Health as a Human Right -- Each briefing paper should answer: How is access to ensured in your country? What challenges does your country face in providing health care for all.

Healthcare in Singapore is mainly under the responsibility of the Singapore Government's Ministry of Health. It has been said that Singapore has one of the top healthcare systems in the world, in terms of accessibility, efficiency and affordability. This has been maintained through the culmination of various factors, the government’s provision of basic healthcare services and infrastructure, as well as the citizens’ personal responsibility for their individual healthcare. Universal Healthcare System The government ensures affordability of healthcare within the public health system, largely through a system of compulsory savings, subsidies and price. Provision of 8 pubic hospitals (Singapore General Hospital, , Kendang Kerbau Hospital, just to name a few) and specialized medical centres to treat various kinds of illnesses and provide diverse medical services. Outpatient polyclinics available in various neighborhoods to provide convenient, no-frills healthcare services such as medical checkups or doctor visits. Elderly daycare programmes for the aged and recuperation homes for those discharged from hospital but still in need of recovery in community centres. Subsidies given to lower income patients who may be unable to afford the full costs of healthcare. Ward C patient receive larger proportions of rebates compared to Ward B and A to ensure that the proportion of subsidies is distributed such that those who are in need of monetary resources are able to obtain them easily. Compulsory Savings Scheme: The (CPF) is a compulsory national savings scheme Medisave where both individuals and their employers contribute a certain sum of money from their monthly pay towards a personal savings account, so as to ensure that individuals have sufficient financial resources in old age. Part of the CPF includes a nationalized plan known as Medisave. Medisave enables claims to be made for various healthcare bills such as chemotherapy for cancer patients, diabetic medication, treatment for patients with high blood pressure etc. In 2005, Medisave was reviewed to include a wider range of healthcare services that could be claimed from this insurance plan, providing better coverage for patients. State-provided Insurance: MediShield is a low-cost medical insurance plan that helps patients cope with Medishield large bills and covers up to 80% for lower class ward patients. Most middle class and higher income buy supplementary Medisave-approved insurance plans for additional benefits, in addition to basic MediShield. About 75% of Singaporeans are covered under MediShield.

Additional Financial Help: Medifund works like a financial safety net to help Singaporeans in genuine Medifund need. Those who still face difficulties with hospital expenses, even after Government subsidies, The fund started with S$20 million in seed money and the interest earned from the account is used to help needy patients pay for in-hospital bills.

Individual Responsibility A key principle of Singapore's national health scheme is that no medical service is provided free of charge, even within the public healthcare system. This mechanism acts as a check and balance intended to reduce the overutilization of healthcare services. Singaporeans are expected to be independent to a certain extent in their payment of healthcare bills, based on the theory that every country has finite financial resources that are unable to support a population indefinitely. The government is willing to make healthcare affordable and accessible to all if citizens are willing to be accountable for their health. ‘Eat Healthy’ and exercise campaigns are held regularly to educate the public on how to stay fit, breeding the culture of a productive workforce that minimizes expenditure on healthcare through an individual effort. Overall government spending on healthcare amounts to only 3-4% of annual GDP, partly because government expenditure on healthcare in the private system is extremely low. This prevents strain on resources and frees up financial reserves to be channeled into other areas of development. Two-Pronged Approach Towards Approximately 70-80% of Singaporeans obtain their medical care within the Healthcare: public health system. However, there is an added option of choosing private Public and Private Support healthcare services. With privatization in the 1990s, the government granted autonomy to certain hospitals to become have a greater degree of freedom in terms of deciding the functioning and running of these medical centres. This allowed hospitals to serve patients better through the added incentive of becoming more efficient and meeting the healthcare needs of the patients with privatization. Being profit-motivated, these hospitals would also reduce costs and find more effective ways of providing high quality medical care for Singaporeans. Singaporeans also can rely on personal healthcare insurance to provide a certain form of financial protection against sometimes rather high healthcare costs. According to news reports, travel receipts from medical hit an all-time high in 2011: more than $900 million dollars. The nation's medical infrastructure is world-class and familiar to tourists from Europe and America who are attracted by an environment where the facilities are clean and orderly and the medical staff speak fluent English. A large number of tourists seek plastic surgery and other cosmetic procedures. Many seek cancer therapies or specialized surgeries such as dental procedures, joint replacements and stem cell therapies. Singapore’s medical industry is known to be highly established and accomplished, having achieved success in medical breakthroughs and medical research. In 2001, Singapore doctors successfully separated a pair of conjoined twins that were joined by the head. Singapore was the first Asian country to successfully perform an Adult Living Donor Liver Transplant in 2002. Medical tourism, does not, however, reduce the number of resources available for Singaporeans in terms of healthcare as the government esnrues that foreigners pay higher costs, protecting the needs of the citizens first before foreign tourists.

Challenges in Providing Healthcare Profit motives, competition and privatization have always provided greater motives for firms in the healthcare industry to become more competitive. The provision of public healthcare services may result in a less efficient healthcare system due to complacency. Although healthcare only takes up 3% of Singapore’s GDP, faced with other pressures to spend tax revenue elsewhere like in development, housing and transport, healthcare costs through a universal system may be a burden.