The many facets of rising healthcare costs in Singapore

20170214060000, Zhi Peng Ho
The rising costs of healthcare
According to the Pricewaterhouse Coopers (PwC) Health Research Institute, the projected increase in global medical costs in 2017 is likely to be the same as that of 2016, i.e. 6.5%. However, the situation of rising medical costs appears to be much worse in Singapore, where according to a report, elderly healthcare costs are projected to rise tenfold over the next 15 years to more than US$49 billion (SG$66 billion) annually.

This also entails that an average of US$37,427 will be spent on healthcare for each elderly person by 2030. This figure is the highest in the Asia-Pacific region.

Causes of rising healthcare costs

1. Advances in medical technology

Medical technology has revolutionised healthcare. Advancements in technology have led to the creation of proton therapy, which delivers higher doses of radiation that is targeted to cancer cells while saving healthy organs and tissue. Additionally, non-invasive heart surgeries have replaced operations that used to begin by cracking open a chest. However, all of these technological innovations cost money – In 2012, about $41 billion was spent in research and development.

Medical innovations have opened new treatment options which allow for early diagnosis and reduced medical errors. However, these options are often costly. In fact, the medical costs of new medicine and improved technology have added to the rise in healthcare expenditure overall.

2. Increasing ageing population

Between 1965 and 2015, Singapore’s population increased from 1.9 million to 5.5 million. However, the number of citizens who were aged 65 and above increased rapidly, as population growth slowed. The size of this group of citizens had doubled from 220,000 in 2000 to 440,000 in 2015; it is expected to increase to 900 000 by 2030.

Worldwide, an estimated 524 million individuals were aged 65 or older in 2010; this made up 8% of the world’s population. By 2050, this figure is projected to nearly triple to around 1.5 billion, representing 16% of the world’s population.

In general, the issue of population ageing would entail higher medical costs. This is because there is likely to be a shrink in labour force, which means that there is lesser tax revenue to finance Singapore’s healthcare, but more dependents to look after.

3. Inefficiency of medical services and procedures

In the context of healthcare, inefficiency refers to the inappropriate and ineffective use of medicines and healthcare services; inefficiency may also occur due to the many administrative procedures for each patient. This will lead to a rise in healthcare costs – In Singapore, the potential range of efficiency savings from Human Resources, Medicines, Hospitals, etc can reach 20% to 40% of Total Health.

How healthcare expenditure can be reduced for Singaporeans

1. Encourage patients to seek early treatment or diagnosis

The Ministry of Health has recommended Singaporeans who are above 50 years of age to undergo colon cancer screening. Despite the fact that screening via colonoscopy is expensive, early detection saves lives. Additionally, many medical studies have shown that colon cancer screening is cost-effective in terms of the costs of different treatment types.

2. Ensure patients are informed about the various healthcare schemes available

The Singapore healthcare provision model is multi-layered. Singaporean citizens are provided with subsidies before they need to use their Medisave, followed by Medishield Life, and lastly Medifund to pay for healthcare costs.

Medisave is a national savings scheme that helps CPF (Central Provident Fund) members to save for their medical expenses in the future, especially during their retirement; Medishield Life is a basic health insurance plan that helps in the payment of large hospital bills and certain expensive outpatient treatments, such as chemotherapy and dialysis. Lastly, Medifund was set up by the Government to help patients who face financial difficulties to pay for their remaining medical bills after obtaining Government subsidies and drawing on other payment means, which includes Medishield Life and private Integrated Shield Plans (IPs).

Doctors will need to make sure that their patients are familiar with the various financial schemes, as well as whether they are medically insured. This is especially important considering that medical inflation is on the rise.

Healthcare providers want to deliver cost-effective healthcare to their patients – doctors or hospitals that charge unreasonably high fees to their patients will be unable to retain patients in the long run. To prevent further increases in healthcare costs, however, requires a good deal more effort from all parties, i.e. the patients, doctors, hospitals and regulatory bodies, and is likely to be a long time in coming. MIMS

Read more:
A look at healthcare systems across Asia
Singapore's MOH lauds efforts towards efficient and improved patient care
Improvements needed in the contrasting healthcare systems of Malaysia and Singapore
Crowdfunding in the face of unaffordable healthcare

Sources:
http://www.todayonline.com/singapore/low-down-rising-medical-costs
http://news.asiaone.com/news/yourhealth/rising-medical-costs-singapore-making-informed-choices
http://www.thehastingscenter.org/briefingbook/health-care-costs-and-medical-technology/
https://www.nia.nih.gov/research/publication/global-health-and-aging/humanitys-aging
http://www.straitstimes.com/singapore/health/elderly-health-costs-to-rise-tenfold-by-2030-report
http://www.pwc.com/us/en/health-industries/health-research-institute/behind-the-numbers.html
http://www.healthcareasia.org/2016/rising-employee-healthcare-costs-in-asia-largely-driven-by-ncds/