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Healthc

are
System
s

CONTENTS
1.

A Snapshot of Healthcare in Asia

2.

Singapores Healthcare system

3.

The Asian silver tsunami


e.g of Japan

Healthcare
in Asia

Healthcare in Asia is going through a period of unprecedented


change

Rapid economic growth

Rapid population growth

Increasing affluence and demand for better, and in some


cases, private healthcare

Public healthcare sector reform and broadening

The introduction of new healthcare challenges

ASEAN TOTAL HEALTHCARE SPEND


OVER $68 BILLION
605 million
people
Average age <
27yo

Data from World Bank 2011 (latest available)

ASEAN TOTAL HEALTHCARE SPEND


AS % GDP = Public + Private
20
18
16
14

Public

Private

12
10
8
6
4
2
0

Vietnam spends the most, while Myanmar spends the least. Looking at public and private spending,
private spending is higher, with the exception of Thailand and Brunei, where public spending is higher.
Data from World Bank 2011 (latest available)
(Total health expenditure is the sum of public and private health expenditure)

ASEAN GOVERNMENT HEALTHCARE SPEND


% OF TOTAL GOVERNMENT EXPENDITURE
Government expenditure on health shows a different but equally revealing picture of healthcare provision. Thailand spends the
most, Myanmar spends the least. Indonesia again is low down on health spending, coming in second last. The top three Thailand,
Vietnam, Brunei all have well developed public healthcare systems. As a comparative, the US and UK are spending around 1916%, against the ASEAN average of 6.7%.
25
20
15
10
5
0

Data from World Bank 2011 (latest available)


Health expenditure, public (% of government expenditure)
(Philippines data not available)

ASEAN Average 6.7%


OECD Average 17.2%

ASEAN SPEND PER CAPITA


We made this graph to give you an indication of just how far behind ASEAN is in terms of real healthcare spending. As you can see, the
comparison between the US and UK is extreme. Singapore is the only ASEAN country that comes anywhere close on comparable
terms. This does not mean that healthcare in ASEAN is small beer; on the contrary, it just goes to show the huge growth potential
there is! All ASEAN countries - with the exception of Myanmar, Cambodia and Laos - are opportunity markets for healthcare and
demand is rising rapidly.
10000
9000
8000
7000
6000

Singapore is rightly proud of the


efficiency of its healthcare sector:
excellent outcomes achieved at a
closely managed cost

5000
4000
3000
2000
1000
0

Data from World Bank 2011 (latest available)


Health expenditure per capita (current US$)

ASEAN Average $422.4


OECD Average $4593

Part 2:
Singapores Healthcare system

Individual
responsibility
Out of pocket,
Insurance
e.g. USA

State
responsibility
Taxes, social
insurance
e.g. UK

Shared responsibility
Taxes, medical saving accounts, catastrophic insurance
e.g. Singapore

Health
Health
Health
Health
Health

SINGAPORE
Key Facts

25 total hospitals

10,756 hospital beds

15 public hospitals

10 private hospitals

Developed country ailments such as


cancer, cardiovascular diseases and
strokes; these account for 60% of all
deaths

4.56
8.82
3.15
1.42
2286.38

Despite the relatively low level of spending on healthcare in Singapore, it has one of the best
healthcare systems in the world.

Economically, Singapore many people travel to Singapore for medical tourism due to efficient
healthcare system world class facilities

Around 70-80% of Singaporeans obtain their medical care within the public health system via the 3M.

Overall, the Healthcare 2020 Masterplan aims to cater toward the aging population.

four new acute hospitals between 2020 and 2030.

Pioneer Generation Package, which will pay for healthcare bills for those in the late 60s and older.

For low-income families, Community Health Assist Scheme (CHAS)

Health Issues

expenditure, total (% of GDP)


expenditure, public (% of government expenditure)
expenditure, private (% of GDP)
expenditure, public (% of GDP)
expenditure per capita (current US$)

3M

Eldershield &
Governent
subsidies

Medisave
compulsory saving plan
Medishield life
catastrophic insurance plan
Medifund
a health endowment fund

The Asian silver tsunami


Singapore,Japan

Silver tsunami

Asias furious development development and urbanization


for the past 30 years lead to a falling birth rate

Rapid advancement
expectancies to soar.

Asia is on track to become the oldest region in the


world by 2050 projected to hit 922.7 million by the
middle of this century.

Japan, Thailand(2030),China(2030),Singapore(2030) and


Malaysia(2050) face an increasingly elderly population

This means more age related diseases and healthcare


needs; needs which are currently largely ignored and in
short supply.

of

medical

care

caused

life

Learning point

Silver tsunami

Japan started grappling with this issue 30 years ago

Universal medical insurance coverage


Pay between 10-30% copayment

Long term care insurance (LTCI)


Mandatory scheme, premium starts at 40 yo & topped up
by subsidies from government
LTCI then reimburses bulk of medical expenses to
hospitals/medical institutions

Japans challenges today

Silver tsunami

Hospital sectors low profitability & inefficiency issues


Too reliant on hospital care
Average hospital stay -> 20 days, world average of 7 days
A third of 1 million beds used for long-term elderly care

Additionally,
Shrinking of population
Fewer working adult : elderly (ratio)

To fund increasing expenditure, taxes increase


Healthcare cost rise, no amount of saving is sufficient

Singapores response to aging

Silver tsunami

Policies can consider more schemes for wide


,encompassing policies
Healthcare 2020
Surveying mindsets of younger Singaporean to paying
higher premiums
Infrastructures such as community hospitals/hospice
closer to home.
Assist healthcare providers in cost-cutting or process
improvement initiatives.
e.g. use of robotic arm in sorting out prescriptions at
the pharmacy

The End