Incentives work to keep people healthy, and are cheaper than treatment

Life expectancy in Singapore is one of the longest in the world.ST PHOTO: ALPHONSUS CHERN

SINGAPORE - The government, and insurance companies that pay the hospital bills, are trying every which way to keep people here healthier.

Life expectancy in Singapore is one of the longest in the world, and the people here enjoy the most number of healthy years in the world at 73.9 years in 2019 - beating the Japanese who were second with 73.3 years of good health.

This is largely due to three main factors - a strong healthcare system to provide good medical care to all who need it, in a timely manner; robust immunisation programme to protect against many preventable diseases; and people following a healthy lifestyle that reduces their risk of serious illness.

Singapore has an accessible and affordable public health network, with heavy government subsidies that ensure no citizen is denied healthcare for the lack of money.

The national immunisation schedule here recommends that all children be protected against 10 diseases, with some like diphtheria and measles being compulsory. Most are free.

The Ministry of Health (MOH) has also introduced, just this month, subsidies for adult immunisation. This will hopefully reduce the number of people getting serious illnesses like meningitis and pneumonia.

But the third factor has to come from people themselves. They need to exercise regularly and avoid eating unhealthy food, or at least, not eat them too frequently.

Most are aware that regular exercise is extremely helpful in keeping them in good health. They know it reduces obesity, the risk of heart diseases and diabetes, medical conditions which result in significant insurance claims.

Mr Dennis Tan, who heads Prudential Singapore, which provides MediShield Life Integrated Plans to many people here, said the top three causes of claims are heart problems, stroke and kidney treatments. In Singapore, the majority of kidney failure is due to uncontrolled diabetes.

Regular exercise could reduce the risk for all three. But not everyone who knows that, actually makes the effort to exercise.

The Health Promotion Board (HPB) has over the years stressed the importance of exercise. The Board's National Steps Challenge, has seen the number of participants grow, from 156,000 in 2015 when it was launched to 913,000 in the fifth session that ended earlier this year.

The Board dangles incentives for those who sign up. They include a free steps tracker for those who do not have one as well as prizes like air tickets for teams and individuals. There are also vouchers for those who fulfil the required number of daily steps.

Mr Zee Yoong Kang, HPB's chief executive officer, sees nothing wrong in giving people incentives to exercise.

But he added: "I don't think people do it for money. I think it's the thrill of getting that voucher as a recognition."

That's because "to earn $35 in our steps challenge programme, you have to walk 960 kilometres, and that's all the way from Singapore to Thailand," he said.

The annual event involves a series of challenges with participants securing a $5 or $10 voucher for clearing a level.

While some people do manage to earn every single voucher offered, there are also others who do not claim them after clearing a level.

About a third of participants would claim the vouchers within a month of qualifying for them, while 7 per cent do not bother at all.

Anything that can get more people exercising regularly is good. While about half a million participants may not care much about the vouchers, there are about 300,000 people who had likely exercised more to get them.

It is far cheaper to provide a little incentive for people to stay healthy, than to treat them for a medical condition that could have been prevented.

Professor Tan Chorh Chuan executive director of the MOH Office for Healthcare Transformation said the rewards can be seen "as encouragement, support, to assist people in making the behavioural change".

Such encouragement is important, which is why Prudential introduced its Pulse App this year. It already has 120,000 users.

The App allows people to check their health status as well as access a tele-consultation should they think they have a problem. It was launched during the circuit breaker period, when most people stayed home as far as possible.

There are also fun elements in the App, like a wrinkle-mirror, to encourage people to lead healthy lifestyles.

For health insurers like Prudential, spending money to get people to stay fit would mean healthier policy holders, which is good for the bottom line.

Prof Tan said more than a third of serious illness are actually preventable. This means, if we all do our part, we should be able to enjoy even more years in good health in our increasingly long lifetimes.