Payment for health in Singapore

Singapore's rapid economic progress has been accompanied by a series of experiments in medical savings and health insurance. This paper aims to examine the “three Ms” – Medisave, MediShield, and Medifund – in order to establish the way in which the policy‐instruments are expected to deliver the status required.

The paper collects evidence on both outcomes and payments.

Results show that a nation in which the median citizen is under 40 is in a strong position to rely principally on individual medical savings accounts. The paper predicts that Singapore, as its population ages, will probably rely more heavily on risk pooling and insurance.

The practical implications are that an extension of insurance is inevitable, but that earmarked savings will probably remain the first line of defence.

The paper is the first to document the Singapore experience of payment for health. It draws inferences and makes recommendations that will be of interest to policy makers both in poorer and in richer countries.