Public Private Partnership in Healthcare
Transforming Singapore Health Care—MK Lim
461
Commentary
Transforming Singapore Health Care: Public-Private Partnership†
MK Lim,1FAMS, FRCP (Edin), MPH (Harvard)
Abstract
Prudent health care policies that encourage public-private participation in health care financing and provisioning have conferred on Singapore the advantage of flexible response as it faces the potentially conflicting challenges of becoming a regional medical hub attracting foreign patients and ensuring domestic access to affordable health care. Both the external and internal health care markets are two sides of the same coin, the competition to be decided on price and quality. For effective regulation, a tripartite model, involving not just the government and providers but empowered consumers, is needed. Government should distance itself from the provider role while providers should compete – and cooperate – to create higher-value health care systems than what others can offer. Health care policies should be better informed by health policy research. Ann Acad Med Singapore 2005;34:461-7 Key words: Health care costs, Health care regulation, Health economics, Health reform
Introduction Should health care services be publicly or privately funded? And should these services be publicly or privately provided? The answers to these questions largely depend on whether one considers health care a public or a private good. Most people would consider the provision of street lighting and national security to be a public sector responsibility, and luxury items like cars and annual holidays abroad to be private consumption goods best left to the individual to purchase and the private sector to provide. When it comes to health care, however, the issues become highly contentious and the answers are not as clear-cut. While consulting a doctor is a very personal matter, the thought of denying a fellow human being access to the same level of health care because of his or her inability to pay, stirs
461
Commentary
Transforming Singapore Health Care: Public-Private Partnership†
MK Lim,1FAMS, FRCP (Edin), MPH (Harvard)
Abstract
Prudent health care policies that encourage public-private participation in health care financing and provisioning have conferred on Singapore the advantage of flexible response as it faces the potentially conflicting challenges of becoming a regional medical hub attracting foreign patients and ensuring domestic access to affordable health care. Both the external and internal health care markets are two sides of the same coin, the competition to be decided on price and quality. For effective regulation, a tripartite model, involving not just the government and providers but empowered consumers, is needed. Government should distance itself from the provider role while providers should compete – and cooperate – to create higher-value health care systems than what others can offer. Health care policies should be better informed by health policy research. Ann Acad Med Singapore 2005;34:461-7 Key words: Health care costs, Health care regulation, Health economics, Health reform
Introduction Should health care services be publicly or privately funded? And should these services be publicly or privately provided? The answers to these questions largely depend on whether one considers health care a public or a private good. Most people would consider the provision of street lighting and national security to be a public sector responsibility, and luxury items like cars and annual holidays abroad to be private consumption goods best left to the individual to purchase and the private sector to provide. When it comes to health care, however, the issues become highly contentious and the answers are not as clear-cut. While consulting a doctor is a very personal matter, the thought of denying a fellow human being access to the same level of health care because of his or her inability to pay, stirs