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Health insurance reforms in Singapore and Hong Kong: How the two ageing asian tigers respond to health financing challenges?

Author

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  • Yin, Jason Dean-Chen
  • He, Alex Jingwei

Abstract

Singapore and Hong Kong, two high-income “Tiger economies” in Asia, were ranked as the top two most efficient health systems in the world. Despite remarkable similarities in history and socioeconomic development, both economies embraced rather different paths in health care reforms in the past decades, which reflect their respective sociopolitical dynamics. Rapidly ageing populations and the anxiety about future funding of health care have prompted them to embark on major health financing reforms in the recent three years. While Singapore has transitioned to universal health coverage with the implementation of MediShield Life (MSL), Hong Kong is about to introduce the Voluntary Health Insurance Scheme (VHIS) to supplement its health care financing. Based on secondary materials including policy documents, press releases, and anecdotal reports, this essay compares these two recent reforms on their political context, drivers of reforms, and policy contents, and assesses their prospects in terms of coverage, financial protection, and major implementation challenges. The preliminary assessment suggests that while both programs are associated with certain drawbacks, those of the VHIS may be more fatal and warrant close attention. This essay concludes with a central caveat that underscores the pivotal role of the state in managing health care reforms.

Suggested Citation

  • Yin, Jason Dean-Chen & He, Alex Jingwei, 2018. "Health insurance reforms in Singapore and Hong Kong: How the two ageing asian tigers respond to health financing challenges?," Health Policy, Elsevier, vol. 122(7), pages 693-697.
    • Handle: RePEc:eee:hepoli:v:122:y:2018:i:7:p:693-697
    DOI: 10.1016/j.healthpol.2018.04.012
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    References listed on IDEAS

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    1. Leung, Gabriel M. & Tin, Keith Y.K. & Chan, Wai-Sum, 2007. "Hong Kong's health spending projections through 2033," Health Policy, Elsevier, vol. 81(1), pages 93-101, April.
    2. Wouters, Olivier J. & Cylus, Jonathan & Yang, Wei & Thomson, Sarah & McKee, Martin, 2016. "Medical savings accounts: assessing their impact on efficiency, equity and financial protection in health care," Health Economics, Policy and Law, Cambridge University Press, vol. 11(3), pages 321-335, July.
    3. Lim, Meng-Kin, 2004. "Shifting the burden of health care finance: a case study of public-private partnership in Singapore," Health Policy, Elsevier, vol. 69(1), pages 83-92, July.
    4. Wouters, Olivier J. & Cylus, Jonathan & Yang, Wei & Thomson, Sarah & McKee, Martin, 2016. "Medical savings accounts: assessing their impact on efficiency, equity, and financial protection in health care," LSE Research Online Documents on Economics 65448, London School of Economics and Political Science, LSE Library.
    5. Marmor, Theodore & Wendt, Claus, 2012. "Conceptual frameworks for comparing healthcare politics and policy," Health Policy, Elsevier, vol. 107(1), pages 11-20.
    6. repec:bla:glopol:v:8:y:2017:i:s2:p:103-109 is not listed on IDEAS
    7. Bloom, Gerald, 2011. "Building institutions for an effective health system: Lessons from China's experience with rural health reform," Social Science & Medicine, Elsevier, vol. 72(8), pages 1302-1309, April.
    8. Panos Kanavos & Olivier Wouters & Jeremy Lim, 2017. "Sustainable Health Care Financing: The Singapore Experience," Global Policy, London School of Economics and Political Science, vol. 8, pages 103-109, March.
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    Cited by:

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