Face Value

$3000 to wash dishes in Singapore!


Earn S$12,000 a month as a Polytechnic graduate!

Earn $4,000 a month operating a crane!

Earns $7,000 as a taxi driver!

Make $20,000 a month selling clothes!


XYZ5 December 2013 08:56

I posted this for your benefit, as you implied Singapore's healthcare system was ranked 6th in the world and therefore it must be good. What criteria was the ranking based on? I think there is a distinctive difference between providing good medical service and an affordable one. I have serious doubts whether WHO is able to correctly determine affordability accurately since even our own government has failed to do so in almost every other sector. If one takes everything in by face value, from the few nice screenshots above, we will have to conclude that life in Singapore is paradise. Heck, why are we even talking about improving the healthcare system when the people are so well off? 


However, when we throw ourselves in the fray, we will find that sometimes there is nothing more real than facts, reports and statistics than reality itself. That may explain why you are still shell shocked over learning how families in Singapore that cannot fork out $50 for utility bills actually exist. They do. And if you ask these families if they prefer the 6th best healthcare system in the world to the fault-laden Australian one, guess which one they will pick. 


To be honest, the fact Australian journalist were looking into Singapore's healthcare system does not impress me because it doesn't indicate anything specific. Truth to be told, it is well documented that almost every government in the world looks at the Singapore government with envy and many are making studies to find out if they can work our system in their respective countries. I suppose some, probably including yourself, may interpret that as Singapore being the 'role model' of democracy, which is why so many seek to emulate us. I supposed some, including myself, wouldn't. Back to the case of imperfect healthcare systems, as I mentioned before, I believe it isn't right to penalise the needy just because of black sheep. That will be like cutting off the nose to spite the face. In my opinion, a tweak in administration procedures or policies will improve its sustainability, not axing the entire system. 


I don't think we define kiasu-ism the same, since you equate kiasu-ism with the abuse of privileges, and I define it as a behavioral consequence of the illusion of lack, in the absence of civic mindedness, generosity, consideration and humility. Under my definition, the situation in Australia is undoubtedly better, though I absolutely agree that will change when circumstances do. Even so, Australia will never catch up on the unparalleled high standards that Singapore set for kiasu-ism in the society.


In short, whether or not the Australian healthcare system can be sustainably emulated in Singapore, much more must be spent and done on healthcare for Singapore citizens not because we can well afford it, contrary to what they claim, but it is the right thing to do.

17 comments:

  1. hey mate, you are rite man. Most of the time, Singapore press like to present thing based on what the leading party want the public and the world to know instead of what is the reality on the ground. Publisher such as Far Eastern Review need to bow down to the old man and his son after writing an article which is deem defaming in their eyes.

    Hence I would say it would take a true blue average Singaporean who has venture of SG to be able to compare the pros and cons of another system. Otherwise, we are like what the Chinese idiom say, "纸上谈兵 – zhi shang tan bing" being an armchair strategist - engage in idle theorizing without experiencing the reality on the ground.

    If you ask an average Singaporean, if he welcome OZ healthcare system into SG. I would safely said more than 70% would say yes. Because we know that in Singapore, you cannot afford to be sick but can die.

    In SG, we may pay lower tax. However,we are tied down with overprice public housing, COE, ERP, monopolies (government linked utilities company) charges, parking, GST, property taxes for public housing and etc. In SG, unless you are rich otherwise it is very hard to understand the life of average Singaporean.

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    1. OZ boy

      Public housing is not that overpriced if you buy directly from HDB and not on open market in a mature estate. Furthermore no one is asking you service the mortgage faster than 25 years repayment period

      COE/ERP/Parking all related to private car ownership. Like Jack Neo famously said 20 years ago when he had a spot on Saturday night variety shows:

      Buying a car is like getting a fine. You get fined for wanting to buy a car (COE), buying a car (100% cost price), keeping your car beyond 10 years (PARF), driving your car (ERP and road tax) and parking your car (parking fees). Why do we like to pay so many fines? Because we are a FINE country? (I know it doesnt translate view well in English, but he did it very well speaking in Mandarin)

      But it is not a must to own a car. Plenty of people survived without owning a car. And no matter how much people try, Singapore simply have no space for everyone to own a car so that's why the Government punishes people for daring to dream their dream, by hitting them where it hurts most, the wallet.

