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health care in singapore - how does it work?

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  • health care in singapore - how does it work?

    anyone here in singapore? i'm curious as to how some of the specifics of their system works. some info (from wikipedia)

    Singapore has a non-modified universal healthcare system where the government ensures affordability of healthcare within the public health system, largely through a system of compulsory savings, subsidies and price controls. Singapore's system uses a combination of compulsory savings from payroll deductions to provide subsidies within a nationalized health insurance plan known as Medisave. Within Medisave, each citizen accumulates funds that are individually tracked, and such funds can be pooled within and across an entire extended family. The vast majority of Singapore citizens have substantial savings in this scheme. One of three levels of subsidy is chosen by the patient at the time of the healthcare episode.

    A key principle of Singapore's national health scheme is that no medical service is provided free of charge, regardless of the level of subsidy, even within the public healthcare system. This mechanism is intended to reduce the overutilisation of healthcare services, a phenomenon often seen in fully subsidised universal health insurance systems. Out-of-pocket charges vary considerably for each service and level of subsidy. At the highest level of subsidy, although each out-of-pocket expense is typically small, costs can accumulate and become substantial for patients and families. At the lowest level, the subsidy is in effect nonexistent, and patients are treated like private patients, even within the public system.

    The increasingly large private sector provides care to those who are privately insured, foreign patients, or public patients who are able to afford what often amount to very large out-of-pocket payments above the levels provided by government subsidies.

    Approximately 70-80% of Singaporeans obtain their medical care within the public health system. 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.
    The government regularly adjusts policies to actively regulate "the supply and prices of healthcare services in the country" in an attempt to keep costs in check. However, for the most part the government does not directly regulate the costs of private medical care. These costs are largely subject to market forces, and vary enormously within the private sector, depending on the medical specialty and service provided.The specific features of the Singapore healthcare system are unique, and have been described as a "very difficult system to replicate in many other countries." Many Singaporeans also have supplemental private health insurance (often provided by employers) for services not covered by the government's programs.


    means tested subsidies: http://en.wikipedia.org/wiki/Healthc...pore_hospitals

    so what i am curious about, is how does this all work together?
    1. the means testing has 5201 and above - does that mean all people get at least this base level of subsidy?
    2. do these subsidies exist for hospital care only?
    3. what is class A? no subsidy? what is an example of a difference between an A B or C level remedy/service?
    4. what has a price control around it and what doesn't? ie. checkup, sore throat, wart removal, MRI, cancer treatment?
    5. what gets subsidies among this group of health items?
    6. what if anything is completely market priced among it?
    7. is the public catastrophic insurance (medishield) just government set rates are based on actuarial data beyond gender/age?
    8. what do parallel/additional private insurance offer?
    9. can public catastrophic insurance be exhausted to a maximum benefit point under a chronic condition (and put one into medifund, financial safety net)? or is it perpetually available?
    10. how are drugs priced?

    i'd like to better understand the details of how tools like controls and markets are actually used there.
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