Universal healthcare consistent with political freedom

September 18, 2013
Singapore Democrats

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Tan Lip Hong & Paul Tambyah
Mr Albert Lim suggests that universal healthcare will restrict individual freedom (Why we should say no to universal healthcare). This is not true. In fact, the ideals of universal healthcare and individual freedom are closely linked to each other.

The SDP is of the view that healthcare is a human right, not a commodity to be purchased and sold. A universal healthcare system ensures that all citizens have equal access to preventative and curative care, and protects them, especially the poor, from the vagaries associated with a profit-driven system. (For an in-depth look at how a profit-making healthcare system endangers the health of the poor, please read SDP’s National Healthcare: Caring For All Singaporeans.)

The SDP has long been a firm defender of the fundamental freedoms of speech, assembly and association. Having a system that ensures that all citizens have a voice by respecting individual freedom protects them from the ravages of a dominant (political) elite.

Both of these positions are perfectly consistent. They are also markedly different from the PAP’s which has never respected the rights of ordinary Singaporeans. In addition, from the little that has been announced so far, it seems that the proposed healthcare changes will fall short of a truly universal healthcare system.

A related point that Mr Lim makes is that universal healthcare makes people dependent on the government because the people will have to “give up a portion of wealth, by force of law, in exchange for healthcare.”

Such an approach is not undesirable. We do it for other essential services such as defence and public security. Users of the country’s healthcare must co-pay for certain services to prevent unnecessary usage and abuse. This will help keep costs down and the system sustainable.

The difference is that under the SDP’s plan, the portion of the country’s total healthcare expenditure paid by patients will be less than the government’s – 30 percent to the government’s 70 percent. Currently, it is the other way around.

For example, a family with an income of $2,000-$3,000 presently pay an average of $1,680 per year into Medisave. Under the SDP plan, the same family will pay only $600 per year – about one-third of the current amount.

And when we are hospitalised Medisave has many restrictions with the payout, making the out-of-pocket amounts very high. Under the SDP plan, patients pay only 10 percent of the bill (capped at $2,000 per year), the government takes care of the rest.

Read also: Crucial differences between Govt’s and SDP’s healthcare plans

The SDP calls for everyone to pay into a pool with the government underwriting the major portion of the budget. It is not unlike car insurance where we share our risks so that in the event of an accident we are able to tap the pool of funds. Otherwise, we face financial ruin. (Of course, the difference is that, unlike car insurance, the SDP’s healthcare insurance is not a business and the government pays the main bulk of the expenses.)

With the people not having to face the financial burden of high healthcare costs, they can live a higher quality of life. Coupled with a government that respects the citizens’ political rights, Singaporeans can finally live in an advanced society, secure in the knowledge that their basic necessities are taken care of while they fulfil their aspirations. These are fundamental freedoms which Singaporeans deserve.


Dr Tan Lip Hong and Professor Paul Tambyah are members of the SDP’s Healthcare Advisory Panel.