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Health Care Reforms in Singapore – Twenty Years of Medical Savings Accounts

Schreyögg J, Lim MK

in: Dice-Report – Journal for institutional Comparisons 2(3): S. 55-60




The health system in Singapore basically consists of three pillars (the so-called 3 Ms), each of which fulfils a different aim and is based on different financing mechanisms.The core is comprised of the MSA system-component called Medisave. This model is based on the idea that the usual insurance systems lead to an inefficient utilisation of resources, because insured persons frequently consume health services that, from a medical point of view, may actually not be needed. Hence, in contrast to commonly-known insurance systems, the MSA model does not incorporate any form of “risk pooling”. This means that individuals do not pay into a common pool, in the framework of a health insurance, out of which, in the event of illness, each insured person receives certain funds to cover the costs of treatment. Instead, everyone puts aside individual savings to cover health care costs. Medical Savings Accounts are part of a superordinated savings programme, called Central Provident approved by the state in a catalogue of services may be financed by the Medical Savings Account. In the case of out-patient services to treat non-serious illnesses or ailments that are not contained in the catalogue of services, the citizens must pay the expenses incurred out of their own pocket. Citizens receive regular statements of account, showing the current status of their savings account.

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