Healthcare reformers often look to Europe or to Canada for models of change. This might be due to the fact that it is geographically closer and more Americans are familiar with Europe from personal visits, or it may be due to ideological reasons. Most European nations have a more or less socialistic approach to health care systems. In "The American" of May / June 2008, Rowan Callick investigates the city-state of Singapore and finds it may have a prescription for America.
Singapore has eschewed the European government-payer-model of health care with a great deal of success. The reason for Singapore's successful health care system is not government spending, says Callick. Compared to the American system, Singapore keeps it citizens healthier for much less cost per person:
Singapore residents are considerably healthier than Americans, yet pay, per person, about one-fifth of what Americans pay for their healthcare.
In Singapore, the government funds only about one-fourth of total health care costs, while individuals and their employers pay for the rest.
According to the World Health Organization's (WHO) report on global health statistics:
The United States spends 15.4 percent of its GDP on healthcare, while Singapore spends just 3.7 percent.
Singapore's government spends only $381 per capita on health- or one-seventh of what the U.S. government spends.
Life expectancy at birth in the United States is 78 years; in Singapore, it is 82 years (I am including this with the limitation that life expectancy is not a good measure for the quality of a health care system, this is included since the single payer supporters always quote these figures)
The U.S. infant mortality rate is 6.4 deaths per 1,000 live births; in Singapore, is it just 2.3 deaths per 1,000 births.
Now, here is the decisive point:
Singapore's system requires individuals to take responsibility for their own health and for much of their own spending on medical care. The system works so well because it puts decisions in the hands of patients and doctors rather than of government bureaucrats and insurers, says Callick.
Source: Rowan Callick, "The Singapore Model," The American, May/June 2008.