Since the release of Vijay’s Mersal this Diwali, there has been a huge controversy involving his punch on GST. The classic moment of the film is when he goes for a take on GST. Vijay asks in an apparently sarcastical way that if people paying only 7% GST can have free healthcare in Singapore, why not in India which has a higher GST. Although his punch went well with anyone going his way, it is surprising how it managed to slip anyone’s attention. How can a nation with one of the highest cost of living in the world really afford to give free healthcare to all at 7% GST.A reality check shows the opposite.
India and Singapore health scenarios are out of comparison at least for our sheer scale. As of 2015, Singapore had only 26 hospitals and specialty centers. Of these 16 are public and 10 private. It is true that healthcare costs are low in Singapore compared to international standards, but it is not at all free to anyone. There are compulsory health savings account and insurance. Individuals have to save and pay under the savings account. Although government claims to subsidize heavily, it is a maximum of UPTO 80%, which means anything till 80%; and that too this is ONLY for ACUTE care in public hospital wards. You can get an idea of Singapore financing from below link
https://www.moh.gov.sg/content/moh_web/home/costs_and_financing/financing.html
On the contrary to what is claimed in Mersal, Healthcare costs are actually increasing in Singapore more than that even in US, in certain aspects. According to the Pricewaterhouse Coopers (PwC) Health Research Institute, the projected increase in global medical costs in 2017 is likely to be the same as that of 2016, i.e. 6.5%. However, the situation of rising medical costs appears to be much worse in Singapore, where according to a report, elderly healthcare costs are projected to rise tenfold over the next 15 years to more than US$49 billion (SG$66 billion) annually.
Source: https://today.mims.com/the-rising-costs-of-healthcare
One must note here that medical costs are considerably high in Singapore without subsidies and insurance. Coughing up even half the bill amount, may be a problem to many. Just check out the hospital general price list. In the first place why is there a price card if it is free at the end of the day?
Source: Ministry of health. Singapore
“As of 2015, there are a total of 26 hospitals and specialty centres in Singapore. The 16 public hospitals and specialty centres have bed complements between 185 to 2,010 beds. On the other hand, the 10 private hospitals tend to be smaller, with capacity ranging from 20 to 345 beds.”
“Within the public hospitals, patients have a choice of the different types of ward accommodation on their admission. 81% of the public hospitals’ beds (class B2 and C) are heavily subsidised with the remaining 19% with lower subsidy at 20% for class B1 and no subsidy for A class wards. In 2012, the average length of stay in the public acute care hospitals is about 5.8 days while the average occupancy rate is around 85%.”
Source: Ministry of health. Singapore
https://www.moh.gov.sg/content/moh_web/home/our_healthcare_system/Healthcare_Services/Hospitals.html
Dental care
Check out dental care charges at Singapore’s private patients IN PUBLIC INSTITUTIONS. The data are from the ministry of health Singapore. One Singapore dollar is close to Rs. 48.
Take for instance a crown capping can that can be a maximum of $2140, which means over one lakh Indian rupees according to their own price list. Check this out at Sri Ramachandra or Madras Dental Hospital or Balaji Dental Hospital; It should probably not be more than 10 to 15% of this. Check out the entire Singapore dental treatment list and compare for yourself:
A WHO 2010 report on the medical savings accounts paints a pathetic picture of Singapore healthcare as being high-cost, poor coverage and despite being compulsory it represented only 8% of the total spending in 1999. The report on Singapore (page 5):
“3.1 Singapore
The impact of MSAs in Singapore is difficult to assess due to concurrent reforms in the health sector and lack of information (Hsiao 1995). What is available indicates that while MSAs were effective in reducing consumption, they were ineffective in containing costs or extending coverage (Barr 2001). In fact, an initial increase in health expenditure followed the introduction of MSAs, likely due to simultaneous infrastructural upgrades (Hsiao 1995). Furthermore, MSAs were not successful in introducing price competition as the Singaporean system operates on quality, e.g. physical amenities, rather than on price or technical measures (Dixon 2002). As such, high-cost not cost-effective care is provided, with service intensity and costs inflated. Reductions were not seen until the government recognised supply-side forces and intervened with regulations (Hanvoravongchai 2002). Cost reductions, therefore, cannot be attributed to MSAs but rather to direct government control (Barr 2001, Hsiao 2001, Dixon 2002). MSAs also failed to fill coverage gaps in Singapore. Despite their compulsory nature and a 95% subscription rate in 1992 (Hsaio 1995), MSAs have played a small role in total spending, representing only 8% in 1999, due to restrictions on their use (Hanvoravongchai 2002). Important population segments remained without adequate coverage, and in recognition, the government created other forms of risk-pooling and safety nets for the poor and elderly. Coverage was extended because of these schemes, not MSAs (Barr 2001, Dixon 2002). “
You can access the complete report here:
http://www.who.int/healthsystems/topics/financing/healthreport/MSAsNo17FINAL.pdf
In conclusion we can say, Vijay and his Mersal that created a sensation and rode successfully on this dialogue; how true were they?. How much did the film’s producers and he himself gain by misleading the public?.
