Irresponsible Government Dodges the Healthcare Bullet Again

Which fucking Mr Lee said that?

I hope it wasn't the one who had all his expensive cancer treatments fully subsidized by the taxpayers of Singapore. I believe this certain Mr Lee knows a fact of life better than anyone - given a choice, who wants to be sick? After all, despite the unlimited resources his family have at their fingertips, he fell sick. Accordingly to this story [link], his father called his illness 'a bolt from the blue,' and advised him 'go through all the necessary tests and take the best medical opinion available'. Apparently, even the rich has the same fear towards death through sickness, how about the common man on the street with very little resources to cope?

I was a cancer patient, diagnosed with bladder cancer this year. It felt like a death sentence when my doctor told me how sorry he was but I had gotten cancer. I didn't want to be sick, I wanted to stay healthy yet I was afflicted with something I didn't ask for. For the rich in my position, they worry about getting well. For commoners, we can't get to sleep in proper at nights, dwelling about the financial burden along the journey back to health, if any. Friends began give advice similar to what the father in the story did, to go for the best medical option possible, even to the extent of dropping work and everything to return for Singapore for treatment and subsequent follow ups for life. For a certain Mr Lee, he could definitely do so but a commoner has different realities to face.

A good buddy of mine had his son just a few weeks after my own daughter was given birth. We shared our experiences as first-time fathers frequently during those days. Like our own situation, his wife had complications during child birth and the doctor suggested the Caesarean section procedure to ensure the safety of mother and child. I could feel the bitterness in his quivering voice he told me over the phone how the hospital made him sign an agreement to pay an additional $3,000 for the procedure before they would proceed. He challenged me, "As a husband and a father, with the lives of your wife and baby at stake, you will sign anything or will you not?" I agreed.

Under the universal healthcare system in Australia, it felt like a blessing I wasn't told to sign financial forms when I was outright flustered watching my wife in pain. The hospital sent her bed to the operation theatre before I could zip up our bags. In less than 30 minutes, I was cutting the umbilical cord cord of my daughter almost in tears. On both occasions walking out of the maternal hospital and cancer hospital, I wasn't made to pay a single cent. I owe my life and am extremely grateful to the healthcare system in place here. Though it is by no means FREE, because we have to pay a levy if rely entirely on Medicare unless we obtain a private health insurance every year, the system protects us from personal financial disaster and relieve us from the anguish of worrying about medical bills. According to the story once again, [link], they believed that stress was a factor behind Mr Lee's cancer. Yet medical bills bring extreme stress for the commoners in Singapore. Go figure.

Mind you, I am not implying you can't fault that statement. Staying healthy is indeed the cheapest treatment these days but I don't believe we need to pay anyone $2.2 million a year to state the obvious because that is as good as saying not going to the toilet is the best way to save toilet paper. I was not implying that the healthcare system in Australia is perfect, in fact many locals think it is far from being so. Singapore however, must take a step towards certain models of universal healthcare for the sake of the people, touted by the government themselves as the only resource of the country.

Providing good healthcare coverage for the people is not welfarism. Healthcare is a basic right. Handouts isn't. Asking for a better healthcare system is not asking for welfare. The government must stop mixing that up and confusing the people. In my opinion providing low cost healthcare should be placed a higher priority than providing housing or education for the people. Just ask any rich people dying from a terminal illness what they will give up in return for their health. I'm sure the certain Mr Lee knows that best.


  1. I will be surprised if you didnt sign a form on admission that you want to come into the public hospital under Medicare, unless the WA hospital system is very slack. Most admission papers must state you are coming under which conditions since it cannot assume everyone who walks through the door as Medicare eligible.

    The rebates for private health insurance rarely covers the cost of Medicare levy and Medicare surcharge. Furthermore the collection of all Medicare levy and surcharge covers less than 50% (some say 30%) of the actual cost of Medicare.