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    2. Public housing not overprice? You make my day mate. Do you read the HDB contract carefully, we don't own the place. We lease the flat for 99 years. Therefore, the HDB will en bloc the flat after 40 odd years and the owner will be tied down with another new mortgage. Have you heard of old folks who need to leave the area since they can't afford to pay for the new en bloc assign flat due to their age and salary.

      COE/ERP/Parking charges. May I know who is better off? The government coffer or the people. What is the govt doing with the overflowing coffer. Are they using it to met the healthcare concern of the people?

      Frankly, why don't you take up the challenge to leave OZ permanently and go back to SG to experience the life of the fine city. Perhaps we can keep in touch to see if what most recent SG quitter comparison is a fair view or just a delusion on our end.

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    3. If you don't like 99 year lease then you may have to avoid places like Canberra Australian Capital Territory where all property are sold on 99 year lease. So it is not just Singapore who have this kind of thing.

      http://www.prosper.org.au/2008/01/16/canberra/

      Singapore's HDB flat BTO on non-mature estate range from S$75K* to 365K excluding other fees/costs. When you convert to A$ these cannot even buy a apartment in Sydney with 20 km of the CBD.

      http://www.hdb.gov.sg/fi10/fi10321p.nsf/w/BuyingNewFlatFlatsonOffer?OpenDocument

      *2 room flat

      There is no doubt that the government profited from the car restriction. But how else do you suggest we can restrict car ownership in Singapore. Balloting? Lotto ticket? The only capitalist way to control car ownership is that you must be able to afford the price.

      Where they they spent the car revenues on? The road of course. Singapore has the best road system in the region. Even regional Australia and some part of Sydney pales in comparison. I guess the Land Transport Authority has plenty of money when I see road being dug up and resurfaced every 5 years or so....

      OZ boy get this right. I am not saying my life in SG is better than OZ and I don't see why you even "challenge" me to go back to Singapore like at 15 year old kid picking a fight. Read and read again all my post: I has always been saying that we can't take every single idea in Australia and expect Singapore to adopt it wholesale since it doesn't work.

      In some areas SG is way ahead of Oz. I remember the time my brother is researching on smart card for public transport in the 1990s (which the LTA was about to introduce the first reusable smart ticket) and he asked me to find out about Sydney's public transport system where they trialed a smart card system for 3 months.

      20 years later in SG we have the 3rd version of the multiuse rechargeable smart card for public transport and NSW transport system only JUST started to introduce smart card (Opal) in limited areas in Sydney for the last 12 months!

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  2. ASingaporeanSon wrote: "much more must be spent and done on healthcare for Singapore citizens... it is the right thing to do"

    If Singapore had Universal Healthcare, this elderly sick would not commit suicide just to save her family from financial disaster. When will Singaporeans wake up?
    http://asingaporeanson.blogspot.ca/2013/11/die-can-sick-cannot.html

    Now let's come back to reality. Below is the reality from my perspective as a nurse in both Singapore and Canada.

    As a nurse in Singapore, I can tell you honestly, the reality is "die can, sick cannot" for the average Singaporean (i.e. not the multi-millionaires, billionaires, or the men-in-white with government-paid healthcare). Most don't realize how close to bankruptcy they are, with just 1 major accident or major/chronic illness. I sincerely hope that most will not have to face the desperate choice between money for medical or for survival.
    http://winkingdoll.blogspot.ca/2010/01/1-calamity-away-from-poverty.html

    As a nurse in B.C., Canada (with universal healthcare), I compared the difference. Imperfect as the B.C. system is, it still far superior in terms of access. The reality here is rich or poor, if you're really sick and/or need life-saving surgery and related post-op physio and/or other therapies, you'll be attended to without you worrying about the in-patient costs.

