Want a better health-care system? Try Singapore’s
Singapore's Merlion statue (Image by Augapfel via Flickr)
I have criticized parts of Obama’s health-insurance plan, infamously so if you believe some critics. Yet I have not proposed any alternative systems or defended the current system. So it’s worth asking which health-insurance system would be best.
I don’t have an answer, which is not to my credit as my mother is a former public health nurse. However, I am interested in Reihan Salam’s characteristically reasonable proposal: the U.S. should follow the model of Singapore, which relies on a one-two punch of compulsory health savings and universal catastrophic care. Here’s Salam:
[M]any on the left emphasize the virtues of the National Health Service, most strikingly the fact that health expenditures in the UK amount to roughly 8.4 percent of GDP, slightly more than half of what the public and private sectors spend on health in the United States. But Singapore, which has a system built around catastrophic insurance coverage and health savings accounts, spends less than 4 percent of GDP. And according to the World Health Organization, Singapore has the world’s sixth best healthcare system, miles ahead of Britain or the United States.
The benefits of Singapore’s system are likely oversold. Sure, the typical Singaporean lives longer than his American counterpart, but a better health care system isn’t the lone or even major reason, as Americans are more likely to die from gunshots and accidents. But its system strikes me as a model, though perhaps not the model.
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Wow, that’s ironic. I lived in Singapore for a year, and have many friends still in country. (And I was under surveillance by Singaporean intelligence, but that’s a story for another time). There are two kinds of political opposition in Singapore: one kind that sincerely thinks the PAP government is oppressive, and the second which uses the PAP’s Nixonian tactics to suppress dissent as an excuse for their real agenda: a more classically liberal economic policy in Singapore.
Those folks have an economic viewpoint that I would describe as more in line with conservatives in this country. And on the whole, they feel that Singaporeans are forced by their government to put aside too much money on things like housing, health care, etc., that all serves to effectively enrich the government at the public’s expense. And they see the government as basically the extension of a large corporation, Temasek Holdings.
I don’t think I agree entirely – Singapore has a lot of good going for it in its current economic stewardship, in spite of all the political ham handedness that drives talented Singaporeans away from the country in droves. But how strange that American conservatives would look at the government’s policies that are far more in line with Democratic thinking (i.e. the HSAs are mandatory) as a potential model for the US.
But I salute Reihan for thinking outside the box. If this kind of thing were really on Chuck Grassley’s side of the table in the Senate Finance Committee, maybe we wouldn’t need to have a debate that involves ‘death panels,’ AR-15 assault rifles, and allegations that anyone is being ‘unAmerican.’
Thanks for the insighful reply. Being under surveillance in country could not have been enjoyable. But now that you’re out, being able to tell the story is, at a minimum, a good look.
More seriously, American conservative support for Singapore’s plan is possible. The best argument, I think, is that it would save money.
In response to another comment. See in context »This the same conclusion and solution presented by David Goldhill in his article over at The Atlantic, is it not? Goldhill makes a decent case for it, and also does a very job of explaining his views on how the current system is broken.
http://www.theatlantic.com/doc/200909/health-care
I also support the Singapore model: http://restrainedradical.blogspot.com/2008/04/universal-health-care-singapore-model.html
Holding out hope for a similar solution in US is the primary reason I’m not supportive of Obamacare. Unfortunately, Republicans will not support a mandate.
I don’t know much about the Singapore system beyond the above articles, but think the problem with “Obamacare” right now is that it’s NOT a plan – it’s a bunch of pieces being fought over. If a piece or two from Singapore could help something get cobbled together then we ought to go for it.