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Citizens' healthcare must remain the state's responsibility

I disagree with the suggestion that Singapore should encourage patients to go abroad in search of lower-cost healthcare, especially if those patients are seeking long-term or palliative care ("Make cheaper healthcare in nearby countries an option"; Aug 7).

We should not forget that the fundamental responsibility of any state is to its citizens, a duty of care that underpins the relationship between the individual and the Government.

Just as Singaporeans have worked hard and contributed to the socio-economic development of our nation, the state in turn has an obligation to provide reasonable access to high-quality and affordable healthcare.

Encouraging patients to go abroad in search of discounted healthcare is a serious dereliction of this duty.

This is considering that, first, neighbouring states have no responsibility or incentive to accept the burden of serving Singaporeans, who are not of their own land; and second, it is difficult to exercise transnational oversight to guarantee adherence to medical standards.

We should also keep in mind how, by encouraging people to tap cheaper healthcare available in neighbouring countries, patients might feel that they are being abandoned by the country of their birth or origin.

This deep and shocking sense of alienation and loss could very well aggravate their ailments.

At worst, such a policy might be construed as unfairly penalising individuals who have contracted environmental- or age-related ailments, or chronic conditions, through no fault of their own. For all the talk of "preventable" diseases, physical well-being in old age remains very much a lottery.

It would be grossly unjust and uncaring for a society to foist its healthcare woes on nearby countries, especially when the roots of the problem - a greying population and ever-escalating healthcare costs - are largely self-inflicted through decades of policy.

The real solution is to rethink government investment and involvement in the healthcare sector, so as to strengthen social safety nets and keep end-user costs low.

It would be deeply ironic if Singapore - one of the wealthiest countries in the world, boasting world-class medical facilities, and a society that claims to be inclusive - had to send its citizens abroad for affordable treatment.

Paul Chan Poh Hoi

A version of this article appeared in the print edition of The Sunday Times on August 28, 2016, with the headline 'Citizens' healthcare must remain the state's responsibility'. Subscribe