Opinion

Besides Affordability, Here are 3 Areas Where the Singapore Healthcare System Has Room For Improvement

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Joanne Poh

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One of those phrases Singaporeans chant all the time like a mantra is “it’s better to die than get sick in Singapore”.

Despite improvements to the MediShield Life system and the fact that many people know enough to purchase private health insurance, the fact remains that it is possible to fall through the cracks. And if you do, survival could be a very expensive affair. But you already knew that.

When it comes to how accessible healthcare should be made, people are divided into two camps. On the one hand, some people think it’s better that the healthcare burden be shifted to the individual, so people are forced to be responsible and do not make frivolous claims. On the other hand, other people think it’s not fair that access to healthcare should be dictated by wealth. We’ll leave you to argue that amongst yourselves.

What we’re concerned about today is the fact that our current healthcare system is exhibiting problems in certain areas unrelated to whether it should or should not be free. It is, quite literally, failing to keep the population healthy in the following ways.

 

1. The current system is inefficient at screening and catching preventable diseases before it’s too late

Here in Singapore, we tend to think of healthcare as a last resort. Presumably, if you take responsibility for your own health and keep yourself in good shape, you will hopefully not have to resort to medical care.

Unfortunately, staying healthy isn’t just about trying to eat right and get enough exercise. It’s also about going for regular checkups and screenings, and monitoring the state of your health over the years. That is where our system fails miserably.

Singapore has the dubious honour of being the nation with the second highest incidence of diabetes, and kidney failure is on the rise tooas of 2014, we were number four in the world. Both conditions are usually preventable, so it’s very sad indeed that not enough people are aware they’re ill till it’s too late.

In healthcare systems like those in the UK and France, everyone is registered with a doctor in the public healthcare system. This is their go-to doctor whenever they fall ill, and because these doctors often follow them throughout their lives, they’re able to monitor their health as they go along. This is extremely useful when it comes to spotting changes in someone’s health before they become too serious.

The Singapore public healthcare system, on the other hand, does not assign particular doctors to people. If you only visit polyclinics, you are usually assigned whoever is on duty at the time.

Of course, there are benefits to this system as there’s no need to make appointments far in advance. But as far as closely monitoring someone’s health goes, it has proven ineffective.

While the government has been encouraging people to go for all sorts of screenings, most people are still clueless about what they need to be screened for and at what age. There’s also the possibility of being struck by diseases that aren’t on the list of common illnesses to be screened for.

WHO may rank Singapore’s healthcare system highly, but it’s worthwhile differentiating between treating illnesses in the hospital when they’re already full blown, and essential healthcare which entails monitoring people’s health and keeping them well before something serious happens. We’re good at the former but, it seems, terrible at the latter.

 

2. The system is inadequately equipped to deal with the silver tsunami

Just about everyone on the island knows Singapore’s population is ageing. But we have yet to experience the effects, since at the moment our population is still relatively young. We will only start to feel a sharp increase in the proportion of old people a few decades down the road.

When that happens, will the healthcare system be able to cope? At the moment, things don’t seem too hopeful.

A recent news report came filled with warnings that the current healthcare system is unsustainable, and that the healthcare industry’s current practices are inefficient.

At the moment, it does seem like the public healthcare system is already struggling to cope with the increase in the population. It’s clear as day to anyone who’s visited a public hospital recently that Singapore is facing a shortage of local doctors and nurses.

In addition, there’s no secret that healthcare costs have risen quite dramatically in Singapore, particularly private healthcare costs, which have seen a big spike since 2015.

It remains to be seen whether healthcare can be kept affordable when the silver tsunami hits, and whether the system will be able to cope.

 

3. There is not enough support for those with mental health issues

When speaking with friends who grew up in other developed counties, I am always surprised to find that quite a few of them saw psychiatrists or psychologists when they were teenagers or young adults.

Seeking mental healthcare is still pretty rare in Singapore, which is probably why we have so many psychos abusing people on the MRT or, like this lady here, in hawker centres. More people die in suicides than in traffic accidents each year, and let’s just say that’s not thanks to the courteous drivers on the road.

The recent announcement that GPs are being trained to diagnose certain mental health conditions is unsettling, because it points to a clear shortage in the number of mental health professionals in Singapore.

At present, MediShield Life coverage for mental health issues is highly limited, meaning many patients are forced to either deplete their Medisave funds or dig into their own pockets to pay for treatment.

Above all, mental illness has always been highly stigmatised in Singapore, and most are clueless about treatment options. I’ve had more than one friend who, when stricken with depression or some other psychologically issue, told their parents and… the latter promptly called an exorcist or bomoh.

Judging by the number of unstable individuals appearing (or making posts) on Stomp, we say it’s high time the healthcare system stepped up to offer better and more accessible mental health support.

What do you think the Singapore healthcare system does well, and what do you think should be improved? Share your thoughts in the comments!

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Joanne Poh

In my previous life, I was a property lawyer who spent most of my time struggling to get out of bed or stuck in peak hour traffic. These days, as a freelance commercial writer, I work in bed, on the beach, in parks and at cafes, all while being really frugal. I like helping other people save money so they can stop living lives they don't like.