Healthcare in Singapore
Singapore has a world-class healthcare system that is being reviewed as a model by the Obama administration’s healthcare team as it explores ways to reform the US healthcare system. In 2000, Singapore’s healthcare system was ranked by the World Health Organization (WHO) as the best in Asia – ahead of Hong Kong and Japan.
The objective of this article is to briefly introduce a newcomer to healthcare system in Singapore.
Healthcare infrastruture in Singapore consists of both public and private healthcare facilities with both offering high quality of medical care but generally different level of service and comfort. Health plans, insurance, and benefits vary largely and depend typically on your immigration status and the employer. Singapore citizens and permanent residents are entitled to subsidized government healthcare services through compulsory national savings scheme whereas foreigners holding various work passes get the health coverage either through their employer or purchase it privately on their own. It is not mandatory for employers in Singapore to provide health insurance benefits. As a general rule of thumb, the larger the company, the higher the probability that the company offers some type of health insurance benefits to its staff.
Government healthcare facilitiesGovernment healthcare facilities are primarily designed to provide subsidised healthcare services to Singaporeans. These facilities consist of a number of government hospitals for inpatient services and numerous polyclinics offering outpatient services. Although wholly owned by the government, the public sector hospitals are operated as private limited companies in order to compete with the private sector on service and quality. They are a far cry from what is generally known as a “government hospital” in other countries. Government healthcare facilities not only provide very good healthcare services to masses but also handle the most complicated cases referred from other hospitals and neighboring countries. A list of major public hospitals and centres is available at the end of this article.
Government health system also sets the benchmark for the private sector on professional medical standards and fees. Specifically, the government influence most long-term trends such as the supply of hospital beds, the introduction of high-tech/high-cost medicine, and the rate of cost increases in the public sector which sets the bench mark in terms of pricing for the private sector. Charges in public health services are subsidised by the government while in the private hospitals and outpatient clinics, patients pay the amount charged by the hospitals and doctors on a fee-for-service basis.
Private healthcare FacilitiesPrivate healthcare facilities in Singapore are as good as any in the world with excellent level of medical care and service levels. For non-Singaporeans, the difference in cost between government and private healthcare facilities is negligible as they directly compete with each other. Since private healthcare facilities in general offer better service level and minimum waiting times, most of the expatriates living in Singapore (as well as medical tourists from abroad) prefer to visit a private healthcare facility.
Private healthcare facilities consist of numerous private clinics offering outpatient services as well as private hospitals. Majority of the private hospitals are JCI-accredited. A list of major private hospitals and clinics is available at the end of this article.
Government health insurance
Singapore citizens and permanent residents are entitled to subsidized healthcare services provided through government healthcare facilities. Depending on various factors, the amount of subsidy can roughly range from 50% to 80%. Further help in co-paying the balance of the medical bill is enabled through a compulsory savings scheme called Central Providence Fund (CPF). Depending on factors such as age and income, a percentage of the monthly salary of an employee is contributed to the CPF. Note that the CPF is not nationally redistributive in that whatever amount you contribute will be for your own or dependents’ use only, it will not be used to subsidize the benefits for another employee who may have earned less than you. Part of the CPF contributions goes towards medical insurance schemes namely Medisave, Medishield, ElderShield and Medifund that collectively can handle major part of the co-pay amounts.
To illustrate an example, Mr. X who is a Singapore citizen earns S$4,167 a month. He is then hospitalised where he chooses to stay in a Class C ward. Below is a breakdown of what he can expect to pay and what he can expect to be subsidised under two different scenarios:
Medisave Bill Subsidy (source: Ministry of Health)
To know more about subsidized healthcare system for Singaporeans, refer to Ministry of Health website.
Private health insurance
If you are a foreigner working in Singapore, you are exempted from CPF contributions but this also means that you do not have access to the government’s subsidized health insurance scheme as above. The good news is that day-to-day healthcare services are quite affordable in Singapore even if you don’t have any health insurance. However you must think about your health insurance options to handle any critical illnesses for you and your family.
