Guide to Singapore's healthcare system: Public vs Private

The pandemic’s over. Wahoo! Singapore’s healthcare system, renowned for its efficiency, quality, and accessibility, was put under the spotlight during the past 3 years of COVID. This post explores the distinctions between private and public healthcare in Singapore, examining factors such as cost, accessibility, and quality of care. Additionally, it delves into the remuneration of doctors in Singapore, shedding light on their earning potential and the considerations surrounding their salaries. Oh, you’ll also find out about the best hospitals and where you can find them. By understanding the dynamics of Singapore’s healthcare landscape, we gain insights into the complex interplay between private and public sectors and the compensation structures that shape the medical profession in the country. We won’t be covering insurance in-depth in this post (especially cheap health insurance). We’ll save that for another time.

HK vs Singapore - a little on their healthcare systems

Let’s begin with comparing these two Asian countries before we double click into Singapore. The healthcare systems in Hong Kong and Singapore are often praised for their efficiency, accessibility, and quality of care. Comparing across a few criteria -

Healthcare Expenditure: In terms of healthcare expenditure, Hong Kong and Singapore differ significantly. According to the World Bank, Hong Kong’s healthcare expenditure accounted for approximately 17.5% of its GDP in 2019, while Singapore’s healthcare expenditure was around 4.8% of its GDP in the same year. This substantial disparity suggests that Hong Kong allocates a higher proportion of its resources to healthcare compared to Singapore.

Infrastructure and Facilities: Both Hong Kong and Singapore boast well-developed healthcare infrastructures. Hong Kong features a mix of public and private hospitals, including several renowned medical centers and specialty hospitals. Singapore, on the other hand, is known for its excellent public healthcare system, with a network of public hospitals and polyclinics. Additionally, Singapore has actively promoted medical tourism, attracting patients from around the world to seek specialized treatments.

Healthcare Outcomes: When examining healthcare outcomes, both Hong Kong and Singapore demonstrate commendable results. According to the World Health Organization (WHO), Hong Kong’s life expectancy at birth is approximately 84 years, while Singapore’s stands at around 83 years. These figures indicate that residents of both regions enjoy relatively long and healthy lives.

Patient Satisfaction: Patient satisfaction is a crucial aspect of healthcare delivery. In a survey conducted by the Hong Kong Hospital Authority in 2020, 76% of respondents expressed satisfaction with the quality of healthcare services provided. Similarly, a survey conducted by the Ministry of Health in Singapore in the same year reported that 85% of patients were satisfied with the overall quality of care received. These high satisfaction rates reflect the emphasis placed on patient-centered care in both systems.

Challenges and Opportunities: Despite the positive aspects, both healthcare systems face challenges. In Hong Kong, long waiting times for specialist appointments and limited resources are areas of concern. In Singapore, the rising cost of healthcare and an aging population present challenges to sustainability and affordability. However, these challenges also present opportunities for continuous improvement, innovation, and policy reforms in both regions.

Overall, both systems are robust, advanced and managed well. If you’re deciding which country to live in, I wouldn’t use healthcare as a deciding factor.

Cost of healthcare

The average cost of healthcare in Singapore can vary depending on factors such as the type of medical service needed, the healthcare facility, and whether an individual is a citizen, permanent resident, or foreigner. However, it’s important to note that the healthcare system in Singapore operates on a mixed financing model, with government subsidies and insurance coverage helping to make healthcare more affordable for residents.

For Singapore citizens and permanent residents, a significant portion of healthcare costs is covered by government subsidies and the mandatory national health insurance scheme known as MediShield Life. MediShield Life provides basic coverage for hospitalization and selected outpatient treatments.

That being said, there may still be out-of-pocket expenses, such as deductibles, co-payments, and non-subsidized services. The specific costs can vary widely based on factors like the complexity of the medical procedure, the ward class chosen (e.g., public hospital A ward, B1 ward, etc.), and the specific healthcare provider.

For foreigners or individuals without permanent residency in Singapore, the cost of healthcare can be higher (significantly). They are generally not eligible for government subsidies and may need to rely on private insurance or self-payment for medical expenses. Private healthcare providers in Singapore often have their own pricing structures, which can vary significantly. All that being said, expats are most likely covered by private insurance from the company, with most being top-class. My company’s insurance covers $500 USD worth of eyeglasses every year. You just can’t complain. Insurance for expats in Singapore if out of pocket is expensive, but we’ll save that for another time.

