Individual Health Insurance Markets That Work, Part Two

Jacqueline Fellows, for HealthLeaders Media , November 20, 2013

In Singapore, all wage earners pay a portion of their income into their health savings account, which is called Medisave, and those accounts are like our 401k accounts. They (Medisave accounts) are individual assets, and there are rules about when you can use them, for what, how much you can use, and how much you can take out. So people are in command of their own healthcare dollars.

Singapore also only spends about 4% of their GDP on healthcare, and of that only one-and-a-half percent comes from the government. The balance comes from out-of-pocket spending and their Medisave accounts.

What you have is a predominantly privately-funded, high-performing healthcare system where people essentially buy their own services. The government sets limits on what Medisave will pay for, but the doctor can charge whatever he or she wants, and the consumer can decide what to buy. The government does not set prices. They'll determine what you can use Medisave for, but if you want to go to a certain doctor, that's fine, you'll just pay the balance out-of-pocket, or you can use private insurance.

While I didn't see the physical manifestation of healthcare retail, what I did see was a very important feature of retail healthcare, which is consumer control over spending.

Jacqueline Fellows is an editor for HealthLeaders Media.
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