atans1

Healthcare: user fees drives up costs

In Political governance, Public Administration on 08/05/2018 at 11:17 am

To show S’poreans that saying that they want to earn the right to lead is more than BS, the coming generation of leaders should start looking at Hard Truths that have become irrelevant or were wrong in the first place. They can do no worse than look at user fees in healthcare.

The PAP administration swears by user fees in healthcare because it says that not to have fees means that there’s a buffett syndrome: Welfare for insurers (cont’d)

It would argue

In the 1980s and 1990s many health economists were relaxed about out-of-pocket payments, also known as user fees. The World Bank saw them as a way of making sure money was not wasted, and of helping health-care consumers hold providers to account. There is merit to this argument. Research by Jishnu Das of the World Bank found that when Indian health workers saw patients in their private clinics, they spent more time with them and asked more questions than when the same health workers saw patients in public clinics.

Economist

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I’ve blogged before that the PAP doesn’t need that many smart people as it follows most of the Economist’s prescriptions (except on hanging, drug legalisation, free media and a liberal democracy): PAP’s bible challenges “market-based solution”)

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Well its bible now says that it’s not a

good idea to rely mostly on user fees to fund a health system. They stop those who need care from seeking it. Concerns that users will consume too much health care unless they have to pay are overblown. And when people are not getting vaccinated to save a few cents, others suffer, too.

Worse

Out-of-pocket payments are also “cannonballs of inefficiency”, says Timothy Evans of the World Bank, which is now sceptical about user fees. If spending is pooled, it can insure more people against the risk of ill health and put pressure on providers to cut prices. Of the $500bn generated globally by user fees every year, the World Bank estimates that 40% is wasted.

https://www.economist.com/news/special-report/21740870-if-universal-health-care-become-ubiquitous-politicians-will-have-act-more

Re the issue that user fees

are also “cannonballs of inefficiency”

seems to apply here as DBS says govt should control costs of households esp in healthcare: See who’s telling govt to control healthcare costs/ What we be should be KPKBing about

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  1. PAPies aren’t stupid. They already saw this 10+ years ago. The 2 big issues are aging population and aging HDB. But it hasn’t reached critical stage yet.

    That’s why they’re building up funds with increased GST after next GE. The extra funds will be the pork barrel in elections after 2025.

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