    I am glad that you have good care for your child and your cancer treatment; you don't seemed to be affected by bureaucracy and inefficiencies affecting most of public hospitals in Australia.

    You lucky man!

    1. I was put to wait a longer time that I preferred before getting treated. For a cancer patient, you wish you can have the treatment yesterday. A day seems like a week under those circumstances. Like I said, the healthcare system in Australia is by no means perfect but if Singapore can provide this level of healthcare for the people, it's a great step forward.

    2. Generally the cancer cases do get treat earlier but that is always at the cost of other long-waits (but non-cancer) cases that can wait (sort of).

      However in spite of postponing other cases, there will always be a waiting list since many people does not want to pay unless they wait too long. The doctors try their best in balancing the high grade cancer compared to low grade cancer which tend to spread more slowly and very responsive to treatment (thus can wait a bit longer)

      For Singapore to have this healthcare system then personal income tax must reach 3 x current rate. Not everyone can survive at this rate on SG wages (as you know Aussie wages is one of the highest in the world even better than the US).

    3. 1) It's always going to be the case of taxing the rich higher and the peasants lower but the government will never be do that.

      2) Australia relies on high tax to run welfare and healthcare schemes but does it necessarily mean Singapore has to increase tax in order to run their own system? The government has a habit of confusing the citizens with threats with higher tax should they ask for more assistance. Eg. Ex.Minister of Transport Raymond Lim told Singaporeans that the GST has to be increased by 2% (from 7% to 9%) if the public transport system is to be run COMPLETELY FREE. As far as I know, when Singapore increases GST to 10%, we will never see free public transport. Where did Raymond Lim pluck the numbers from?

      Don't be confused Singaporeans. Take away tax from the Australia government, they are virtually bankrupt. So it is correct to say that pro-people policies run on high tax. Singapore, on the other hand, enjoys a budget surplus EVERY YEAR and have accumulated hundreds of billions of money from the people in reserves. The budget surplus suggests it is possible to run a better healthcare system without further taxing the people.

    4. I beg to differ.

      Singaporeans consume free things/service very differently from Australians.

      When things are free, SGs line up for hours, sometimes days just to get it. And we are talking about low cost things < $5.

      If we suddenly talk about something like $15K bypass surgery, they will not hesitate to put their name down. Whether or not they will go through with such a big operation (and related side effects/problems) they down care until their day comes and then if they get cold feet they will cancel themselves, and waste other people's slot.

      This is kiasu in the extreme, but highly possible.

      For example I remember the early 80s National Day Parade at old Kallang stadium, when they give out tickets for free (still free today but only by ballot) people book in lots of tens, so when local RC thought so many people coming from our zone, they book 5 buses also for free as a service. End up only 1 bus is needed. So many no shows it is amazing how hard they hide the fact on TV broadcast, avoiding blocks of empty seats in the stadium.

      As a result of this distorted consumption of "free" service, the unit cost per Singaporean for universal health care will be much higher than what an Australian will consume. I have no doubt it will cut the surplus by at least 50%.

      Moreover, statistics suggest "Australia discharges 162 patients per 1000 population, which
      compares with 158 on average for Organisation for Economic Cooperation and
      Development (OECD) countries, 138 for New Zealand, 126 for the USA, 126 for
      the UK and 84 for Canada, and includes same day admissions, which are not
      counted as admissions in some of these other countries"* which suggest either Australians are a sicker bunch of people or they use more of the "free" service; you decide.


      Furthermore spending more money does not mean better health care. See

      Ignoring the US (which spends double what Oz spend on health care per person) with the distorted cost but really poor health care system, if you look at for example Japan which is one of the top Asian healthcare system, they (both people and government added together) spend at least 15% less than Australia and their system of patient accepting responsibility for 30% of these costs while the government pays the remaining 70% curbs excessive consumption. Furthermore we are dealing with a highly disciplined society in which people also look after their elderly (not necessarily blood related either).

