Affordable Excellence

Affordable Excellence (2013) by William Haseltine looks at a truly remarkable story in healthcare, namely that of the Singaporean Health Care System. Singapore has the equal fourth longest life expectancy in the world and yet spends only 4% of GDP on health care, making it only the 32nd  highest spender on health care. Singapore’s healthcare system is not experiencing rapidly rising costs that threaten the financial viability of the state as are most developed countries. How this is being done should be of critical importance to anyone interested in world affairs. This book covers the whole medical system in detail. It’s not a light read but is fairly short.

Singaporeans have a system called Medisave where 6.5-9% of their income is put aside into a medical savings account. This can be used for their own health care or that of their immediate family. In addition the government provides catastrophic cover.

The government and private industry then provide health services and people are able to choose what sort of service they want but much of the money comes from their own Medisave account so people care about the cost of the service they are receiving. People also have means testing for the subsidy they get for care.

The end result of all this has been a medical system that is, in many ways, world leading. It’s remarkable that no one has emulated this system unlike Singapore’s compulsory savings system that has been copied by Australia.

The book looks at the end products of the system, how the payment system works, how costs are controlled, how it’s financed, the history of the system, research done in Singapore and has a Q & A session with Singapore’s Ministry of Health.

One thing worth noting is that the quality of the graphics in the Kindle version is seriously substandard and they are very difficult to read.

The book is a dry, technical, somewhat difficult read but it does cover a really important health system. Singapore shows that high quality health care can be provided at low cost. It’s really worth reading for anyone interested in health policy.


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