SGH ranked world’s top-10 but S’poreans pay highest in medical out-of-pocket expenditure

It was reported that the Singapore General Hospital (SGH) has been ranked as the third-best hospital in the world by Newsweek magazine, partly for its clinical research and “outstanding nursing”, following two American hospitals, the Mayo Clinic and Cleveland Clinic.

SGH’s chief executive officer Prof Kenneth Kwek said, “We are humbled to be recognised for our medical and nursing care.”

He further commented on SGH’s strong tradition of working to improve their patients’ outcomes through integrated clinical practice, innovation, cutting edge research and new models of care.

“Our staff are passionate about healthcare and we continually challenge ourselves to do better for our patients, their family members and our staff,” he added.

Out of the 10 top hospitals ranked, 4 were from US, 1 each from Germany, Canada, Switzerland, Israel, Japan and Singapore.

Singaporean patients pay the most out-of-pocket medical cost

Among the 7 countries whose hospitals were ranked top 10 by Newsweek magazine, Singapore 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%

Even as it has been declining over the years due to increased government spending through subsidies and increased Medishield payouts, 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 are 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.

While Malaysia also has the same percentage which it maintained over the years, one has to note that its medical fees are significantly lower than that in Singapore.

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‘).