      I agree that the SG system can run on a more Government subsidised ratio of payment but I totally disagree that Australian Medicare is equitable in Singapore OR Australia!

      Medicare really only existed less than one generation, and let me predict that it will not (and cannot) run at its current form for long, by the time I retire. I suggest that everyone should put aside some extra money for health care.

      Just to show you how deep the rot has set in. At first 10-15 years Medicare provide funds to nursing home at nearly no cost to the resident but they then have to set the rule that the resident must pay for their stay in the home if they are found to own assets like the family home or money in the bank.


    5. I am not a GP but let's say you see a doctor (a highly trained professional studied for at least 8 years) at your GP. If your GP bulk bills you for the consultation (say 15 minutes) guess what the Government pays him/her?


      The Australian medical association actually recommend at least $73 per normal consultation

      Remember this involves hiring people, setting up equipment, the practice building, computer system etc.

      Try to remember how much it will cost you to get the plumber to come to your place?

      Before he even step on your property he already charges you $40 (1990s rate).

      Say a lawyer, who spend less time studying to be a lawyer than a GP, and deals with less important things than your health, guess how much they charge?

      The Australian court consider anything under $56 per 6 minutes as very reasonable.

      I don't expect to change people's perception of how much doctors earn but I ask you to consider several things:

      1. If a doctor earns a lot of income, he/she generally have to train and work a lot to do so.

      2. The Australian government is very smart to try to suppress the GP's rebate. But don't blame the doctors who choose not to bulk bill. In fact some only ask for extra $5 to the $36 (ie $41) but this is enough to deter some Australians. Seriously if they don't buy a pack of cigarette or a glass of beer that would have saved them $5. In Canberra where I used to live, 90% GPs do not bulk bill.... but if you only go to bulk billing doctors good luck to you since you get for what you pay.

      3. Highly trained specialists who spent at least 12 years studying rarely bulk bill.

      4. Under the Medicare system the number of beds in public hospital has cut by 60% since 1984. In the same period the administrators running the hospital more than doubled.

      Just to show use how crazy it is out there, I personally know a 220 bed hospital building a 7 storey tower for expansion which essentially double to available floor space.

      How many extra beds they allocated for the patient care?

      22 beds.

      This is very funny since this hospital used to have 400 beds in 1990. Where did the beds gone to? To make room for administrators.

      Medicare ultimately is a very inefficient way to run a healthcare system.

      Not trying to depress you but don't expect Medicare to run forever at the current way.

    6. Thank you for taking time to spell out the imperfections of the Australia healthcare system. It never hurt to understand more. May I stress again, I stated it was nowhere perfect right from the start. I can double your list with the problems of our healthcare system in Singapore. If you think the healthcare situation in Australia is so dire, try Singapore. I promise you won't be disappointed.

      I don't think it is fair to deny Singaporeans a better healthcare system based on a generalisation that most will abuse the system because it's free/cheap. I wouldn't ask for a surgeon to probe a tube through my penis just because it is free. That was what I had to go through for my cancer treatment. Your example of putting the name down for a heart by pass procedure as a kiasu habit is therefore, far fetched if I may say so.

      If anything, kiasu-ism is a culture breed from lack, not abundance. It is not innate trait but a habit cultivated among the generations of people from being perpetually denied from privileges, kindness, courtesy, trust, space and time. If you want proof, observe foreigners picking up kiasu-ism themselves being exposed to the Singapore environment. Observe Singaporeans who came to Australia and diluted their kiasu-ism. This is precisely why we should provide, not deny, if anything, the first mental illness a better healthcare system can cure Singaporeans of will be kiasu-ism.

      The Singapore government have crafted so many policies to kill the good with the bad. Just because there is a few black sheep among us, the real needy are denied so that the black sheep cannot take advantage of the system. The same reasoning was used in the early days citing old farts spending their entire CPF savings within a few years and that was deemed a reason good enough to deny later generations from withdrawing their rightful share of money in the CPF and gradually abused by the government to hold our money for good after the people show virtually no resistance against a robbery.

