Here’s Matt Yglesias describing the Singapore health care system:
— “The first tier of protection is provided by heavy Government subsidies of up to 80% of the total bill in acute public hospital wards, which all Singaporeans can access.”
— “The second tier of protection is provided by Medisave, a compulsory individual medical savings account scheme … Singaporeans and their employers contribute a part of the monthly wages into the account to save up for their future medical needs.”
— As best I can tell, these Medisave accounts are deposited into the Central Provident Fund, a government-run investment pool, rather than constituting private savings as we would understand them.
— “The third level of protection is provided by MediShield, a low cost catastrophic medical insurance scheme” supplemented if like by private insurance called Integrated Shield plans and “Singaporeans must subscribe to the basic MediShield product before they can purchase the add-on private Integrated Shield Plans.”
— “Finally, Medifund is a medical endowment fund set up by the Government to act as the ultimate safety net for needy Singaporean patients who cannot afford to pay their medical bills despite heavy subsidies, Medisave and MediShield.”
None of this sounds to me like anything American conservatives favor.
Compared to America’s health care system, this sounds like utopia. Let’s take them one at at time:
Tier 1: The big problem in health care in America is inefficiency. Part of that has to do with deciding what health care to provide, and what not to provide. But everyone seems to agree that when people get into traffic accidents they need to be patched up. Even the uninsured are often helped in ERs. So “acute care” seems a no brainer. I gather that Singapore provides this service at very low cost. Their government spends only 1% or 2% of GDP on health care. Conservatives love that.
Tier 2: Medical savings accounts are loved by conservatives, because they put the market to work. Most of my health care expenditures have been a complete waste, but I made them because I was on OPM. I mean I was using Other People’s Money. In Singapore I would have saved that money. I wouldn’t care if they put my savings into a Sovereign Wealth Fund, as I have lots of other funds I can gamble with. And there is the EMH.
Tier 3: Conservatives love catastrophic health insurance. Indeed we believe non-catastrophic health “insurance” is an oxymoron. It’s prepaid health care. Would you buy auto insurance for an oil change or tune up or new tires? Then why buy insurance for things like maternity care? Is having a kid a “disaster” that has to be insured against?” If you think so, you shouldn’t be a parent.
Tier 4: Some conservatives oppose any form of redistribution. But I love the fact that after the Singapore government has set up a streamlined health care system with the right incentives, they can take care of the truly needy at a trivial cost. In America our government spends a massive amount on health care, and for all that money we still have 45 million uninsured. For any pragmatic utilitarian conservative, the Singapore system is so much better than the American system it’s ridiculous.
BTW, they live longer than we do, and also longer than Europeans, although health care probably has little or no impact on life expectancy, at least at the margin.
PS. Many conservatives undoubtedly disagree with me, and would hate the Singapore system. There are actually conservatives who defend our system of “private” health insurance, even though it is nearly as statist as the Soviet economy circa 1980. I’m not fooled, America has no truly free market sector for health care, although plastic surgery comes close. So if we can’t have freedom, let’s at least have efficiency.
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