Incentivise health, not sickness

OK, one more post on thoughts stemming from Tan Jee Say’s prescription to the Government on rescuing Singapore from the brink. And I’ll be done. Promise!

TJS’s prescription, touching on hospitals and doctors, called for $10 billion to be pumped into enlarging the healthcare sector, as follows:

Hospitals Regeneration – Singapore is lagging far behind other First World countries in key indicators of healthcare; we have only 32 hospital beds per 10,000 population, about half the average number of 58 beds in high income countries, 17 doctors per 10,000 population compared to an average of 28 doctors in other high income countries, and 53 nurses and mid-wives versus their 81. The $10 billion fund will be used over the next 5 years to add another 8,500 beds in public hospitals and to double the number of healthcare personnel so as to achieve First World norms.

I’ve always had problems with the term “healthcare sector” or “health sector” when essentially it’s really a sickness sector. So talk of euphemism!

And I shudder at the thought of seeing money spent on adding more hospital beds and doubling the number of sick-care personnel.

Rather, my proposal is that money could be better spent in encouraging Singaporeans to stay healthy and stay away from doctors and hospitals as much and as long as possible.

Here is what I would do if I were in charge of what is truly the Ministry of Health (instead of what is currently an euphemsim for the Ministry of Sickness!)

First, I would provide all Singaporeans with $5K worth of “sickness” credit every year which could be used at hospitals and clinics, public or private, when they fall sick.

Stay healthy for 3 years and the sum of $5K (or any leftovers after medical bills) from the credit from year 1 would be the recipient’s to spend or invest as he/she or his/her parent/guardian deems fit.

Second, I will get the Ministry of Manpower, NTUC and SNEF — as a tripartite effort — to persuade employers to complement the Government’s move to incentivise the nation to stay healthy by letting

  • any and all sick leave not taken in one year by employees to be carried over to the following two years and
  • anything not consumed in Year 1 by year 3 be given out as as paid leave

This means that all Singaporeans will have good and solid incentives to stay well.

Now isn’t this a better way of spending the nation’s $$$$$ instead of promising free or heavily subsidised medical support, with a doctor at every bus stop and a hospital around every corner?

PS The scheme might also allow for undrawn health credits from the Government to be accumulated for future consumption or withdrawal. Perhaps impute a small interest element to discourage unnecessary (ie sickness unrelated) and immature use and encourage accumulation?


2 thoughts on “Incentivise health, not sickness

  1. I can see both pov’s lah. Your method would surely keep the ‘everything must self refer to a+e’ patients out of the emergency department for trivial stuff, and reduce the incidence of anyhow claiming MC’s for work.

    OTOH, a bigger proportion of the primary care sector than you think does tend to bounce patients off to the hospital for even the most managable problems, and worse, may deter the ones with the truly serious conditions from seeking the help that they require, because they would rather be ill and keep the credit.

    Anyway hor, the gahmen wanna win votes mah. If they went with your idea that won’t happen loh. LOL. The general public loves the idea of accessibility of a person/place to seek help in case of illness.

  2. I see your POV all right. Also, my household had been quite frequent at A+E too, mostly because we haven’t much faith in most GPs and some specialists: not because they r money-minded (which mayb they are) but mostly because we suspect they aren’t so up-2-date.

    I humbly disagree with you that pple won’t love the money/extra holidays embedded in my proposal. After all, most pple are healthy and this way, their good health could be monetised! The real trouble is getting pay masters in the public and private sectors to buy in.

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