      The lack of money is the last excuse the Singapore government can give for slamming a third world healthcare system at us. Not when we can fork out hundreds of millions to hold a sports days in our backyard, hundreds of millions a year to watch fast car whizzing past us in blurred frenzy, a cool billion bucks to build a garden which makes incur huge losses a year, designer covered linkway with finishes finer than your colourbond sheets on your roof in Australia, millions of dollars to rename public structures with the existing name just to name a few. If you think can pick any of the above mentioned a high priority than deriving a better, sustainable healthcare system, I rest my case.

    7. I am not trying to change your mind and I totally agree that neither health system are perfect.

      But if you think that kiasuism will not exist in Singapore, I strongly disagree.

      We are not talking about cancer surgery here, which is highly emotional. And I have not seen one person cancel their own curative cancer operation... yet. I guess this is close to your heart.

      But I am talking, in general, patients who put their name down for major elective surgery who end up cancelling or worse still simply don't turn up without bothering to tell anyone in the hospital (we have to call them and they say they changed their mind). We are talking about 10- 15% of the patients who cancel without advanced notice, leaving the hospital with $1million equipment and parts ordered in on standby, $10,000 worth of manpower and expertise, 3-4 hours of operation time, wasted in big cases

      Sure the patient can change their mind any time, but they come into contact with hospital staff at least 3-4 time over 2-3 months in preparation for surgery and they don't say a single thing before then?

      So kiasu-ism (abiet not in that term in Oz) is here and is real in Australia. Like I suggested earlier, Australians seemed to have more admissions into hospitals than other OECD countries and there are 2 possible explanation to it; I chose over-consumption as the reason.

      I dont think the Singapore government used the "lack of money" as the main excuse for not funding the healthcare system like Australia; in fact they advertised the current model as "universal healthcare"


      which you will agree is misleading but hey if the WHO considers Singapore model 6th best healthcare system in the world (not just developing nations) then the it is the perfect advertising fact for the government.

      Also even Australian journalists are looking at Singapore model:

      I have to say they that Singapore government have quite of few duds in spending for the wrong reason: YOG, linkways that needs high maintenance for tropical climate and these monies should be used for emergency grants to help people to make ends meet or health care.

      I am still shocked and appalled by stories 5-6 years ago (boom time before GFC) when some families in SG who cannot afford $50 for the electricity bill or the co-payment to government's CPF top up (some allege this top up is a sweetener for the 2006 election)

      In short, I agree the SG Government can be more humane and helpful to those in need, but universal healthcare in the Australian model is unsustainable in any country

    8. PS

      Just called up a few friends in town about the local public hospital in Oz:

      Some operating list run at as low as 61% efficiency since patients cancelled their own operations or decided not to turn up.

      Just yesterday a person who knows he needs an emergency operation and signed up for it, turned up drunk even though he have been warned about it. Obviously he was not fit for surgery.

      "Lack of understanding", people will use this excuse to defend him, but anyone who have to pay for the cost will not treat this operation so carelessly. A few black sheep may be tolerable but if your local hospital run at only 70-80% efficiency, you really have to worry.

      If the system is more efficient it can save $1.3 Billion annually. Christopher Pyne gets into so much trouble for not supporting the coalition pledge to continue previous Labor's Gonski reform due to $1.2B shortfall. If the public knew the inefficiency of public hospital is so much there should be similar public outcry

    9. Sorry I meant to say:

      But if you think that kiasuism will not exist in AUSTRALIA, I strongly disagree.

  2. Addit:

    Strictly speaking: UN article 25 Part 1 for Universal declaration of human rights states:

    Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

    This does not dictate any level of standard, just the level of medical care adequate to maintain health and well-being.

