Keep healthy, watch costs as Singapore adopts universal coverage, WHO chief advises

SINGAPORE- Singaporeans should keep fit and healthy in order avoid overburdening the health-care system and incurring higher premiums under MediShield Life, said Director-General of the World Health Organisation, Dr Margaret Chan.

Governments would have to increase health-care budgets if they have unhealthy populations but the government's wealth comes from the taxpayer's dollar, she said. "It is in your interest that you use the health-care system judiciously," she said. "Take the more cost effective measures like immunisation - prevention is always the best policy," she added.

Dr Chan was in town for the Ministerial Meeting on Universal Health Coverage at the Grand Corpthorne Waterfront hotel, which saw representatives from countries such as Bangladesh, Brunei and Finland.

"Pay attention to diet, no smoking and drink moderately," said the vivacious 67-year-old.

"People who keep healthy in their younger age will also be better in their functional capacity as they age."

Lifestyle-related diseases like obesity and diabetes, if not managed properly, can pile on to health-care costs and "break the bank", she added.

While citizens should do their part to stay healthy, doctors should also avoid over-prescribing, which would add to health-care costs. And health-care managers should keep an eye on that.

"Health institutions should share data...if you look at all the data and make comparisons, then you would know what is the right level of care," she said. "It is important that the managers of health services are making sure that data is put to good use to help the government to put in place the right incentives (for cost-effective treatment)."

If volume of services were rewarded, people would visit the doctor more often without necessarily getting the best health-care outcomes each time. But if health-care outcomes were rewarded, it could result in a different picture, she said,

Dr Chan cited Monaco, which charges an "all-inclusive charge" for removing the appendix of an appendicitis patient. If the patient experiences complications thereafter, he would be re-admitted with no additional fee. This is an example that incentivises outcomes and not volume of services, she said.

However, each country should adopt policies to suit their own health-care model. There is no one-size-fits-all solution, she said.

Universal health coverage helps mitigate a big inequity gap, which more countries round the world are seeing, said Dr Chan. "It is a solidarity mechanism where the healthy help the not so healthy and the rich help the poor," she said.

Dr Chan will be in Singapore till Thursday.