Parliament: Don't politicise Singapore's excellent public healthcare system, says Janil Puthucheary
Published on May 27, 2014 7:18 PM
SINGAPORE - An MP and medical doctor on Tuesday warned against the dangers of politicising issues as important as healthcare.
Dr Janil Puthucheary (Pasir Ris-Punggol GRC) was concerned that a different picture was being painted of Singapore's healthcare system, which he lauded as one of the best on the planet, based on the longevity and health of its people.
"The facts are out there together with a whole host of hysterical, irresponsible and inaccurate claims about a catastrophically dysfunctional system," said the paediatrician and medical school don.
In his 27-minute speech, he kept going back to his theme of politicisation, with echoes of the previous day's debate between Workers' Party chief Low Thia Khiang and the PAP's Indranee Rajah over the nature of constructive politics, including whether it is rhetorical, as Mr Low suggested, or real as Ms Indranee argued.
He had earlier exceeded his allotted 20 minutes, prompting Speaker of Parliament Halimah Yacob to cut him off. However, in a rare move, the Government Whip and Health Minister Gan Kim Yong stood up, noted the "interesting speech" the member was making and got the House's consent to extend his speaking time.
Dr Janil had begun by arguing for adopting a risk-averse stance towards public healthcare and its finances. He later suggested radically changing Singapore's public healthcare system. He noted that a centralised authority oversees preventive medicine, which is effective and cheap. But market-driven medical interventions, such as surgery and chemotherapy, have turned out to be expensive and inefficient, possibly because people did not have enough information to make comparisons, he said.
He suggested doing the reverse: have a diffused, market-based environment to drive diet and exercise, and "a centralised command approach to the complex acute expensive care so that inefficiencies are removed and the information asymmetry is no longer a problem".
He added: "This kind of outcome driven, evidence-based restructuring is all we will need to think about 20, 30 years ahead."
But the poilticisation of healthcare to gain electoral votes can pose a challenge to reform, he warned. "The more politicians play with healthcare, the worse the health of the nation, because short term popular political interests overthrow the long-term outcome and the true deep issues.
"It would start with sound-bite politics, like making comments about active ageing as a joke about corridor beds, when these are not reflective of the health outcomes."
He called for intellectual honesty in making arguments by comparing the risks of one's proposal with the risks of one's opponents', and similarly, the benefits of both proposals. Focusing one's energy on one point of disagreement "would be self-serving, confrontational, and serves the interest of the person giving the second opinion", he said.
A collaborative, collegial and constructive approach will build trust in people for being honest and open, and in the institution of the profession, he argued.
He also addressed obliquely Mr Low's argument that the extension of media licensing requirements on online news sites, could have stifled a diversity of views and led to compliant, and not constructive, politics.
Dr Puthucheary said he was not claiming that a diversity of opinions was unnecessary, but that it was insufficient to make hard choices. Also, to agree with someone else's policies is not compliant politics, he added.
He said: "When you fail to acknowledge the good, when you avoid discussion of consequences and trade-offs, when you spend a whole speech attacking one point you disagree with and fail to support all the other points you should agree with, when you incite division in the name of diversity, when you silently support xenophobia in the name of nationalism, these are not the markers of good politics, no matter how much debate and diversity of opinion they reflect."