Change mindset to curb rising costs

The Government's expenditure on health care has almost doubled in just three short years - from $4 billion in FY2011 to $7.5 billion in FY2014.

This does not take into account the $8 billion put aside for the pioneer generation.

While this is great news - as it means more help for people with their health bills - it is, at the same time, rather scary.

In Budget 2012, Finance Minister Tharman Shanmugaratnam projected that health expenditure would hit $8 billion in five years.

Last friday, it is almost there - much faster than projected.

Health Minister Gan Kim Yong predicted in Parliament on Wednesday that government expenditure "will continue to increase in future".

But how fast will it rise? Will this rapid rate of increase continue? If it does, can Singapore continue to afford it? And if not, what will happen?

As the population ages, the call on health-care services will rise.

Plans are afoot to increase the number of beds in hospitals and nursing homes by 11,000 by 2020.

This means that more health workers and managers will be needed to service an ever-ageing population.

While the needs of the sick cannot be ignored, something must be done to curb the spiralling cost of health care.

After all, Singapore - where health-care spending as a proportion of gross domestic product (GDP) is a single-digit figure - does not want to go the way of the United States, which spends almost 18 per cent of its GDP on health.

By 2030, almost one million people - or about one in five people here - will be 65 years and older, the definition of elderly today. This is more than double the number today.

Older people require more health care.

If national health-care expenditure is $7.5 billion last friday, what will it need to be by 2030 with more than double the number of seniors?

How many people will be needed to look after one million seniors?

Add to that, Singapore's track record of increasing lifespan by three years every decade, and there will be large numbers of septua-, octo- and nonagenarians, not to mention the centenarians, who today already number close to 1,000.

What Singapore needs is the mother of paradigm shifts.

First, people need to stay healthy for as long as possible.

Bad habits like smoking, binge drinking, sedentary lifestyles, and high sugar and fat consumption are still rampant.

The Ministry of Health is not unaware of this.

The Health Promotion Board was set up to tackle just this problem.

Unfortunately, progress is slow, while poor health will snowball as the population ages with little regard to staying fit.

It would be better if a larger part of health expenditure is spent on prevention rather than treatment, too.

Another shift that is needed is a move towards better and stronger primary and community care, so that chronic diseases can be kept under control and not result in ever-worsening health.

And if those two conditions are to be met, a huge mindset change is needed, as a healthy society means people in their 60s and 70s can remain active contributors.

Then perhaps the increase in health-care spending will not spiral out of control.

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