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    1. Strangely and I still am amazed by this:
      Canada can get near universal health partly by private health provider but yet not has cost blowout like Australia. Maybe it is because they don't have as much public hospitals (many working at inefficient level for the amount of money throw it them) as Australia.

      The biggest compromise is that there is a significant waiting list in Canada. Sometimes to see a specialist is 6 months or so. I don' t know how long it is to wait for an operation after seeing a specialist.

      But do you suggest that if you are involved in a car accident and have massive bleeding and broken bones Singapore hospitals will not treat your life threatening condition if you cannot prove you can pay (whether or not you are a local or not?).

      I doubt so. They will do everything stabilise your condition such that you are not in immediate danger.

      However this does not include doing procedure or treatment that people call 'life saving" in a lay person sense.

      Cancer or fracture surgery is serious surgery and often life saving but not always immediately life threatening (that is, if you don't operate in 1-2 weeks, you won't necessary die)

      For example there was a public outcry that peritonectomy (a complex expensive operation that involves the removal of cancers in the tissue [peritoneum] that line the abdominal cavity and envelopes vital organs) was limited to 72 operation per year in the entire NSW state (since only one surgeon perform them in only one hospital). A woman who was put on the waiting list waited at least 3 months and started a social media movement to push for her operation to be done earlier.

      Ultimately this will mean she get to jump queue if she succeed.

      The survival rate for 5 years after this operation is less than 50%.

      http://www.theleader.com.au/story/1918505/no-increase-in-peritonectomy-surgeries-at-st-george-hospital-official/

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    2. Hi XYZ,

      I cannot speak for the entire Canada as I have not experience healthcare outside of B.C.

      > Maybe it is because they don't have as much public hospitals (many working at inefficient level for the amount of money throw it them) as Australia.

      In B.C., only elective procedures/operations are done by private hospitals, all other acute care are serviced within the public hospitals. It is illegal for private hospitals to cover care which is done at public hospitals. So I think, if you compare Perth (where ASingaporeanSon lives) and B.C. (where I live), I think there are probably more private hospitals in Perth than in B.C.

      The healthcare system in B.C. typically works this way: unless it is absolutely necessary, a patient will not be admitted into public hospital care as in-patient. There will be options offered such as visits by home health nursing -- including daily cancer therapy treatments! I suspect that may have helped to keep costs down.

      As I've mentioned, the B.C. system is IMPERFECT. E.g. Wait-times is a common grouse -- those with imminent issues get surgery first. I have seen a patient fast daily for 3-4 days awaiting for surgery to be inserted with a PICC line for cancer therapy -- possibly not top priority because of her elderly age reducing her chance of a good prognosis.

      > They will do everything stabilise your condition such that you are not in immediate danger.

      That said, uncle Wing (of SG-Quitter) blog would not hesitate to choose B.C. public healthcare system over Singapore's public healthcare system. If I understood correctly, uncle Wing told me of how he narrowly escaped death while in a Singapore hospital. Long story short: Uncle Wing was in a coma for days in a Singapore public hospital's ICU, the healthcare professionals demanded a deposit of $10K before they are willing to give him an injection that "may" revive him from his coma state, although he was still a Singapore citizen at that time. The alternative given was to "pull-the-plug" on uncle Wing! As they were returning to Singapore for a visit, neither uncle Wing nor his wife had a large sum of money on-hand, and thus his wife went around begging friends/relatives for $$$ just to revive her husband. Sorry, I do not know any more details of the circumstances beyond what I can recall of his sharing.
      http://www.sg-quitters.blogspot.ca/

      As for myself, I could have lost my life if I relied on the mis-diagnosis by the public hospital A&E doctor. I was lucky in that my nursing education gave me enough understanding of the severity of my condition such that I sought a 2nd opinion at a private hospital. I do not blame the public hospital A&E doctor, I believe he was overworked and the A&E was understaffed, which possibly caused him NOT to have enough time to do his due-diligence assessment of his patient (i.e. yours truly). I know of another public hospital doctor who also migrated to Canada -- he also rants about the overwork and abuse of the healthcare workers in Singapore.
      http://winkingdoll.blogspot.ca/2009/08/pneumonia.html

      So no system is perfect. But IMHO the access to appropriate healthcare for a "nobody" in Singapore sucks-big-time compared to that for a "nobody" in B.C., Canada. That's my 2 cents opinion.

      As for the cost recovery, I think ASingaporeanSon and other bloggers such as The Heart Truths have already provided data on how/why the Singapore government can clearly afford to provide better access to public healthcare.

      Cheers, WD.

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    3. WD

      "But IMHO the access to appropriate healthcare for a "nobody" in Singapore sucks-big-time compared to that for a "nobody" in B.C., Canada. That's my 2 cents opinion."

      That is very true....

      "ASingaporeanSon and other bloggers such as The Heart Truths have already provided data on how/why the Singapore government can clearly afford to provide better access to public healthcare."

      "Afford" and "better" are a relative term

      Let's put it this way:

      Say a labourer has $1500 monthly salary and $14000 in the bank. One day he was told that he needs a heart bypass which costs $15000.

      So by the book it looks like he can afford the operation (just like to cold calculation of any hospital administrator) but it did not take into account extra charges, months of not working and perhaps even not being able to work as a labourer forever. In other words he may be able to afford the operation but he may not be able to afford living after he survived the operation.

      Similiarly the Australian government under Labour inherited the surplus from the Howard government, and they spent it like there is no tomorrow. The money they spent did not help the Australian economy, since it is the commodity boom that supported the economy during the GFC not the government spending. Now the boom is over, there is no money to spend when the economy is slowing and needed it the most.

      Just because the Singapore government has surplus and can afford the Australian style Medicare system doesn't mean it is right to spend the money for a completely "free" healthcare system.

      But I stress I agree that the Singapore Government can do more to help needy people who cannot pay for their medical bills (and those who cannot even live in SG properly when they are healthy). And they need to stop spending on things like YOG and Grand Prix

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    4. But do you suggest that if you are involved in a car accident and have massive bleeding and broken bones Singapore hospitals will not treat your life threatening condition if you cannot prove you can pay (whether or not you are a local or not?).

      The article speak for itself.
      http://singaporeseen.stomp.com.sg/singaporeseen/this-urban-jungle/elephant-man-of-little-india-has-leg-four-times-the-size-of-the-other.

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    5. OZ boy

      Elephantiasis is neither immediately life-threatening nor slowly life-threatening.

      In fact there is no 'cure' to elephantiasis. In the purest form any surgery for this condition is cosmetic since the operation involves removing the skin and putting new (but not normal functioning) skin on the leg but will forever be scarred.

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    6. Hi XYZ

      In the article, it mentions that the hospital require the man pay $8k deposit before operating on him. Since he has NO MONEY, he chose to skip the op. Do you think it is ethnical for SG public hospital to deprive this man of proper medical treatment? If it is Australia, will he be turn away due to lack of money?

      In 2011, World Health Organization has included Elephantiasis or podoconiosis into the Neglected Tropical Disease list.

      Hence at the end of day, if a healthcare professional would continue to allow the parasite to stay in the man body without treating him. Then he should reconsider if he is in the right profession.



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    7. Hi XYZ,

      You wrote: "Afford" and "better" are a relative term.

