Monday, October 26, 2009

William McGurn: What Singapore Can Teach the White House -

William McGurn looks at an example of a free market health care system in action: What Singapore Can Teach the White House

In Singapore, by contrast, they already have universal coverage. They also have world-class quality care at world-competitive prices. And in a week when White House chief of staff Rahm Emanuel is meeting behind closed doors with Senate Majority Leader Harry Reid, Singapore's example might have something to teach them about the kind of reform Americans really need.

"When I'm asked to describe the differences between the U.S. and Singapore systems, my one-word answer is 'complexity,'" says Dr. Jason Yap, director of marketing for Raffles Hospital, a leading private care facility in downtown Singapore. "There are so many parties in the American system that do not really contribute to care."

Dr. Yap is referring to the higher costs that come from an American system that depends on regulation and oversight to accomplish what Singapore tries to do with competition and choice. At the Raffles lounge for international patients, he shows me an example of the latter. It's a one-page, easy-to-read list of fees.

At the high end of accommodation, a patient can choose the Raffles/Victory suite for about $1,438 per night. That price includes a 24-hour private nurse, a refrigerator stocked with drinks, and an adjoining living room to entertain. At the other end of the scale, a bed in a six-person room goes for just $99.

As Dr. Yap points out, the actual care is the same whether a patient decides to stay in a deluxe suite or a dormitory-style room. But the choice is the patient's; the financial incentives encourage the patient to think about those choices; and the low-priced options help keep the overall costs down.
As any American who has ever tried to make sense of a hospital bill or haggled with his insurance company over a payment can tell you, even for those who have decent coverage our system can be a bureaucratic nightmare. Singapore's system isn't perfect. It does suggest, however, that the Average Joe stands more to gain from a system where hospitals and doctors compete for patients, where patients have different price options for their hospital stays and appointments, and where they pay for some of it out of pocket.

No comments: