SINGAPORE – Government healthcare spending is set to almost treble by 2030, but rising healthcare costs cannot “cripple our future”, Health Minister Ong Ye Kung said on Tuesday (May 25).

Singapore should thus continue to shift healthcare emphasis away from acute hospitals and towards the community, with an emphasis on a patient-centric approach, he added.

Two weeks into the job, Mr Ong was laying out plans for the healthcare industry at the Ministry of Health Work Plan Seminar, held virtually.

Addressing more than 700 people working in healthcare, Mr Ong touched on “three beyonds” that were first mentioned at the ministry’s Committee of Supply debate in 2017. These are: “beyond healthcare to health”, “beyond quality to value”, and “beyond hospital to community”.

He emphasised the last one and said patients will benefit from less hassle, greater accessibility to care, and lower cost.

“The centre of gravity must shift away from the acute care hospital, towards the community, with focus on appropriate care in the right setting,” said Mr Ong.

“That way, our already heavily loaded hospitals can then focus on patients who need specialist care, or emergency cases.

“At the same time, numerous primary healthcare providers in the community can take on larger roles.”

Mr Ong added that private general practitioners (GPs) can become an integral part of “the continuum for healthcare”, alongside polyclinics – already regarded as community institutions.

“A GP’s care for his patient goes beyond the four walls of his private clinic,” Mr Ong said.

“He can be the village doctor who understands the patient and his family, helps them manage chronic diseases; the confidant whom stubborn family members listen to; and often the link to the wider healthcare network.”

Pharmacists, too, can play important roles like educating patients on the proper use of medication to reduce hospital re-admissions, said Mr Ong, while nurses trained in diagnosing and managing common medical conditions can order tests and prescribe medicines, saving patients time and cost.

The minister also said patients in rehabilitation should “step up” and not “step down” to community hospitals and long-term care facilities.

He said multidisciplinary teams can provide “the right care at the right site” for medically stable patients in those facilities.

Mr Ong made these comments after addressing rapidly rising government spending on healthcare, which has more than doubled from 2010 and is projected to almost treble by the end of this decade.

Healthcare expenditure is set to hit $59 billion in 2030, up from $21 billion in 2018 and $10 billion in 2010.

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“The exponential rise is worrying,” said Mr Ong, adding that taming healthcare costs is not about denying quality healthcare, but about spending wisely and effectively and reducing wastage.

He laid out several approaches to managing rising costs under his ministry’s “beyond quality to value” approach.

First, the costs of drugs and treatments have to be contained, he said. A list of cost-effective drugs and treatments will have to be identified and maintained.

This will then be aligned with subsidy frameworks and insurance claim limits. There will be negotiations with suppliers to ensure prices charged match the outcomes they deliver, said Mr Ong.

Second, an element of co-payment has to be maintained in insurance schemes, to prevent cost inflation, he said.

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“Once there is some skin in the game, consumers will exercise prudence in healthcare spending and doctors will exercise more discretion in recommending the appropriate treatments,” he said.

Mr Ong also said the “beyond healthcare to health” approach will continue to be pursued, with intervention going upstream to encourage healthier lifestyles.

“The Health Promotion Board and our (healthcare) clusters must integrate their efforts and do what it takes to reshape lifestyles,” he said.

“After all, we are Ministry of Health, not healthcare.”

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