What percentage of Singapore is on welfare

Health system in Singapore: a lot of personal contribution required

| Law & Taxes Abroad

Depending on the source, between 7,000 and 10,000 Germans currently live in Singapore. Due to its geographical location and excellent infrastructure, the city-state is a popular strategic location for German and international companies. The level of the healthcare system is extraordinarily high and quite comparable to that in Germany. However, the structure of the social security and health system is very different from that in Germany. The government communicates quite openly that welfare is not just a matter for the state, but is first and foremost in the hands of the individual or the family. Accordingly, the system demands a great deal of personal responsibility, also of a financial nature, from people.

Until the end of colonial dependence on Great Britain in 1963, the health system was almost identical to the British tax-financed National Health Service (NHS), but those responsible gradually rebuilt the principle in several health reforms. While tax financing is still an important pillar, much of the financing of healthcare costs has been shifted to the private sector.

Social savings account as a basic provision

The cornerstone of the Singaporean welfare system is the Central Provident Fund (CPF), which was founded in 1955, a type of social savings account that is financed by contributions from both employers and employees. Only the residents of Singapore and foreigners with the residence status "permanent resident" are obliged to pay contributions. According to a survey in 2009, an estimated 3.29 million people pay into the state savings account - that is 90 percent of the local population. The CPF provides cash benefits for three main elements of financial security: retirement, health and home ownership. The latter appears remarkable from a European point of view, but is an essential component of old-age provision in Singapore, which is massively subsidized by the government.

The employer and employee contributions to the CPF are divided into three accounts (“Ordinary”, “Special” and “Medisave”). Since the healthcare reform in 2011, members under 50 years of age have paid 20 percent of their income and employers 15.5 percent into the savings account (see also figure below). Those older than 50 years of age or earn less than 1,500 US dollars a month pay Less. The contribution measurement limit is a monthly income of $ 4,500.

Source: Central Provident Fund Bord Singapore

With the credit in the “ordinary account”, the insured person is able to purchase residential property and to spend on education. The “special account” is intended for retirement provision and the acquisition of pension-related investments. Nonetheless, the CPF board also automatically sets up a retirement account as soon as employees have reached the age of 55 (the retirement age is currently 62). The most important account for the health care system is the “medisave account”, the credit of which is used on the one hand for the costs of a hospital stay or certain outpatient expenses (e.g. simple visits to the doctor). On the other hand, health insurance contributions also flow into the “MediShield”, a system that pays for long hospital stays and was only introduced in 1990. In addition to MediShield insurance cover, it is possible to improve your insurance cover with so-called "Private Integrated Shield Plans" (ie integrated private health insurance). However, these can only be taken out if you already have MediShield insurance. Shield plans could be taken out by individuals as well as by employers as group insurance for their employees. In 2011, around 2.2 million people had such private supplementary health insurance.

Basic care is provided by nurses and general practitioners

Anyone who falls ill in Singapore is treated by general practitioners and nurses who are employed either in the 18 state polyclinics or in around 2,400 private clinics. They are the first point of contact for patients who - if necessary - are referred to a clinic for treatment by specialists. Basic care includes outpatient medical treatment, aftercare after a hospital stay, vaccinations, screening, health education, diagnostics and drug supply. According to the Ministry of Health, about every fifth basic care is provided by polyclinics, 80 percent by private clinics. Dental treatment takes place either in a public hospital or dental center or in a private dental clinic. There is a free choice of doctor and hospital. Doctors in Singapore do not have to comply with any state fee schedule, which means that each doctor can freely determine the amount of his fee.

You can find more statistics at Statista

Travelers in Singapore should have a foreign health insurance in their luggage, as without the "permanent resident status" they are not entitled to benefits in the health system. There are numerous ways to take out global protection for singles and families in advance. It is important that vacationers make sure that the corresponding tariff covers 100 percent inpatient and outpatient stays in private clinics and guarantees free choice of doctor.

By the way, Singapore's government is facing the same problem as Germany: The aging of the population and the associated massive increase in health costs (see also statistics on “Private health expenditure in Singapore”). Even if new hospitals are currently being built - four complexes are planned for 2020 to 2030 - the focus in the care and treatment of older people must shift more to the private sphere.

Sources of information: Scientific Institute of PKV (WIP), gtai, CFP, https://www.cpf.gov.sg/members

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