    This also does not say this must be free either

    Medicare as we know it today only existed from 1985. That does not mean that Australia did not have a good standard of health care before 1985:

    Back then 70-80% australians have private health care

    The honorary doctors who visits and work part time in the public hospital works for free for poor people and old people. They charge the the rest of the patients fees which is paid for by private health insurance or from own pocket.

    Hospitals work more efficiently then. Back then, patients does not stay in hospitals unnecessarily just because they don't feel like going home or families does not want to their loved wants to come home because its 'inconvenient' for them.

  3. From my experience especially heard lots of stories fron frens. Here if you got admitted to a govt hospital they are worried if you could afford to pay rather than worried about your sickness. They will keep asking you how are you going to pay so much amount if money. They are asking you such questions with no feeling of shame on their part. They run government hospitals like private enterprises. But they will to throw nearly $300 million on YOG and waste millions on foreigner scholarships, foreign integration programes etc. It makes me wonder what sort of government we've put in place with no feelings for our citizens who voted them I power?

  4. I wouldn't fuck Mr Lee, but Ms Mohandas can Channing all over my Tatum anytime!

    That is all.

  5. We should not have fought for independence long ago and now we will enjoy same level of healthcare welfare like Oz.

  6. A little history of Universal Healthcare System to explain how/why universal healthcare was deemed required.

    "The existence of poverty is a political decision" -- Dr Allyson Pollock, University of Edinburgh

    1. "The existence of poverty is a political decision"

      Which is why kee chiu decided that there is no poverty on the island.

    2. As they say:

      If you don't collect the right data you will never prove it exists.

      If you don't draw a poverty line no one will be below it.

  7. In Australia, people fail to turn up for medical operation appointment is because people take the healthcare system for granted. Frankly, XYZ is there a solution for this socially irresponsible behaviour for turning up drunk prior to operation. This create inefficacy and extra cost for the system. Perhaps you should create a penalty system for such people or put them on the waiting list. Since the patient himself do not treasure life and what the system is offering to him.

    Whereas in Singapore, people turn down operation due lack of money. This Little India Elephant Man story was reported in Stomp Strait Times

    1. Australia is always considered as a second chance country, esp for migrants like you and me.

      People can start life anew even if you wasted your life previously.

      In university a long time ago, there was a series of talks by different people about life.

      One day, a fat but well dressed man addressed the theatre audience.

      He started by telling us he had a good background in childhood, studied in university, graduated and got a job with fantastic working prospect, and studying while working to become a top professional.

      Then his marriage broke up and he took to drink. Subsequently he lost his job and his family.

      For 7 years he drifted between homelessness, rehab home, hospitals or friends place with no prospect in life.

      One day for some reason when he woke up with a hangover, he decided to stop drinking. No religious experience or miracle, but just will power. He abstained from drinking since then

      But he still have no job and his studies was disrupted for years.

      No one was giving him a job as most people he knew had moved on, so he went to his old mentor for his studies and ask if he can be given another chance.

      He was given that chance. And it took a lot of hard work to get back to where he was.

      Now he is an ophthalmologist (eye surgeon) for he was a doctor. If you know healthcare the medical world is small and reputation is important. Make a mistake and your career comes to a halt. Which is amazing but inspirational true story.

      Back to this patient who needed his operation done. The fact is that this is his SECOND operation with him having buggered up the first one within 4 weeks by not following instructions.

      Unfortunately although our Singaporean style is 1 or 2 strikes you are out, as health care workers in Australia we have to try not to judge people as hard as it is to do so, and to show empathy where we can.

      The man got his emergency surgery done the next day, but using up emergency surgery time slots share with many other people who needs emergency surgery.

      I am not sure if we are punishing ourselves in allowing him to have his operation done as he may still very end up not following instruction and ruining the operation giving the hospital more work.

      I guess we as healthcare works have to learn not to be too judgmental.

    2. PS: Ophthalmology is one of the hardest speciality to get into in Australia, some taking 10 years and still cant get in