While Singaporeans are experiencing increased longevity, many will spend their later years in ill health, concluded a study commissioned by major insurance company Prudential. The study called Healthy for 100? Healthy Care in Singapore was conducted and published by the Economic Intelligence Unit (EIU).
Interviewing 203 people in the healthcare field including physicians, nurses, senior management and administrators as well as 1,214 residents of Singapore, the study urged the entire nation, especially younger generations, to do more to prevent chronic illness.
Singapore’s populating is both ageing rapidly and living longer, the report noted. The UN estimates that by 2035, 26.6% of Singaporeans will be over 65 years old, more than double the figure of 11.7% in 2015.
The report pegs the current average lifespan in Singapore at 83.1 years and rising. But in order to enjoy this extended lifespan, the report posits that people in Singapore need to be well-supported in terms of health and healthcare.
“Singapore’s rapid ageing will accelerate in the coming 15 years, shifting the country’s disease load. In particular, a greater proportion of people will need to manage one or more chronic diseases,” says the report.
Dr Lim Wee Shiong, a senior consultant at the Institute of Geriatrics and Active Ageing at Tan Tock Seng Hospital said in the report, “The older population is not inherently unhealthy but has specific medical needs different from those Singapore has faced in the past, such as more co-existent chronic diseases and a greater prevalence of certain diseases such as dementia.”
It was found that more than half of Singaporeans age 60 and above suffer from more than one chronic condition, terms ‘multi-morbidity’. More people will begin to fall into this multi-morbidity category as life expectancy inches towards 100.
Preventive healthcare from a young age
According to the survey, 70% of doctors and clinicians agree that people are responsible for supporting their own health ageing, there is a worrying lack of effort being made by those under 45 in proactively preventing chronic illnesses such as heart disease and diabetes.
Phua Tien Beng, CEO of the Singapore says, “it is extremely difficult to communicate to someone who is 30 today the risks of disability later in life.”
Chiming in, Dr Angelique Chan, executive director, Centre for Ageing Research and Education and Duke-NUS Medical School says, “young Singaporeans are not very active in disease prevention. They do not think about ever being disabled or ill.”
“I think that when we are at that age, we seldom think of the ramifications. Young Singaporeans are not very active in disease prevention because the idea of being disabled or ill seems far-fetched,” said Dr Lim.
Head of medical portfolio management at Prudential Singapore, Dr Sidharth Kachroo said that a healthy lifestyle isn’t something that happens over nights. “The earlier we start taking care of our well-being by keeping to a good diet and lifestyle, the higher are our chances of ageing well. After all, good health is earned, not given.”
Which is why the focus on disease prevention has to be emphasised as it is critical in the long-run, notes the report.
Solutions to the healthcare problem
Preparing to live longer from a health perspective is one thing, while being financial prepared for the health-related expenses is an different thing altogether. The report said that 49% of respondents say that Singaporeans are, to some degree, unprepared for the health-related expenses of living to 100.
Dr Jeremy Lim, partner and head of health and life sciences Asia Pacifc, Oliver Wyman, explains that this is a legitimate concern, saying, “Singapore, like the rest of the world, has seen healthcare inflation far outpace general inflation.”
However, he does note that the combination Medisave, Medishield Life, and Medifund does help address the rising cost of treatments. Even so he suggested the addition of new funding models where fees charged to the patient are determined by the improvement in their health, suggesting that it might be a better approach to pricing healthcare.
Long-term care for seniors
Another major concern according to the report is access to adequate care. Only 51% of healthcare providers agreed that their patients currently have access to the caregiving support that they need. Additionally, 57% said that the cost of caregiving outside of hospitals and clinical settings is adversely affecting access among their patients Looking to the future, only 26% of healthcare professionals say they are confident that their patients will have adequate access to caregiving support in 10 years.
Unsurprisingly, 41% of respondents recommend “more support for caregivers” as one of the top healthcare strategy in preparing for the inevitable ageing population.
Citing a study by the Lien Foundation published in August last year, the Prudential report said that a place in a nursing home run by a Voluntary Welfare Organisation in Singapore costs S$2,400 per month on average. That’s more than half the median gross monthly income, notes the report.
Suggesting that technology could be a solution to the caregiving problem in Singapore, the report highlights that home health technologies might be the way to go, according to healthcare respondents. 77% say that greater investment in at-home technology to support chronic disease care will be needed as population ages.
Taking the right steps
The report concludes that Singapore’s government, healthcare system and residents have begun to engage with the changes necessary for reshaping the areas of disease prevention, medical provision and long-term care for an older society, however more is always better.
It was proposed that the focus now should be on promoting healthier lifestyles from a younger age, lowering costs of healthcare, and developing ways to support seniors in living a fulfilling life with the help of home health technologies and appropriate long-term care. The difficulty is getting there, says the report.
Dr Jeremy Lim explained that “there is recognition that this is a wicked problem. With so many moving pieces it is really challenging which to do first or if all need to move in concert. I don’t think we have cracked the code yet. Hopefully we will get it right.”
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