That should be the theme song for current health-care reform proposals—here we come, California, land of bloated public programs and debt as far as the eye can see. But perhaps we should be looking to Singapore.
The Wall Street Journal’s Bill McGurn admits that many of us “have fun referring to it as the ‘nanny state’ for its laws against spitting, littering, or leaving behind an unflushed loo.” But Singapore also has an excellent health-care system that not only is based on free-market principles but—get this!—actually works. McGurn wrote yesterday (sorry for the delay—I’ve been on the road with my portable computer!):
In Singapore…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.
In Singapore, everybody but the very poor pay something for their health-care. The health-care is the same for rich and poor, but there are choices about, say, hospital accommodations, from a frightfully expensive room for more than a thousand dollars a night to a more modest $99 room. Find me a hospital room in the US for $99!
Medical savings accounts are a tool of the Singapore system. Combined with patient choice, this has helped to keep costs significantly lower than in the U.S. where most of us without accounting degrees can’t even decipher a hospital bill :
According to a Raffles Hospital official, a knee replacement surgery runs between U.S. $12,000 and $14,000. Spinal fusion runs between $10,500 and $14,000, and a heart bypass (coronary artery bypass graft) from $23,000 to $26,500. Conservatively speaking, these prices are less than a third of what the same procedure would cost in the U.S.—that is, when you can even get the price.
McGurn admits that Singapore, a small nation, is different from the US. But this model is so much better than the European one. And is anyone on the Hill considering it?
Don’t think so. Why? Because it doesn’t require the overall change to our system that is being pushed under the aegis of health-care reform.