Chapter 4: Affordable Health Care
CPF is a republic with three states. The Ordinary and Special Accounts were visited in Chapter 3. The Medisave Account will be visited in Chapter 5. The present chapter deals with the philosophy of care. Health policy is about morbidity and mortality. Yet it is about the national ideology and the social consensus as well. This chapter argues that Singapore’s three Ms of medical savings, medical insurance and medical assistance can only be understood in the context of the tasks and objectives that the system has set itself. The Government in 1993 issued a White Paper. That document, Cmd. 16, Affordable Health Care, remains the guiding light and the manifesto. In it the policy-makers state that, while health status must be the primary maximand, subordinate objectives must also be defined in order that the route and not just the destination should be in line with the national need. Affordable Health Care sets out five intermediate objectives, five agreedupon ends along the way (Ministry of Health, 1993: 2). The five sections of this chapter explain in turn the properties of those subordinate goals. 4.1 PROMOTION AND PREVENTION The first goal is ‘to nurture a healthy nation by promoting good health’. The first objective relates to education and deterrence, in the belief that prevention is cheaper and more humane than a subsequent cure: ‘The most effective way of reducing disease levels in a community is to prevent the onset of the disease condition . . . Disease prevention . . . has formed the basis for health care...
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