ch 3 managing healthcare

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Healthcare Systems in Britain and Sg


  • 1. Managing Healthcare: Case Studies of Singapore and Britain Chapter 3 Done by: Ms Karen Ang 08/23/10

2. Essential Questions:

  • To what extent is healthcare the responsibility of the government?
  • How effective are the various healthcare models in meeting the peoples needs?

08/23/10 3. Challenges in managing healthcare

  • Need to provide basic healthcare regardless of whether ppl can afford to pay
  • Rising expectations and demands for quality healthcare
  • Rising cost of healthcare

08/23/10 4. Who Pays For It? 08/23/10 Individual Self: People pay for healthcare services directly Personal insurance: Buy insurance and make claims from the insurance company to pay for treatment Employer Employer-paid insurance: Employers pay a certain sum of money to insure workers. Claims are then made to the insurance companies Government taxes: Govt collects taxes from ppl and uses a portion for medical services 5. Healthcare in Singapore, 1960s-70s

  • 1960s: Healthcare was part of Singapores overall plans for improvement and development after independence
  • Healthcare measures as part of housing programme
  • Need to curb spread of infectious diseases

08/23/10 6. Healthcare in Singapore, 1960s-70s

  • Hospitals, clinics and outpatient dispensaries
  • Vaccination
  • Medical officers and nurses sent to schools to provide healthcare for students

08/23/10 7. Healthcare in Singapore, 1960s-70s

  • 1970s: Singapore economy improved, higher standard of living
  • People wanted better healthcare services
  • Polyclinic replaced dispensaries
  • Facilities in gov hospitals and quality of healthcare improved

08/23/10 8. Healthcare expenditure in 2004 08/23/10 9. Healthcare Since 1980s

  • Concern: rising cost of healthcare
  • National Health Plan, 1983
  • Wanted to encourage public debate on how to manage long-term healthcare needs

08/23/10 10. Aims of National Health Plan

  • Build a healthy and physically fit population
  • Encourage Singaporeans to stay well and reward those who do
  • Build up individual resources so that those who fall sick will be able to pay

08/23/10 11. National Health Plan 08/23/10 Individual Government Community

  • Encourages self-reliance
  • Maintains good health
  • Keeps healthcare affordable
  • Promotes healthy lifestyle
  • Provides some healthcare services
  • Provides support services

12. 08/23/10 Medisave Scheme Medishield Scheme

  • compulsory
  • retirement plan
  • 6 8% salary
  • voluntary
  • medical plan
  • small sum through
  • Medisave

Encouraging Self-Reliance 13. Encouraging Self-reliance

  • Medisave Scheme, 1984
  • Certain amount from workers CPF channelled into Medisave accounts
  • Can be used to pay hospital bills and certain medical treatment
  • Shared responsibility between government and individual
  • No need to raise taxes to pay for rising healthcare costs

08/23/10 14. Encouraging Self-reliance

  • Medishield, 1990
  • National healthcare insurance scheme
  • Covers large medical bills for illnesses not covered under Medisave
  • For people who require long-term treatment of more serious illnesses

08/23/10 15. Keeping Healthcare Affordable

  • Government subsidies
  • Medifund
  • Restructuring of hospitals
  • Means-testing

08/23/10 16. Government Subsidies 08/23/10 Ward Class Subsidy Rate Individual A No subsidy 100% B1 20% 80% B2 65% 35% C 80% 20% 17. Medifund

  • Started in 1993
  • Provide help to those who cannot afford healthcare
  • Started with $200million
  • Interest earned is provided to hospitals to help needy patients
  • Patients can apply for the fund at hospital

08/23/10 18.

  • To reduce medical costs
  • Health education and campaigns
  • Working with Organisations:
  • Some voluntary welfare organisations (VWOs) organisations given grants to provide medical care
  • Community hospitals

Promoting a Healthy Lifestyle 08/23/10 19. Have Singapores healthcare policies met the needs of the people? Done by: Ms Karen Ang 08/23/10 20. 08/23/10 Origins of the National Health Service (NHS) Managing the NHS The Welfare State of Britain Effectiveness of the British healthcare system 21. 08/23/10 Origins of the Welfare State

  • Sir William Beveridges report in 1942
  • recommended that the govt put an end poverty, disease and unemployment
  • rebuild peoples lives after WWII
  • Britain after World War II
  • high unemployment and poverty
  • cradle to grave policy: minimum standard
  • for a decent life (pg. 83)
  • - NHS is part of the welfare state: free healthcare for ppl

22. Early Beginnings of the NHS

  • Very popular with the ppl
  • All medical services free of charge
  • Br. Gov expected demand for healthcare to increase and then stabilise
  • Hwr, demand was overwhelming
  • By 1951, the NHS was unable to meet these demands
  • A small fee was charged

08/23/10 23. Managing the NHS

  • Managing government spending
  • Increasing efficiency
  • Providing quality

08/23/10 24. Managing government spending

  • 1980s Margaret Thatcher
  • Cut back on govt spending on welfare benefits
  • Wanted to create a system that would make the individual more responsible
  • Reason: govt was spending too much on welfare benefits

08/23/10 25. Managing Government Spending

  • Fear that reduction in welfare would result in inferior healthcare services
  • 2000: PM Tony Blair promised increased spending on healthcare
  • Accompanied by increases in National Insurance contributions

08/23/10 26. Increasing Efficiency

  • Problem of insufficient doctors, nurses and facilities to cope with increased demands
  • Tatcher policy of privatisation
  • Reduce govt subsidies
  • Save costs
  • Make the NHS more efficient
  • Services no longer free except for a few groups of ppl

08/23/10 27. Providing Quality Service

  • By 1980s people felt the NHS had poor standards
  • Provide more information to help patients decide on own treatment
  • Problem of long waiting time
  • NHS Plan (2000)
  • NHS Improvement Plan (2004)
  • NHS Direct

08/23/10 28. Have British Healthcare policies met the needs of the people? Done by: Ms Karen Ang 08/23/10 29. Conclusion

  • Similar problems, different approaches
  • Singapore: shared responsibility
  • Britain: provide welfare