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21 May 2019
Ministry of Health
Suggestion View - 166
A single payer system for health care

The Singapore Democratic Party advocate a single payer system for health care.  What are the features of this system and how is it different from the current 3M system adopted in Singapore?

Here are the features of a single payer system:

a) It is a health care system that covers the population. Every resident is covered. Pre-existing illnesses are not excluded.

b) The state (or its appointed insurer) is the single payer for the medical services covered under the scheme.

c) A large part of the cost of the health care is paid by compulsory contributions (e.g. by employers) or by general taxation. The patients may have to make a modest co-payment for each service. 

d) The state can provide the medical facilities or appoint private providers on negotiated fees. This approach helps to control the health care cost.

e) There is a defined level of services and providers under the single payer system. Wealthy individuals can opt out of the single payer system to buy their own private insurance.

The advantages of a single payer system are:

a) The ability to keep the health care cost under control and ensure an acceptable standard is provided.

b) The low cost of health care to the people as a large part is paid by general taxation.

Here are the disadvantages of the current 3M system (medisave, medishield, medifund) adopted in Singapore?

a) It is a messy and confusing system with a high administrative cost

b) It is not able to control the health care cost which keeps escalating at a high rate.

A single payer system works well in many countries, such as Japan, Taiwan and UK. While each of these countries has its own set of problems, the system generally works better than the free market system adopted in America and, to a large extent, Singapore.

Tan Kin Lian

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