the state of health: singapore
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THE STATE OF HEALTH: SINGAPORE
Healthcare policy changes and what they mean for
Singaporeans and the healthcare ecosystem
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CONTENTS
1. Executive Summary
2. Healthcare in Singapore
3. Healthcare 2020 Master Plan
4. What Are the Changes to the Healthcare System?
5. How Will This Impact Industry Subsectors?
Patients Healthcare Providers, Hospitals & Clinics Pharma and Medical Device Industries
6. Conclusion
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1. EXECUTIVE SUMMARY
Starting January 2014, Singapore has begun instituting changes to
existing healthcare policies.
While older Singaporeans, low-income families and those who
require outpatient treatments will benefit most from these
modifications, all stakeholders in the health ecosystem will be
affected in some way.
Outlined in this document is an overview of the health policy
changes in Singapore and suggestions for how various stakeholders
can update their communications strategies based on the changing
priorities and needs of the market.
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2. HEALTHCARE IN SINGAPORE
Singapore has established strong fundamentals in healthcare
excellence, providing strong infrastructure and universal coverage for
its citizens, while dedicating a relatively small portion of its GDP (4%)
on healthcare.1
As a result of the emphasis on quality care, Singaporeans have
experienced positive effects, including high life expectancy (#4 in the
world2) and the lowest infant mortality rate in the world.3
However, as one of the fastest-aging populations in Asia, Singapore
faces challenges ahead in the form of greater demand for
specialised elderly care, constraints on healthcare infrastructure and
rising costs.
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1World Competitiveness Yearbook 2010, IMD. 2World Health Organisation 2008. 3UN Inter-agency Group for Child Mortality Estimation 2012.
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3. HEALTHCARE 2020
To address these challenges, in 2012, the Ministry of Health introduced
Healthcare 2020, a master plan to ensure Singapores healthcare system better meets the needs of the people.
The plan focuses on using the three pillars of Accessibility, Affordability
and Quality to measure the effectiveness of healthcare in the country.
Image reprinted from HealthScope June-July 2012 issue.
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HEALTHCARE 2020 (CONTINUED)
In the next few years, improvements to healthcare in Singapore will revolve
around these strategies:
Working more closely with community clinics and
general practitioners (GPs)
Improvements to MediShield, the national health
insurance system
Subsidies for high cost drugs and treatment
Efforts and financial aid to be allocated to raising
health workforce productivity and capacity
Healthcare subsidies for a wider range of
Singaporeans
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4. SPECIFIC CHANGES
Community
Health
Assist Scheme
(CHAS)
Subsidy for
Specialist
Outpatient
Clinics
Former System
Beneficiaries need to
be at least 40 years old
to qualify for CHAS
50% subsidy for patients
who fall under the
lower middle income
bracket
Medisave
for outpatient
treatment
Age restriction removed and
is now open to those below
40
System as of Jan 2014
An increase of 10-20% for
outpatient treatment
subsidies; means testing will
be applied
Healthcare Item1
Medisave can only
be used for
chemotherapy and
major outpatient
operations
Increased coverage for
Medisave, which now covers
vaccinations such as
pneumococcal and
influenza for high-risk groups
MediShield
now
MediShield Life
Coverage only
applicable for people
under 90 and is an
optional scheme
Age ceiling lifted; those with
pre-existing illnesses are
covered; MediShield Life is
mandatory and premiums
will be higher
1http://www.straitstimes.com/breaking-news/singapore/story/budget-2014-relief-the-elderly-cpf-boost-all-workers-20140221
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5. HOW WILL THIS IMPACT
INDUSTRY SUBSECTORS?
Patients
Healthcare Providers, Hospitals & Clinics
Pharma and Medical Device Industries
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After revision of the Community Health Assist Scheme,
young people who belong to the lower income group
now qualify for subsidised healthcare (previously
available only to individuals above the age of 40)
and increased healthcare options.
The Ministry of Health (MOH) has dramatically
increased the number of surgical procedures paid for
through MediShield and Medisave. Previously, 1,600
procedures were covered; as of January 2014,
MediShield Life and Medisave cover about 2,350
procedures.