Singapore healthcare is one of the best support systems for the nation’s prosperity

Service providers

Public Singapore hospitals form the backbone for most of the country. Whilst the wait for public hospitals is generally much longer, the quality of them is top notch in Singapore. These hospitals provide high-quality medical services to cater to the healthcare needs of both local residents and international patients. Here are some features of public hospitals in Singapore:

• High-quality medical services: Singapore’s public hospitals have modern facilities and advanced medical technology to deliver excellent healthcare services. These hospitals have top-notch medical experts and nursing staff dedicated to the treatment and care of patients (comparable to private)
• Wide range of specialized healthcare: Singapore’s public hospitals cover various specialized fields, including internal medicine, surgery, obstetrics and gynecology, pediatrics, cardiology, ophthalmology, orthopedics, and more. Whether it’s routine health check-ups or complex surgeries, these hospitals provide comprehensive specialized medical services.
• Medical technology and innovation: Singapore’s public hospitals are committed to driving medical technology innovation and application. These hospitals adopt advanced diagnostic and treatment technologies, including medical imaging, surgical robotics, genetic testing, precision medicine, and more, to provide more accurate and effective healthcare.
• Medical research and education: Public hospitals in Singapore collaborate closely with academic and research institutions to advance medical research and education. These hospitals constantly strive to enhance the level of healthcare and service quality through scientific research and the exchange of medical knowledge.
• Comprehensive healthcare services: Singapore’s public hospitals offer comprehensive healthcare services, including preventive care, health screenings, chronic disease management, and rehabilitation care. These hospitals are committed to maintaining people’s overall health and provide various preventive measures and health promotion activities.

In conclusion, public hospitals in Singapore provide top-quality medical services, advanced technology, and a wide range of specialized healthcare. They prioritize patient care and continuously contribute to medical research and education. These hospitals play a crucial role in ensuring the well-being and health of the population in Singapore.

Here’s a list of the popular public hospitals

• Singapore General Hospital (SGH): SGH is the largest and oldest public hospital in Singapore. It offers a comprehensive range of medical services and specialties, including general medicine, surgery, cardiology, oncology, and more.
• National University Hospital (NUH): NUH is a tertiary hospital linked to the National University of Singapore. It provides specialized medical care in various areas, including cardiology, orthopedics, neurology, and pediatrics.
• Changi General Hospital (CGH): CGH is located in the eastern part of Singapore and offers a wide range of medical services, including emergency care, surgery, women’s health, and geriatrics.
• Khoo Teck Puat Hospital (KTPH): KTPH is a community hospital with a focus on holistic healthcare and patient-centered services. It provides general medical and surgical services, as well as specialized care in areas such as psychiatry and rehabilitation.
• Tan Tock Seng Hospital (TTSH): TTSH is a leading acute care general hospital in Singapore. It offers a comprehensive range of medical services, including infectious diseases, respiratory medicine, gastroenterology, and more.

Others include Alexandra hospital, KK Women’s and Children’s Hospital (KKH), national university hospital and woodlands hospital. When looking for a hospital, remember to see what’s your nearest hospital and the hospital visiting hours.

What are polyclinics?

Polyclinics in Singapore are primary healthcare facilities that provide a range of general medical services to the public. These clinics are operated by the National Healthcare Group (NHG) and SingHealth, two major healthcare clusters in Singapore. Polyclinics aim to offer accessible and affordable healthcare services to Singaporean residents.

Here are some key features and services provided by polyclinics:

• General Medical Services: Polyclinics offer general outpatient services such as consultations, examinations, diagnosis, and treatment for common medical conditions. They are staffed by a team of general practitioners (GPs) who provide primary healthcare.
• Chronic Disease Management: Polyclinics play a vital role in managing chronic diseases such as diabetes, hypertension, asthma, and others. They provide regular monitoring, health education, and medication management to help patients manage their conditions effectively.
• Health Screening: Polyclinics offer health screening programs that cover various age groups and specific health concerns. These screenings help detect and prevent potential health problems at an early stage.
• Dental Services: Many polyclinics have dental clinics that provide basic dental services like check-ups, scaling, polishing, and extractions.
• Health Promotion and Education: Polyclinics conduct health promotion activities and provide education on preventive measures, healthy lifestyle practices, and disease management.
• Allied Health Services: Some polyclinics have allied health professionals such as dietitians, physiotherapists, and occupational therapists who offer specialized services to support patient care.

