Table 6.1 Fee Scheme at Ang Mo Kio Polyclinic
Table 6.2 Intermediate and Long-Term Care (ILTC) Services
Chapter 7
Table 7.1 Statistics, Biomedical Industry
Figures
Chapter 2
Figure 2.2 In-Hospital Case-Fatality Rates within 30 Days after Admission for Ischemic Stroke, 2007
Chapter 3
Figure 3.1 How MediShield is Utilized to Pay for One's Healthcare Bill: Case 1
Figure 3.1a How MediShield is Utilized to Pay for One's Healthcare Bill: Case 2
Chapter 7
Figure 7.1 NUS Yong Loo Lin School of Medicine, NUS Faculty of Dentistry, and NUS Alice Lee Centre for Nursing Studies
Charts
Chapter 2
Chapter 3
Chart 3.1 Distribution of Medisave Withdrawal
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Acknowledgments
This book was inspired by a speech given in 2010 by then Minister for Health of Singapore, Khaw Boon Wan, to an international group of health specialists. I had the good fortune to attend the meeting of NIHA (the Initiative to Improve Health in Asia), a Pan-Asian Policy Program sponsored by the National University of Singapore and the Global Asia Institute. The Minister's speech outlined the history and more importantly, the thinking, behind the creation of the Singapore healthcare system. The system he described is both effective and unique. I asked if a book existed describing the Singapore approach to healthcare and was surprised to learn that none did. A few weeks later, I had a follow-up conversation over dinner with the NUS President, Tan Chorh Chuan, Director of the Global Asia Institute, Seetharam Kallidaikurichi Easwaran, and Paul Kratoska, then Director of NUS Press who encouraged me to write this volume. Seetharam Kallidaikurichi kindly provided support for a researcher for a year and the book was on its way. I mentioned that I was writing a volume on the Singapore healthcare system that might provide lessons in the creation of sustainable healthcare system to others in both developing and developed countries to Strobe Talbott of the Brookings Institution, and he and his colleagues kindly offered to jointly publish the book with NUS Press. I am grateful to Robert Faherty, Director of the Brookings Press for his encouragement. I thank Peter Schoppert, now Director of NUS Press, for his enthusiasm and assistance.
I owe special thanks to Claudia Olsson, Managing Director of ACCESS Health International, Singapore for her valuable assistance throughout. She organized interviews for me, conducted others herself, did much of the research for the final chapter of the book and worked closely with our researcher, Eti Bhaskar. Eti was tireless in preparing background material for each chapter and tracking down the necessary information. I owe her a deep debt of gratitude.
Both the Ministry of Health and the Singapore Economic Development Board were very helpful. The current Minister Gan Kim Yong graciously allowed us to interview him and his colleagues at the Ministry. Both helped to arrange the numerous interviews with key players in the healthcare system, both public and private, as well as past and present. Special thanks go to Lee Chien Earn, former Head of the Department of Public Health and Deputy Chief Medical Officer of the Ministry of Health and Lim Eng Kok, Deputy Director (Service Management) of the Ministry of Health, for their continued assistance and help in identifying people and documents important for this story. Representatives from the Ministry of Health graciously responded to my long series of written questions. I have cited this material and reproduced some of these answers in the Appendix of this volume.
I list here many of the people who were kind enough to grant us interviews, without which we would not have been able to assemble the remarkable story of the Singapore healthcare system past and present. They were to a person helpful in all ways and patient in answering our questions.
These include: Tan See Leng, Group CEO and Managing Director of Parkway Pantai Limited; Tan Ser Kiat, Chairman of SingHealth Foundation; Chee Yam Cheng, Group CEO of National Healthcare Group; Yong Ying-I, Previous Permanent Secretary for Health; Yee Ping Yi, CEO of the CPF Board; Sarah Muttitt, former CIO, Information Systems Division, MOH Holdings; K. Ranga Rama Krishnan, Dean, Duke-NUS Graduate Medical School; Edward Holmes, A*STAR Executive Deputy Chairman, Biomedical Research Council; Phua Kai Hong, Associate Professor of Health Policy and Management, Lee Kuan Yew School of Public Policy; Chia Kee Seng, Dean, NUS Saw Swee Hock School of Public Health; Jason Cheah, CEO, Agency for Integrated Care; Wong Loong Mun, Chief Care Integration Officer, Agency for Integrated Care (AIC); C. Frank Starmer, Associate Dean for Learning Technologies, Duke-NUS Graduate Medical School; Lim Chuan Poh, A*STAR Chairman; John Lim, CEO, Health Sciences Authority; Chua Song Khim, Group CEO of China Healthcare Ltd; Anthony Tan, former Director of the Healthcare Finance and Corporate Services of the Ministry of Health; Ang Hak Seng, CEO of the Health Promotion Board; John Wong, former Dean of the NUS Yong Loo Lin School of Medicine; Benjamin Ong, Chief Executive of the National University Health System; Elizabeth Koh, former Group Director (People Matters) and Senior Director (Healthcare Leadership Development), Ministry of Health; Elizabeth Quah, Group Director (Planning), Ministry of Health; Peter Lee, former Deputy Director of the Learning Systems Standards & Quality Improvement Division, and the Organizational Excellence Corporate Human Resource Division, Ministry of Health; David Matchar, Professor and Director, Program in Health Services and Systems Research, Duke-NUS Graduate Medical School; Tan Yong Seng, Chairman, People's Association Active Ageing Council; Mary Ann Tsao, President, Tsao Foundation; Susana Concordo Harding, Director, International Longevity Centre Singapore, Tsao Foundation; Phua Puay Li, Director, Manpower Planning & Strategy Division, Ministry of Health; Martyn R. Partridge, Senior Vice Dean, Lee Kong Chian School of Medicine; Lim Siong Guan, Group President, Government of Singapore Investment Corporation; Denise Lee, Manager (Clinical Benchmarking), Performance and Technology Assessment Division (PTA), Ministry of Health; Kishore Mahbubani, Dean and Professor in the Practice of Public Policy of the Lee Kuan Yew School of Public Policy at NUS.
Others who provided support and assistance thoughout the research and writing include: Lee Suet-Fern, Senior Director, Stamford Law Corporation; Min-Tze Lean, Director, Stamford Law Corporation; Bernard Yeung, Dean at NUS Business School; Sofi Bergkvist, Managing Director, ACCESS Health International; and Priya Anant, CFO, ACCESS Health International.
I am grateful to support from ACCESS Health International, a not-for-profit operating foundation dedicated to promoting access to high-quality and affordable health worldwide, of which I am Chairman and President. The proceeds from this book will be going in their entirety to supporting its work.
My thanks also go to my very good friend Ambassador Chan Heng Chee. Over the many years we have known each other, she has worked tirelessly on behalf of her country. Starting many years ago, she introduced me to key decision-makers in Singapore from all walks of life. She, more than any other person, is the inspiration for this volume. It is my hope that others will find lessons in the Singapore healthcare story and experience to apply