      Here an example I heard directly from an elderly patient at a Singapore public hospital while I was still training as a student nurse. Old lady had been in-and-out of hospital for health issues. Old lady told hospital staff she "money not enough", referral to Medial Social Worker (MSW) done. MSW told that her she needed to sell her 3-room HDB before she can be considered for Medifund. Old lady dutifully followed instructions, sold her HDB-leased apartment. When old lady asked to be re-considered for Medifund, the MSW told her "No", she had to pay the hospital bills with the proceeds from her HDB sale. Soon enough even the $ from the HDB sale ran-out. Old lady was then without savings, without any source of income, without a roof of her own, and was totally dependent on and living with a niece who was herself struggling to make ends meet. Once again, old lady asked to be considered for Medifund. This time MSW said niece is working, so must use niece's CPF to pay for old lady's medical bills. So is this "affordable" healthcare? Does the 3M's approach to finance medical care really "better" access to healthcare?

      You wrote: But I stress I agree that the Singapore Government can do more to help needy people who cannot pay for their medical bills (and those who cannot even live in SG properly when they are healthy). And they need to stop spending on things like YOG and Grand Prix

      I agree.

      Cheers, WD.

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    9. OZ Boy

      "In the article, it mentions that the hospital require the man pay $8k deposit before operating on him. Since he has NO MONEY, he chose to skip the op. Do you think it is ethnical for SG public hospital to deprive this man of proper medical treatment? If it is Australia, will he be turn away due to lack of money?"

      In Australia, the treatment is drugs to kill the parasite. Surgery is strictly for cosmesis and hygiene, nothing more. I believe in Singapore it will be the same.

      Like I have written previously, if you come to Australian public hospital, and you are not entitled to Medicare benefits, then like in Singapore, you will be treated for immediate life-threatening conditions and no more than that. You will be advised to return to your country of origin to undertake treatment for all other conditions.

      There are plenty of examples I know of whereby overseas patients travelled to Australia to seek medical attention particularly cancer treatment and the public hospital made it absolutely clear that they must pay up front partially or in full for the operation or chemotherapy.

      If you have Medicare access, then you will be treated as a public patient, which covers for all life-threatening conditions and most elective surgery BUT NOT ALL. There are operations in Australia that are done only in private hospitals since they are not considered as high priority in the public hospitals.

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  3. If those adverts are true, why are they still paying $3-4k per month for a graduate with several years experience?

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    1. Don't know the rest but the dish washer for ad is a gimmick.

      Then the chinese wan-bao make such a big deal and the employer say no Singaporean want to do it and that's why we need foreigners in SG.

      I don't recall it in chinese newspaper as working 12 hours for 6 days but from memory it appears to be 12 hours for 7 days or something like that.

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  4. Hi Nix

    Firstly I am not suggesting that being 6th in WHO's ranking means the healthcare is better in SG (in fact Australia was ranked, I think, 26th, so I definitely disagree with the ranking) but I am not the SG Government promoter and I am surprised that they have not used this as a promotion for their policies.

    Secondly: your statement "whether or not the Australian healthcare system can be sustainably emulated in Singapore, much more must be spent and done on healthcare for Singapore citizens not because we can well afford it, contrary to what they claim, but it is the right thing to do." is true which is what I acknowledge earlier but if you read what I wrote, what I was saying is Singapore cannot and should not take Australian Medicare system as a model since it is unsustainable.

    If you look around there are amazing health system like Japan and Canada who are not ideal but does work efficiently and humanely with much less cost than how Australian Medicare is priced at.

    Thirdly I am not still in shock for SG people with no $50 to cover their bills, since I accept in a capitalist society with no minimal wages there will always been people who live in relative poverty. What I am surprised about was the fact that Straits Times actually published a in depth review about this during the boom time (2006-7).

    Most Australians and many Singaporeans know nothing about poverty. Real poverty at our doorsteps is going to rural Malaysia and Indonesia and see the people living day by day with no hope or chance to improve themselves.

    Nix, this is your blog not mine. I am not picking a fight; I am trying to give a alternative view to the world you experienced, but we live in the same world. But if you talk about healthcare a matter close to my heart then I feel that I should let your readers know more about the background, unless you chose to exclude dissenting views.

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