There are several observations about the healthcare system in Singapore that I wish to share with Singaporeans.
Firstly, we need to deal with the greed in the pharmaceutical and medical professions. We have commercialised medical care and patients and diseases have become ways to make money. Medicine has become a business rather than a vocation.
We need to encourage the public to speak up against the commercialisation of medicine and to recognise the danger of the fee for service system turning doctors into crooks.
The Ministry of Health has the responsibility to be a role model of health care as a social responsibility rather than being part of a system that turns medical care into a business enterprise.
In this regard, a much higher percentage of the taxes collected must be channelled into health care for our citizens. This is the only way to ensure universality and affordability of health care.
Secondly, we need to recognise that the essence of a democratic society is a caring and sharing co-operative. We pool our resources for the common good – that is the primary objective of our taxes.|
Thirdly, it is important to recognise that different areas of health care require different forms of health financing:
a. Maternal and child care services – these should be free and funded by the government from the taxes as these are health promoting.
b. Primary health care services – these should be paid through a system so that the cost of running these services will be shared by all in the community.
It is only with a prepaid system that the doctors can focus on health promotion activities instead of earning money through dispensing of medications for coughs and colds which are often unnecessary. The patients can then pay only for the medications that they need.
c. Hospital services – the cost of running the hospitals must be paid from the taxes. The cost of services at point of use can be paid through medical insurance and the premiums can be lower.
d. Hospice care – caring for the dying. No one can abuse such services and such services should not be dependent on charity. Funding for such services should be from our taxes as well as from donation from appreciative family members of the care receivers.
e. Home care for the nonambulant chronic sick – these services should also be funded in the same way as hospice care.
We also need to recognise the importance of our environment and family service centres in contributing to the health of our nation. It is important to understand that providing more medical services does not necessarily promote the health of our citizens – in fact we may be creating a more neurotic society – kiasu and kiasi – that is so fearful of dying that we forget how to live.
Dr Patrick Kee is a medical doctor specialising in palliative medicine. He is a director of TLC Home Medical Services Pte Ltd and is also a member of the SDP’s Healthcare Advisory Panel.