Commentary: Making universal health coverage a reality for more people in Singapore

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Monday (Dec 12) marks International Universal Health Coverage Day. 

Achieving universal health coverage involves optimising three competing components of healthcare — quality, access and cost — so that everyone has access to good quality healthcare without financial hardship.

While this goal may seem utopic and unattainable, countries have affirmed their commitment to progressing toward universal health coverage in a 2012 United Nations resolution and in adopting the UN’s Sustainable Development Goals in 2015. 

The Leadership Institute for Global Health Transformation at the Saw Swee Hock School of Public Health, National University of Singapore, is conducting research on universal health coverage, health equity and health systems strengthening.

To commemorate International Universal Health Coverage Day, here we explore universal health coverage in the Singapore context.

TALE OF TWO SINGAPORES

Singapore has achieved good health outcomes, with one of the lowest infant mortality rates and highest life expectancies in the world.

However, is our healthcare truly universal? Our research reveals a tale of two Singapores.

First, the globally renowned success story where Singapore citizens and Permanent Residents enjoy world-class healthcare and a high standard of living. And the other, a Singapore where some vulnerable communities can fall through the cracks of the Government’s safety nets. 

While the Singapore healthcare system caters well to the masses, there are still gaps in care for those who do not fall within this majority.

The non-resident population is not covered by national healthcare subsidies and health insurance schemes; this includes approximately 1.47 million people, or 27 per cent of Singapore’s population.

Other vulnerable groups include LGBTQI+ persons, persons with mental health conditions, persons with disabilities, low-income workers and the otherwise economically disadvantaged such as gig workers and sex workers.

Some populations (notably the LGBTQI+ community, drug users and people with mental health issues) face significant societal stigma surrounding their identities or health challenges — often even from healthcare providers.

While stigma surrounding mental health is gradually reducing, starting with the decriminalisation of suicide in 2019, issues like substance use are looked down upon and th...

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