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Nothing for Heng Swee Keat to shout about for spending only $13b on healthcare from 2020

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By: Vincent Low/

The Straits Times reported yesterday that spending on healthcare is expected to rise sharply, quoting Finance Minister Heng Swee Keat’s prediction that healthcare spending would rise to at least $13 billion from 2020 onward. The daily added:

“To put that in perspective, the total budget for the Ministry of Health (MOH) in 2010 was $4 billion. In this year’s Budget, Mr Heng allocated it $10 billion.”

On the surface, it sounds like the PAP government has become very generous in taking care of the social welfare of Singaporeans. But in reality, it is merely playing catch-up with OECD countries after it was embarrassingly “shamed” in social media few years ago, revealing that Singapore’s healthcare spending has been inadequate for a so-called developed first-world nation.

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According to the most recent data (2014) from World Bank, Singapore can be seen to be spending the least in healthcare as % of GDP among the first world countries (this is total health spending including private and public spending):

US – 17.1%
Sweden – 11.9%
Switzerland – 11.7%
France – 11.5%
Germany – 11.3%
Austria – 11.2%
New Zealand – 11.0%
Netherlands – 10.9%
Denmark – 10.8%
Belgium – 10.6%
Canada – 10.4%
Japan – 10.2%
Norway – 9.7%
Finland – 9.7%
Portugal – 9.5%
Australia – 9.4%
Italy – 9.2%
UK – 9.1%
Spain – 9.0%
Iceland – 8.9%
Greece – 8.1%
Israel – 7.8%
Ireland – 7.8%
South Korea – 7.4%
Luxembourg – 6.9%
Singapore – 4.9%

At 4.9% of healthcare expenditure, Singapore is ranked along with countries like Burkina Faso (5.0%), Libya (5.0%), Ethiopia (4.9%), Mauritius (4.8%).

OECD countries pay for majority share of total health expenditure – Singapore prepares to pay only 40%

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And to make matter worse, the 4.9% quoted above for Singapore was for total healthcare spending, which includes both public and private spending.

Among the OECD countries, the average out-of-pocket or private expenditure as a share of total health expenditure in 2015 was 20.2%. That means, public spending as a share of total health expenditure was a whopping 79.8% for OECD countries on average. Even Korean’s share was 63.2%.

As for Singapore, Health Minister Gan Kim Yong could only announce few years ago that he will set the share of public spending on healthcare to about 40%. He said in Parliament:

“We will in fact take on a greater share of national spending, from the current one-third to about 40 percent and possibly even further, depending on various factors such as demographics, and our ability to manage healthcare costs and target our subsidies.”

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That means to say, for every dollar spent on healthcare, Singaporeans have to foot the majority of the expenditure through private means (e.g., personal savings, insurance etc) at $0.60 per dollar while Minister Gan will pay only $0.40 for you.

Miserable $13 billion healthcare spending from 2020

Indeed, putting aside private spending on healthcare, the Singapore govt’s health spending as % of GDP is even more miserable, substantially lower than the overall 4.9% stated by World Bank above. MOH’s own data can confirm this:

SG Government Health Expenditure (in S$Billion and as % of GDP)
FY13 5.938 1.6% (i.e, GDP=$371b)
FY14 7.221 1.8% (i.e, GDP=$401b)
FY15 8.610 2.1% (i.e, GDP=$410b)

Coming back to what Minister Heng said about spending $13 billion from 2020 onwards, readers should take note that our GDP would have also grown substantially by that time.

According to a projection by DBS, Singapore’s economy will grow to USD354 billion (at 2010 USD) or S$453 billion by 2020:

That means, the Singapore Government’s health spending as % of GDP would only amount to 2.9% by 2020, nowhere near what OECD countries are willing to spend for their citizens.

And, going by what Minister Gan has promised in Parliament, 60% of the health cost will be paid for by Singaporeans privately. This will work out to be a whopping $19.5 billion by 2020 to be paid for by you and me.

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