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Affordable Excellence: The Singapore Healthcare Story Paperback – April 30, 2013


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Product Details

  • Paperback: 182 pages
  • Publisher: Brookings Institution Press with the National University of Singapore Press; 1 edition (April 30, 2013)
  • Language: English
  • ISBN-10: 0815724160
  • ISBN-13: 978-0815724162
  • Product Dimensions: 8.9 x 6 x 0.5 inches
  • Shipping Weight: 12 ounces (View shipping rates and policies)
  • Average Customer Review: 3.8 out of 5 stars  See all reviews (21 customer reviews)
  • Amazon Best Sellers Rank: #222,471 in Books (See Top 100 in Books)

Editorial Reviews

Review

"William Haseltine's comprehensive account of how Singapore laid the foundation for an equitable, affordable, accessible, and sustainable quality healthcare system should be on the reading list of anyone designing healthcare systems for the 21st Century. It is a fascinating read, even for someone who grew up within this system." —John E.L. Wong, National University Health System, Singapore

About the Author

William A. Haseltine is President and Founder of ACCESS Health International dedicated to promoting access to high-quality affordable healthcare worldwide, and is President of the William A. Haseltine Foundation for Medical Sciences and the Arts. He was a Professor at Harvard Medical School and was the Founder and CEO of Human Genome Sciences.


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9 of 9 people found the following review helpful By sien on September 7, 2013
Format: Kindle Edition Verified Purchase
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.
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3 of 3 people found the following review helpful By Nat on August 31, 2013
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The first few chapters start out strong, with a bird's eye view of the philosophy and framework underlying Singapore's healthcare system. Those were well worth the read, though the author's adulation of the Lee Kwan Yew and the Singapore system felt a bit excessive at times.

The later chapters were long on facts and figures, short on analysis and implications, and occasionally repetitive. I would have liked a focused chapter taking a critical look at the challenges facing the Singapore healthcare system -- rising citizen expectations/demand for healthcare, overcrowding at public hospitals and polyclinics, etc. -- instead of just looking at what the government has done and intends to do next.
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2 of 2 people found the following review helpful By H. Temple on March 23, 2014
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Singapore's heath care plan seems like an excellent system of health care funding that could actually work in the USA, except for the chapter on CONTROLLING COSTS. The medical mafia is currently harvesting billions or trillions of dollars by keeping hospital costs as high as possible. High costs fund huge "Wall Street" salaries and bonuses for hospital administrators and fund lucrative kickbacks for hospital supplier chains which are more often than not, family businesses of the hospital administrators or their relatives.

For example a toothbrush may cost a hospital $10.00, a bottle of shampoo might cost $15.00. The real cost to the supplier is .25 cents and 90 cents respectively. These exorbitant costs are passed on to the consumer, the patient, and the health care program and the mafias get the profit. No mafia easily gives up power because power=profit. By these methods it is possible for a man with little education to make as much money as a highly skilled doctor. His job is eventually passed on to another family member, so the big money can be kept within the control of the family. This is how US hospitals are run today. Singapore has evidently found ways to make such nepotism transparent by posting hospital bills online. They have also managed to somehow protect their investigators from assassination by the medical mafia. Perhaps someone needs to write a book on how US hospitals get away with this and how we can eliminate future medical mafias.
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2 of 2 people found the following review helpful By Amazon Customer on August 3, 2013
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It's a bit dry and academic, but gives a clear overview of an extraordinarily successful system which may not be transferable to other countries: Singapore is, after all, a pretty unique place. Nevertheless, it offers ideas that developing countries that are trying to improve their population's health may wish to consider. Developed countries would probably find the ideas difficult to introduce as they would first have to change their own established systems - always politically problematic. Still, this should be recommended reading for all ministers of health and for all civil servants in the health department.
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1 of 1 people found the following review helpful By Cheng Yi Chiao on September 21, 2013
Format: Kindle Edition
This is a good write up about the Singapore healthcare system.

It does paint a broad picture as to how the healthcare system works in Singapore from the resourcing to the financials.
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1 of 1 people found the following review helpful By ljm on August 28, 2013
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A useful introduction to a world class healthcare policy system. Of exceptional value to economists, policy makers and health care professionals.

A relatively low degree of comparative policy analysis is the only downside.
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1 of 1 people found the following review helpful By Livia on July 12, 2013
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I downloaded this because it was free. I stopped about a third way through. The last third of the book consists of references, indexes, so that's no big deal.

The author writes an interesting story about Singapore's Health System. He makes some good points about how if everything is free, then people begin to have a gimme gimme mentality, and that's why so many country's have a ballooning health budget. It will be impossible for any Western government without balls of titanium alloy to make the changs needed to reduce the health expenditure, becuase they will definitely be kicked out of power at the next election. The way to make health better, more affordable, is to make sure it is never free. There always needs to be some small co payment. Also, make sure the public housing and utilities are made properly.

The problem with this book is the repetition of several points, and rather unnescessary repeated praise of Lee Kwan Yew and his government. I have a lot of respect for Mr Lee for his achievements. But it's not necessary to repeat it several times.
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