Singapore points the way to better healthcare

Market-based systems benefit patients

State-dominated healthcare systems are failing the poor and chronically sick, argues a new study from the Institute of Economic Affairs.* Even in prosperous countries people are becoming increasingly disillusioned with government-directed healthcare systems.

Britain’s NHS is one of the worst examples. It is plagued by waste, inefficiency, under-investment, rationing and constant political interference.

The result has been poor health outcomes for British citizens compared with other wealthy countries. Long waiting lists, high infection rates and under-nourished patients result from a bureaucratic system that misallocates resources in the absence of market prices and competition.

The authors** show why private, market-based healthcare systems would be much more responsive to patients’ needs. They would provide strong financial incentives for better treatment and improved conditions.

Indeed, the quality of some state healthcare systems, such as the NHS, is so poor that private provision is likely to expand rapidly in coming years. If they care about patients’ wellbeing, politicians should facilitate the growth of this market by removing regulatory barriers to the development of choice and competition.

In Singapore, 68% of healthcare expenditure is market-based with every individual controlling his/her own health savings account. This system has produced far better outcomes at around half the cost (per capita) of the NHS.

The success of Singapore’s system stems unequivocally from a high degree of consumer choice. Spending decisions mostly take place between doctors and patients instead of between politicians and health bureaucrats.

*
Healthcare: State Failure
, edited by Helen Evans and Tim Evans, Economic Affairs, Vol. 28, No. 4, Institute of Economic Affairs.

** Helen Evans is Director of Nurses for Reform; Tim Evans is President of the Libertarian Alliance; Brett J. Skinner is Director of Bio-Pharma, Health and Insurance Policy for the Fraser Institute; Pierre Bessard is President of the Liberales Institut in Zurich; Brian Micklethwait is a libertarian author.

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