Explaining how factor leads to better management of the healthcare system.
Explain Factor 2 Improve the quality of healthcare services	Furthermore, the British tried to improve the quality of the healthcare service provided as a way of better managing the NHS. Improving the quality of service means that British citizens enjoy better healthcare services in the form of a wider array of treatment choices or better standards of healthcare treatment. This means the British Healthcare system (NHS) is better managed. The British tried to improve the service standard through several policies such as NHS 2000 that offered patients faster service as patients could use private hospital services and not have to pay for it. Also there was NHS 2004 where the British public could choose 4 different healthcare providers and NHS would pay for the services rendered. There was also “Health Space” system which allowed patients to make informed choices by being able to access their own medical records online. Furthermore, NHS direct allowed for students to call a doctor for medical advice on the phone and not has to queue to see a doctor. This cut down waiting time and improved the overall service standard for the British. However, this may not be the best way to effectively manage healthcare in Britain because better quality without improving efficiency will cost more money and thus, it may not be sustainable in the long-term as the NHS cannot keep increasing the National Insurance Tax to pay for all these additional services. Hence this is why….	Point/Factor Describing factor Explaining how factor leads to better management of the healthcare system.
Explain factor 3 Managing expenditure by either decreasing or increasing it.	Another attempt at improving the management of the NHS is through managing government expenditure. However, no attempts to reduce healthcare expenditure has succeed because the British are so used to having free healthcare that reducing government expenditure is very unpopular and so no government in Britain has done this successfully. A sudden reduction in expenditure will also cause the service quality to fall and so this is not a wise thing to do. On the other hand, increasing expenditure in healthcare while popular would require the British government to raise the National Insurance Tax and income tax. This would mean healthy Britons would also have to pay this high tax even though they had never used the services of the NHS. Hence, this reduces the British incentive to work hard. By spending more on healthcare without improving the efficiency of resource use, taxes will have to be continually raised to pay for the increased spending. This is not wise as Britons will have to have to pay more tax. Ultimately, the British government cannot sustain such rising expenditure on healthcare as taxation increments have a limit. Hence, this is not the most effective approach.	Point/Factor Describing factor Explaining how factor leads to better management of the healthcare system.
Weighing Compare given and 2 other factors on a basis of comparison	Weigh on the Basis of comparison = Sustainable or not? In conclusion, the most effective way is the method that is more sustainable. Hence, the best approach is through increasing efficiency. This will allow for fewer resources to be used and thus less tax burden on the British citizens without sacrificing quality of healthcare provided. On the other hand, by managing expenditure to improve quality would mean increasing the expenditure and this would require an increase in taxation to which there is a limit to which it can be done. If the way to manage the system is to decrease expenditure without improving efficiency, it would mean that the quality of healthcare is likely to fall and not serve the British public. Also, if the approach is to improve the quality of healthcare services, it has to be done with improvements to productivity otherwise, it would mean increased expenditure and this is not sustainable. If the approach is simply to control healthcare cost by decreasing the amount of expenditure on healthcare, the British public would protest as they did in the 1980s as they are already so used to the healthcare system that is almost 100% free. Hence, the best way to ensure that the British healthcare system can meet the needs of the British public is through improvements of the efficiency

Essay Example
One way in which Britain tried to better manage healthcare its healthcare system is through increased efficiency. Increasing efficiency means being able to providing better healthcare service using fewer resources. This is done through privatization. Privatization means the government passes some or all of the management of a government hospital over to private companies. Private companies will be more efficient and lower wastage of resources as they are experts in some of these areas of service provision. With less wastage, healthcare expenditure by the British government can be reduced and so less government funds are needed to run the healthcare services and yet the quality remains high. Thus, with privatization, the British enjoy value for money healthcare services. For example, the British government let private companies run the non-medical related services in government hospitals like catering, cleaning ad laundry. These private companies are experts in these areas and so can give good quality service at a lower price. Hence, this leads the government spending less on healthcare but still being able offer good quality services. This is how an increase in efficiency through privatization helps the British government manage their healthcare system more effectively. Hence this is why…..

Furthermore, the British tried to improve the quality of the healthcare service provided as a way of better managing the NHS. Improving the quality of service means that British citizens enjoy better healthcare services in the form of a wider array of treatment choices or better standards of healthcare treatment. This means the British Healthcare system (NHS) is better managed. The British tried to improve the service standard through several policies such as NHS 2000 that offered patients faster service as patients could use private hospital services and not have to pay for it. Also there was NHS 2004 where the British public could choose 4 different healthcare providers and NHS would pay for the services rendered. There was also “Healthspace system” which allowed patients to make informed choices by being able to access their own medical records online. Furthermore, NHS direct allowed for students to call a doctor for medical advice on the phone and not has to queue to see a doctor. This cut down waiting time and improved the overall service standard for the British. However, this may not be the best way to effectively manage healthcare in Britain because better quality without improving efficiency will cost more money and thus, it may not be sustainable in the long-term as the NHS cannot keep increasing the National Insurance Tax to pay for all these additional services. Hence this is why

Another attempt at improving the management of the NHS is through managing government expenditure. However, no attempts to reduce healthcare expenditure has succeed because the British are so used to having free healthcare that reducing government expenditure is very unpopular and so no government in Britain has done this successfully. A sudden reduction in expenditure will also cause the service quality to fall and so this is not a wise thing to do. On the other hand, increasing expenditure in healthcare while popular would require the British government to raise the National Insurance Tax and income tax. This would mean healthy Britons would also have to pay this high tax even though they had never used the services of the NHS. Hence, this reduces the British incentive to work hard. By spending more on healthcare without improving the efficiency of resource use, taxes will have to be continually raised to pay for the increased spending. This is not wise as Britons will have to have to pay more tax. Ultimately, the British government cannot sustain such rising expenditure on healthcare as taxation increments have a limit. Hence, this is not the most effective approach.

In conclusion, the most effective way is the method that is more sustainable. Hence, the best approach is through increasing efficiency. This will allow for fewer resources to be used and thus less tax burden on the British citizens without sacrificing quality of healthcare provided. On the other hand, by managing expenditure to improve quality would mean increasing the expenditure and this would require an increase in taxation to which there is a limit to which it can be done. If the way to manage the system is to decrease expenditure without improving efficiency, it would mean that the quality of healthcare is likely to fall and not serve the British public. Also, if the approach is to improve the quality of healthcare services, it has to be done with improvements to productivity otherwise, it would mean increased expenditure and this is not sustainable. If the approach is simply to control healthcare cost by decreasing the amount of expenditure on healthcare, the British public would protest as they did in the 1980s as they are already so used to the healthcare system that is almost 100% free. Hence, the best way to ensure that the British healthcare system can meet the needs of the British public is through improvements of the efficiency.