At a grassroots event yesterday (24 Mar), Transport Minister Khaw Boon Wan shared his experience about his fall at home, which broke his left arm.

He said the accident happened at around midnight while in bed, when he wanted to go to the toilet.

“My wife was sleeping very well, and I am a very good husband, so I did not want to disturb her,” he recounted. “I knew I should not have jumped out of bed, but I did so anyway.”

Next thing he knew, he fell creating a loud bang that woke the family up. They called for an ambulance.

“I have never experienced so much pain! The doctors told me this type of fracture, the pain is more painful than delivering babies, but I said I don’t know because I never had that experience. But I can tell you it is very painful,” he said.

The doctors believed that Minister Khaw had fainted while getting up quickly at night, leading to his fall.

He also took the opportunity to advertise HDB’s Enhancement for Active Seniors (EASE) programme, which subsidises the installation of elderly-friendly features for HDB flats.

He mentioned that one in three Singaporeans above 65 suffer from falls. “That is a very high frequency. It is miserable for yourself, for your family and also to the Government because when you stay two weeks in the hospital, it is a lot of subsidy.”

“The best thing is to not fall,” he added.

Singapore govt subsidises the least

It’s not known why Khaw said that his government feels “miserable” when it subsidises Singaporeans for their hospital stays, given that Singapore actually subsidises the least among many countries when it comes to healthcare.

For example, among the 7 countries whose hospitals were ranked top 10 by Newsweek magazine recently, Singaporeans incurred the most out-of-pocket expenditure as a percentage of total health expenditure. This is according to the latest data provided by World Bank:

Out-of-pocket expenditure (% of total health expenditure)

  1. US 11.1%
  2. Germany 12.5%
  3. Japan 13.1%
  4. Canada 14.6%
  5. Israel 24.4%
  6. Switzerland 28.4%
  7. Singapore 36.7%

The out-of-pocket expenditure (percentage) was even higher than the average of the East Asia & Pacific countries. When the high income countries in this region were taken out leaving only the 3rd world countries in the calculation, Singapore’s out-of-pocket expenditure (percentage) was still higher than the average:

  • East Asia & Pacific 26.1%
  • East Asia & Pacific (excluding high income) 33.5%

In other words, Singaporean patients paid more from their own pockets as percentage of total health expenditure than even other 3rd world countries in East Asia & Pacific region, on the average. This also meant that the Singapore government subsidised the least.

The World Bank defines out-of-pocket expenditures as any direct outlay by households, including gratuities and in-kind payments, to health practitioners and suppliers of pharmaceuticals, therapeutic appliances, and other goods and services the primary intent of which is to contribute to the restoration or enhancement of health status. This definition can include transport costs for accessing healthcare and over-the-counter medicines and supplies, but does not include pre-paid fees for health-related taxes or insurance.

With the threat of paying high medical costs out from own pockets, it’s not surprising that some Singaporeans has even tried to commit suicide from inside a hospital (‘Woman attempted suicide in Changi Hospital, allegedly from her fear of facing possible high medical costs‘).


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