If your Singapore employer is a medium to large size company, it’s likely that the company will provide a health insurance policy that covers you and your family. You should check health insurance benefits with your potential employer if you are in the process of relocating to Singapore. If you have your own business or are considering providing health benefits to your employees, you should seriously consider taking up a private health insurance policy to cover for at least critical illnesses. There is a variety of choices and healthy competition among internationally recognized health insurance companies who can offer you a policy that suits your needs. Depending on your age, lifestyle habits, and the type of policy, the monthly cost of a critical illness private health insurance may range from S$75 to S$400 per insured. Below is a list of some of the established private insurers in Singapore:
Finding the right medical insurance policy can be a very time-consuming task and prone to error as the insurance companies usually have many exclusions and exceptions in their coverage policies. It’s very important to read the fine print to be sure you know what you are getting in the policy. A good alternative is to engage an independent insurance broker who has in-depth knowledge of policies from various insurance companies and can recommend you a policy that’s best suited to your particular requirements.
Public healthcare facilities are divided into 6 clusters: Alexandra Health Pte Ltd (anchored by Khoo Teck Puat Hospital in the North), Eastern Health Alliance (anchored by Changi General Hospital in the East), National Healthcare Group (anchored by Tan Tock Seng Hospital in the central region), National University Health System (anchored by National University Hospital), Jurong Health (anchored by the upcoming Jurong General Hospital in the west) and SingHealth (anchored by the Singapore General Hospital). These clusters were made to foster vertical integration of services, enhance synergy and economies of scale in-line with the government’s aim to spur innovation and improve the quality of healthcare while keeping medical costs affordable.
Below is the breakdown of public hospitals and centres:
- Tan Tock Seng Hospital
- KK Women’s and Children’s Hospital
- Changi General Hospital
- Institute of Mental Health/Woodbridge Hospital
- Singapore General Hospital
- Alexandra Hospital
- Khoo Teck Puat Hospital
- National University Hospital
- Ng Teng Fong General Hospital & Jurong Community Hospital
- Polyclinics SingHealth
- National Skin Centre
- National Cancer Centre Singapore
- NHG Polyclinics
- National Dental Centre
- National Heart Centre
- The Eye Institute
- National Neuroscience Institute
- The Heart Institute
- Singapore National Eye Centre
Below is a list of major private hospitals and medical centres in Singapore:
|Major Private Hospitals||Major Private Medical Centres|
|Mount Elizabeth Hospital||Camden Medical Centre|
|Gleneagles Hospital and Medical Centre||Thomson Medical Centre|
|Mount Alvernia Hospital and Medical Centre||Novena Medical Centre|
|Raffles Hospital||Johns Hopkins Singapore International Medical Centre|
Healthcare cost examples
Charges listed here are for general information purposes only and perhaps more relevant to non-insured individuals. For government subsidized as well as privately insured patients, clearly the majority of the medical services bill will be absorbed by the third party.
Primary healthcare costs
Day-to-day healthcare services are relativey affordable in Singapore. A routine check-up with a General Practicioner plus (generic) medicine will likely cost you around S$20-S$30 while blood-work and x-ray will cost you around S$50-S$80. Roughly 20% of primary health care is provided through the government polyclinics, while the remaining 80% is provided through some 2,000 private medical clinics. Specialist consultation in a private clinic might cost you between S$75 -S$125.
Hospitalization charges vary depending on the type of ward choosen. Wards in Singapore vary from open wards with no air-con in place to a private medical suite that resembles a royal suite at a 5-star hotel. Accordingly the daily charges for a ward can vary from S$30 to S$3000. Charges between government and private hospitals for non-subsidized patients are very similar. For more details on charges by various Singapore hospitals, refer to MOH web page.
Major surgery costs
Singapore provides a unique value-proposition for major surgeries to patients arounds the world. The city-state is able to provide world-class healthcare service at a relatively affordable cost. The table below provide a rough comparision chart for illustration purposes:
The video below highlights the salient features of Singapore’s healthcare system, which is hailed as one of the most successful in the world.