Was just talking to my friends in Australia and US. You know,
medical costs in Singapore are actually too low for the level of
service we receive and expect. Sorry, I know this is not a popular
view but it is true. Problem is that we (myself included) now
expect first world medical service but we are not prepared to pay
first world prices cos our salaries aren't equivalent to western
developed nations.
Some countries like Thailand and India can ameliorate the
differential somewhat cos most of their population is blissfully
unaware of the adavances in medical technology and so can keep
demand down. High tech medicine is therefore available quite
cheaply to the small minority of those who can afford it. The other
advantage is their ability to produce cheap generics...that's why
our HIV patients have to go to Thailand to get anti-retrovirals.
(we cannot make cheap generics cos we want to attract all the
pharmaceuticals to do business here).
Here our doctors want to engage the latest technology available
(see the constant boasting in the papers of their latest toys and
techniques) but they do not come cheap. We the patients get all
excited and demand the latest drug or keyhole surgery or
investigation. But it is expensive and we cannot afford to pay the
full cost. The government does not want to subsidize or they will
have to raise taxes. The hospital goes into the red and so they
want to raise charges.
Another problem is that the doctors who provide these latest
techniques demand higher salaries (remember the salary of the eye
surgeons at SNEC?). Surgeons as a whole earn 3-10 times more than
other specialists because they bring business to the hospital.
Hospital administrators have to break even and so squeeze the
salary of other specialists, junior doctors and nurses; make them
work harder for less pay. Other specialists see the huge difference
in remuneration and are not happy....contributing to an exodus to
the private sector.
The private sector pays about two to three times the salary of
doctors in the government sector, but sees only a third of patients
in Singapore. It is no secret that every young surgeon works hard
in the public hospitals to gather experience and clients for his
move to the private sector. Those that remain are either not as
good or stuck in specialties that are necessary but not easy to go
private eg. psychiatry, radiology, pathology..
So I buy enough medical insurance to cover me so that I can afford
good but expensive medical treatment if I need it when I am still
economically active. Keep healthy when young so I can work and earn
as much as possible, retire early and enjoy myself before I get
really old and inevitably fall ill to cancer or whatever
degenerative diseases that will eventually get all of us. When that
day comes, I will take a handful of sleeping pills and die
peacefully rather than bankrupt my family with long and expensive
hospital stays.