As MediShield transitions to MediShield Life, enrolment
will become compulsory for everyone Those who are
already enjoying personal or company insurance will
be doubly covered by insurance, providing them with
the option to withdraw from private schemes and
save money on premiums.
HOW WILL THIS IMPACT
PATIENTS?
More young people
will qualify for
subsidies
More operations and
procedures will be
covered
MediShield Life may
overlap with existing
health insurance
coverage
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As more Singaporeans gain access to a wider
variety of treatments, there is a need for large-scale
education efforts to determine who qualifies for
increased financial support and the benefits and
drawbacks of specialised plans.
Increased access to testing creates more
opportunities for preventative health campaigns.
If a Singaporean requires healthcare beyond the
limits of current plans, additional coverage may
require higher premiums. Insurance providers may
overhaul their offerings to cater to more specialised
groups and may levy higher charges to go with it.
For Singaporeans aged 65 and older as of 2014,
MediShield Life will now cover medical bills regardless
of pre-existing conditions and will offer a further 50%
off specialist outpatient clinic fees. They will also
receive a further Medisave top-up of S$200 to S$800,
depending on their age group.
HOW WILL THIS IMPACT
PATIENTS?
Communication Opportunities
Pioneer Generation
to receive greater
support for medical
bills
Higher premiums for
specialised plans
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Clinics and hospitals may become more
crowded
A greater pool of individuals is now eligible for
coverage. Assuming the number of healthcare
providers remains about the same, existing resources
may be strained by increased demand. However, this
may also present market entry opportunities for
healthcare providers.
Increased eligibility may stretch
healthcare resources
Adoption of innovative health information technology
can increase efficiency by effectively managing
complex patient records and outfitting patients with
more information so that they can make informed
decisions about their treatments.
Innovations in health
technology
HOW WILL THIS IMPACT HEALTHCARE
PROVIDERS, HOSPITALS & CLINICS?
Clinics and hospitals may become more
crowded
Greater need for
clinical data and
information sharing
Providers can become part of proactive disease
awareness initiatives, prevention campaigns,
educational sessions and roundtables to identify best
practices for addressing new and evolving challenges.
Opportunities include partnerships with pharma and
medical device industries and community outreach
programs, such as educational sessions in the
heartlands. Digital extensions like web resources and
apps can expand campaigns reach and influence.
As data sharing between hospitals, providers and
clinics improves, providers will carry some of the
burden to explain and to help provide fixes for any
deficiencies identified in the healthcare system.
Communication Opportunities
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Out-of pocket costs for patients will be lower as
coverage increases for medications. More patients
may start seeking treatments for chronic conditions
like anxiety, osteoarthritis and Parkinson's disease.
Public health campaigns, building disease awareness
and drives for early detection and treatment remain
strong communication opportunities for pharma and
medical device industries.
Companies may also consider partnership
opportunities with governmental organisations to
improve patient compliance and to address unmet
needs.
HOW WILL THIS IMPACT
PHARMA AND MEDICAL DEVICE
INDUSTRIES?
Lower out-of pocket
costs for
medications
Wider availability of
surgical operations
The number of covered surgical procedures rose
almost 50% from about 1,600 to 2,350 to include
operations for abnormal heart rhythm and piles.
Procedures have been reclassified to better reflect
improvements in technology and their relative
complexity.
Pharmacist as
gatekeeper
As a key touchpoint in the medical service process,
pharmacists are usually the last point of contact for
patients. This is significant as educational programs
and initiatives for these important yet overlooked
stakeholders can bolster a campaign at an
additional point of contact with patients.
Communication
Opportunities
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Singaporeans are just beginning to understand the implications of
new healthcare policies.
The fast-changing health landscape provides a slew of opportunities
for the private and public sector to lead large-scale education
efforts, upgrade digital capabilities, drive disease awareness and
prevention campaigns as well as provide platforms to discuss and
shape the future of healthcare in Singapore.
As the Singapore governments approach evolves and as 2020 healthcare goals come into view, it is important for all subsectorshealthcare providers, hospitals and companies in the
pharmaceutical, medical device and biotech industriesto continue growing and tailoring their communication efforts to match
the changing nuances and needs of the local communities.
6. CONCLUSION
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Edelman Health
Phone: +65 6733 1110
E-mail: singapore@edelman.com
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