"Providing good health care a challenge: PM - Feb 11, 2015 The Straits Times
HEALTH care has always been both an emotional and political issue, said Prime Minister Lee Hsien Loong, and "it is always tempting to say we will do more, we will do better and it will cost less... maybe even free".
But governments have to be trustworthy stewards and present the trade-offs as they are to citizens and not sacrifice tomorrow for today's political gain, he said.
Every dollar the Government spends on health care is a dollar taken from taxpayers. It is "a dollar we cannot spend on education, housing, defence, or on personal needs of our people", Mr Lee noted.
When it comes to health care, the usual economic models do not work, Mr Lee told the 300-strong audience, including the health ministers from Bangladesh, Brunei, Finland, Indonesia, Myanmar, Thailand and Vietnam.
Expanding capacity for future needs may stimulate a supply-induced demand. As doctors know far more than patients, a "willing buyer, willing seller" model does not work. And protecting patients from financial consequences could lead to overtreatment.
So, a variety of tools are needed, Mr Lee said, from pricing and regulation to incentives, exhortation and, sometimes, even compulsion, "to shape behaviour by doctors, patients, administrators, drug suppliers, in order to produce a good collective outcome"."
Interesting comments from the PM.
Lessons for me are:
1. the pragmatic mind-set of the government that there is NO altruism and NO true integrity means 'there is a need to SHAPE behaviours by doctors (who are supposedly to be there to save lives and NOT to just profit from selling medication and performing surgeries whether they are needed or not), patients (who supposedly want to get as many treatments as possible regardless if they need them or not), etc. With this mind-set, there is no doubt it will be difficult to 'allow the government to allocate more money from the total financial budget to health care'!;
2. the question is: is affordable healthcare a public good or a private good? If it is a public good, then public funding MUST be made available regardless. Having said that, it does not mean it will be given a free tap with unlimited money! Prudent management of costs and resources CAN help to keep costs down. Improved quality means higher productivity and lower costs. So, these CAN BE controlled!;
3. human factors of 'abuses' since PUBLIC money is abundant! Well, besides putting trust in the doctors and patients, the insurance folks, etc. Some categorisation of 'novel and expensive' medical treatments CAN BE monitored and 'approved' by some national board while 'reasonably advance treatment adopted' can achieve economy of scale with shared resources across the WHOLE national healthcare system instead of the current regional duopoly.
Maybe the possibilities I suggested here cannot work. At least we must try as saying: health care costs can only escalate simply is NOT good enough knowing that WE cannot afford it!
HEALTH care has always been both an emotional and political issue, said Prime Minister Lee Hsien Loong, and "it is always tempting to say we will do more, we will do better and it will cost less... maybe even free".
But governments have to be trustworthy stewards and present the trade-offs as they are to citizens and not sacrifice tomorrow for today's political gain, he said.
Every dollar the Government spends on health care is a dollar taken from taxpayers. It is "a dollar we cannot spend on education, housing, defence, or on personal needs of our people", Mr Lee noted.
When it comes to health care, the usual economic models do not work, Mr Lee told the 300-strong audience, including the health ministers from Bangladesh, Brunei, Finland, Indonesia, Myanmar, Thailand and Vietnam.
Expanding capacity for future needs may stimulate a supply-induced demand. As doctors know far more than patients, a "willing buyer, willing seller" model does not work. And protecting patients from financial consequences could lead to overtreatment.
So, a variety of tools are needed, Mr Lee said, from pricing and regulation to incentives, exhortation and, sometimes, even compulsion, "to shape behaviour by doctors, patients, administrators, drug suppliers, in order to produce a good collective outcome"."
Interesting comments from the PM.
Lessons for me are:
1. the pragmatic mind-set of the government that there is NO altruism and NO true integrity means 'there is a need to SHAPE behaviours by doctors (who are supposedly to be there to save lives and NOT to just profit from selling medication and performing surgeries whether they are needed or not), patients (who supposedly want to get as many treatments as possible regardless if they need them or not), etc. With this mind-set, there is no doubt it will be difficult to 'allow the government to allocate more money from the total financial budget to health care'!;
2. the question is: is affordable healthcare a public good or a private good? If it is a public good, then public funding MUST be made available regardless. Having said that, it does not mean it will be given a free tap with unlimited money! Prudent management of costs and resources CAN help to keep costs down. Improved quality means higher productivity and lower costs. So, these CAN BE controlled!;
3. human factors of 'abuses' since PUBLIC money is abundant! Well, besides putting trust in the doctors and patients, the insurance folks, etc. Some categorisation of 'novel and expensive' medical treatments CAN BE monitored and 'approved' by some national board while 'reasonably advance treatment adopted' can achieve economy of scale with shared resources across the WHOLE national healthcare system instead of the current regional duopoly.
Maybe the possibilities I suggested here cannot work. At least we must try as saying: health care costs can only escalate simply is NOT good enough knowing that WE cannot afford it!
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