Yesterday (22 Nov), ST published a news article about some of the governments of OECD countries cutting back in their health spending (‘Drop in health spending for several rich countries: OECD’).
It reported that a third of the world’s 34 advanced economies cut their health spending between 2009 and 2011.
It said:
“Per capita spending on health fell in 11 of these countries, notably by 11.1 per cent in Greece and 6.6 per cent in Ireland, while growth in spending slowed in others, including Canada (0.8 per cent) and the United States (1.3 per cent).”
Only 2 of the OECD countries, Israel and South Korea, saw an acceleration in the growth of health spending, compared with the previous decade.
The news article was quoting from a new OECD report on healthcare, “Health at a Glance 2013“, which was published on 21 Nov. This report provides the latest comparable data on different aspects of the performance of health systems in OECD countries. The report also provides information on health status, the determinants of health, health care activities and health expenditure and financing in OECD countries.
However, examining the OECD report in detail, it was found that even after cuts in healthcare spending for some of these OECD countries, the governments of all OECD countries are still spending more as a percentage of public share in health spending compared to Singapore’s PAP government does.
Most of the OECD countries spent more than 50% in terms of share of public spending on healthcare in 2011. Only in Chile (45%), Mexico (47%) and the United States (49%) was the share of public spending on health below 50%. In these 3 countries, a great proportion of health spending was, therefore, financed privately.
Private financing of healthcare consists mainly of payments by households (either as standalone payments or as part of co-payment arrangements) as well as various forms of private health insurance.
On average, the share of public spending in healthcare for OECD countries was 72% in 2011. Private out-of-pocket payments was 20%. Private insurance took up 6% with others taking up 2%.
| Expenditure on health by type of financing, 2011 (or nearest year) | |||||
| Public Spending | Private out-of-pocket | Private insurance | Other | Private Total | |
| Netherlands | 85.6 | 6.0 | 5.6 | 2.9 | 14.4 |
| Norway | 84.9 | 15.1 | 0.0 | 0.0 | 15.1 |
| Denmark | 84.7 | 13.3 | 1.9 | 0.1 | 15.3 |
| Czech Rep | 83.9 | 15.0 | 0.1 | 1.0 | 16.1 |
| Luxembourg | 83.0 | 12.3 | 3.8 | 0.9 | 17.0 |
| UK | 82.8 | 9.9 | 3.0 | 4.2 | 17.2 |
| NZ | 82.7 | 10.9 | 4.8 | 1.6 | 17.3 |
| Japan | 81.9 | 14.6 | 2.4 | 1.1 | 18.1 |
| Sweden | 81.6 | 17.2 | 0.3 | 1.0 | 18.4 |
| Iceland | 80.4 | 18.2 | 0.0 | 1.4 | 19.6 |
| Estonia | 80.2 | 17.8 | 0.3 | 1.8 | 19.8 |
| Italy | 77.8 | 18.0 | 1.0 | 3.2 | 22.2 |
| Austria | 77.2 | 17.0 | 4.5 | 1.2 | 22.8 |
| France | 77.2 | 7.7 | 14.4 | 0.7 | 22.8 |
| Germany | 77.0 | 12.4 | 9.7 | 0.9 | 23.0 |
| Belgium | 75.9 | 19.7 | 4.2 | 0.2 | 24.1 |
| Finland | 75.3 | 19.5 | 2.2 | 3.0 | 24.7 |
| Slovak Rep | 73.8 | 23.6 | 0.0 | 2.6 | 26.2 |
| Slovenia | 73.1 | 12.2 | 13.6 | 1.1 | 26.9 |
| Spain | 72.9 | 21.1 | 5.7 | 0.3 | 27.1 |
| Turkey | 72.7 | 19.2 | 0.0 | 8.1 | 27.3 |
| Poland | 70.9 | 24.0 | 0.7 | 4.4 | 29.1 |
| Canada | 69.9 | 15.5 | 12.9 | 1.6 | 30.1 |
| Australia | 68.0 | 20.4 | 8.3 | 3.4 | 32.0 |
| Ireland | 67.0 | 18.1 | 11.9 | 3.0 | 33.0 |
| Greece | 65.9 | 30.9 | 2.8 | 0.3 | 34.1 |
| Portugal | 65.5 | 28.9 | 4.9 | 0.6 | 34.5 |
| Switzerland | 64.9 | 25.8 | 8.6 | 0.8 | 35.1 |
| Hungary | 64.5 | 26.8 | 2.7 | 6.0 | 35.5 |
| Israel | 62.3 | 24.8 | 10.1 | 2.7 | 37.7 |
| Korea | 56.6 | 36.8 | 5.8 | 0.7 | 43.4 |
| US | 48.8 | 12.1 | 35.2 | 4.0 | 51.2 |
| Mexico | 47.3 | 49.0 | 3.7 | 0.0 | 52.7 |
| Chile | 44.9 | 38.3 | 16.9 | 0.0 | 55.1 |
| OECD34 | 72.4 | 19.8 | 5.9 | 1.9 | 27.6 |
[Source]: OECD Health Report
In the case of Singapore, during a recent parliamentary debate on 12 Nov, Health Minister Gan Kim Yong assured that the government will do more to enlarge its share of healthcare cost from the current less than one-third to more than 40% (he did not give a time-frame to implement such an increase).
On the surface, it sounds as if Minister Gan has suddenly found his conscience to want to increase the government’s share of healthcare cost rapidly to more than 40%. However, comparing with the data from OECD countries above even using Gan’s 40% figure, the Singapore government is still very much less generous than others, preferring the citizens to bear more in healthcare either through out-of-pocket payments or buying more private insurance.
It is indeed hard to consider Singapore a first world country when its citizens are treated this way.
Richard Wan
*The author blogs at www.TREmeritus.com