Polyclinics in Singapore operate on an appointment-based system, although walk-in consultations may be available for urgent cases. The fees charged at polyclinics are subsidized for Singaporean citizens and permanent residents, making healthcare services more affordable. Patients can also use their national health insurance, MediSave, to pay for eligible services at polyclinics. Polyclinics serve as an essential component of Singapore’s primary healthcare system, providing accessible and comprehensive care to the community.

On to private hospitals

Why go private?

There are several reasons why individuals might choose to go to private hospitals instead of public hospitals in Singapore. Here are some possible reasons:

• Shorter waiting times: Private hospitals generally have shorter waiting times for consultations, treatments, and surgeries compared to public hospitals. This can be appealing for individuals who prefer quicker access to medical services.
• More personalized care: Private hospitals often provide a more personalized and luxurious healthcare experience. They may offer amenities such as private rooms, personalized attention from medical staff, and a greater focus on patient comfort and convenience.
• Access to specific doctors or specialists: Private hospitals may have a wider selection of doctors and specialists who may be renowned in their respective fields. Patients who have specific preferences or seek specialized care from a particular doctor may opt for private hospitals to access their preferred healthcare providers.
• Comprehensive health screening packages: Private hospitals often offer comprehensive health screening packages that cater to individuals who prioritize preventive care and regular health check-ups. These packages may include a wide range of tests and examinations to assess overall health and detect potential health issues at an early stage.
• Greater flexibility and choice: Private hospitals provide individuals with more flexibility and choice in terms of appointment scheduling, treatment options, and hospital preferences. Patients may have more control over their healthcare decisions and the ability to tailor their treatment experience according to their preferences.
• Availability of alternative therapies: Private hospitals may offer a broader range of alternative therapies and complementary medicine options that are not typically available in public hospitals. This can attract individuals who prefer a more holistic approach to healthcare. We’ll cover Traditional Chinese Medicine (TCM) another time, but that’s also a huge industry in Singapore.

Popular private hospitals

Here are some notable private hospitals in Singapore:

• Mount Elizabeth Hospital: Mount Elizabeth Hospital is one of the largest private hospitals in Singapore. It has two branches, Mount Elizabeth Orchard and Mount Elizabeth Novena, and offers a comprehensive range of medical specialties and advanced treatment options. This is part of the Parkway Health Group.
• Gleneagles Hospital: Gleneagles Hospital is a renowned private hospital in Singapore known for its high-quality healthcare services. It provides specialized care in areas such as cardiology, oncology, orthopedics, and women’s health. This is also part of the Parkway Health Group
• Raffles Hospital: Raffles Hospital is a leading private hospital that offers a wide range of medical services and specialties. It is known for its advanced diagnostic and treatment capabilities and provides personalized and holistic healthcare.
• Thomson Medical Centre: Thomson Medical Centre is a private hospital that specializes in women’s and children’s healthcare. It offers a comprehensive range of obstetrics, gynecology, and pediatric services.
• Parkway East Hospital: Parkway East Hospital is a private general acute care hospital located in the eastern part of Singapore. It provides a broad range of medical services, including surgery, internal medicine, and specialized outpatient care.

My humnble opinion of what’s best - I’ve spent a long time at Raffles and recently moved over to Gleneagles / Mount E. Whilst Raffles doctors are fantastic, I struggle with their nurses, booking systems that surprisingly don’t communicate much with each other and insurance expenses (despite having the best medical insurance policy in Singapore). P.S., their health checks all suck.

Private versus public comparison

Whilst these are just approximates, here are cost ranges for healthcare services in Singapore, comparing public and private sectors:

Consultation fees

• Public healthcare: GP consultation fees range from SGD 20 to SGD 50.
• Private healthcare: GP consultation fees can range from SGD 50 to SGD 150 or more.

Hospitalization costs (per day)

Public healthcare:

• Class B2 ward (shared room): SGD 200 to SGD 400.
• Class B1 ward (semi-private room): SGD 500 to SGD 800.
• Class A ward (single room): SGD 800 to SGD 2,000 or more.

Private healthcare: Hospitalization costs can range from SGD 1,000 to SGD 3,000 or more, depending on the ward type and hospital.

• Outpatient services and treatments:
• Public healthcare: Diagnostic tests and procedures may have subsidized rates, varying depending on the specific service.
• Private healthcare: Diagnostic tests and procedures in private clinics or specialist centers can range from SGD 100 to SGD 500 or more, depending on the test or procedure.

Medications:

• Public healthcare: Medications in public hospitals are typically available at subsidized rates, with prices varying based on the specific medication.
• Private healthcare: Medication costs in private healthcare settings can vary significantly depending on the medication and the pharmacy. Branded or specialized medications may be more expensive.

Singapore absolutely crushed the pandemic

Singapore has been widely recognized for its effective management of the COVID-19 pandemic. The government implemented a comprehensive and proactive approach to control the spread of the virus and protect public health. Here are some key measures and strategies employed by Singapore:

• Early Response and Preparedness: Singapore responded swiftly to the outbreak by establishing a multi-ministry task force and implementing a range of preventive measures even before the first local cases were reported. This included border controls, contact tracing, quarantine measures, and public communication campaigns.
• Robust Testing and Contact Tracing: Singapore implemented widespread testing to identify and isolate infected individuals. Contact tracing efforts were intensified through the use of technology, such as the + TraceTogether mobile app, which helped identify and notify close contacts of confirmed cases.
• Stringent Quarantine and Isolation Measures: Infected individuals and close contacts were required to undergo mandatory quarantine or isolation in dedicated facilities or at home. Strict enforcement and monitoring were in place to ensure compliance.
• Public Health Measures: Singapore implemented various public health measures such as mask-wearing, safe distancing, and regular hand hygiene. These measures were communicated to the public through extensive public education campaigns.
• Effective Healthcare System: Singapore’s healthcare system, with its strong infrastructure and capacity, played a crucial role in managing the pandemic. The government worked closely with healthcare institutions to increase testing capabilities, hospital capacity, and ensure sufficient resources for patient care.
• Clear Communication and Public Engagement: Regular updates and clear communication from government authorities helped to keep the public informed and educated about the evolving situation. Public engagement and adherence to guidelines were emphasized to foster a collective responsibility in managing the pandemic.

Given the healthcare system is so robust, how much are doctors being paid?

You’ll be surprised with this one.

1st year doctor pay in USD

• SG: $3400
• HK: $10K
• US: $5400

Median gross monthly salary for Singapore fresh graduates is $3.1K USD. (source - Strait times). It baffles me how little these first year doctors earn. For context, a fresh non-tech grad at Google in the US earns $8000 working 40 hours a week. Singapore first year doctors work at least 60% more hours.

I personally know 1st year doctors who were thrown into COVID wards, and whilst there was overall fear, the resounding message was the government is in control. All that being said, they were awarded with medals (versus any sort of monetary reward) for their service. I understand doctors are here to serve the public but it’d be nice for them to be compensated.

No wonder there’s a shortage on doctors…

What’s interesting now is that there’s a shortage of doctors. As of my knowledge cutoff in September 2021, Singapore has been experiencing a relative shortage of doctors in certain specialties and settings. While Singapore has a well-established healthcare system and a sufficient number of doctors overall, there are specific areas that face challenges in terms of doctor availability.

One area of concern is the demand for specialized medical professionals, such as oncologists, cardiologists, and psychiatrists, which has been growing due to an aging population and increased healthcare needs. Additionally, some rural or remote areas in Singapore may have difficulty attracting doctors, leading to a disparity in healthcare access.

To address this, the Singaporean government has implemented various initiatives to increase the supply of doctors. These efforts include expanding medical education capacity, attracting foreign doctors, and offering scholarships and incentives to encourage medical students to specialize in needed fields. It’s important to note that the situation may have evolved since my last update, and it’s recommended to refer to recent reports and studies for the most accurate and up-to-date information on the current doctor shortage in Singapore. Please increase pay for public doctors.

The healthcare system in Singapore is undeniably a privilege. With its efficient, high-quality, and accessible healthcare services, supported by well-funded public hospitals, advanced medical technology, and government subsidies, Singaporeans are fortunate to have comprehensive healthcare coverage that is the envy of many nations. The ability to receive top-notch medical care without significant financial burden truly makes Singapore’s healthcare system a valuable privilege for its expats and citizens.

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