Ageing population, medical advancements among factors that contribute to rising healthcare costs: Koh Poh Koon

SINGAPORE: An ageing population, medical advancements and higher operating costs are among the factors that contribute to rising healthcare expenditure in Singapore, said Senior Minister of State for Health Koh Poh Koon in Parliament on Monday (Nov 2).

Dr Koh was responding to a question by Ang Mo Kio Member of Parliament (MP) Ng Ling Ling on the "key drivers of cost increases in healthcare" and "the target to keep cost increases in the next five years to a publicly announced range".

Dr Koh said that with an ageing population in Singapore, older patients tend to have more more than one disease or condition at the same time as well as more complications, all of which require more medical attention, medication, procedures and longer hospital stays.

In 2019, patients aged 65 and above spent an average of 6.9 days in a public hospital, compared with 3.9 days for those under the age of 65.

“Therefore, as we grow older, we are likely to spend more on healthcare. And collectively, as we have increasingly more older persons in our population, our overall expenditure on healthcare will also rise correspondingly,” he said, adding that the Ministry of Health’s expenditure on the long-term care sector increased from S$296 million to S$723 million between 2013 and 2018, a 20 per cent increase per annum.

In September, the MediShield Life Council recommended raising premiums for Singapore’s national healthcare insurance, with premiums potentially rising by up to 35 per cent for some. Rising healthcare costs was cited as one of the reasons for increasing premiums.

READ: MediShield Life premiums may rise by up to 35% for some, higher claim limits proposed as part of review

MEDICAL ADVANCEMENTS AND HIGHER OPERATING COSTS

Medical advancements will mean that previously untreatable conditions may now be treatable, and older treatments may be replaced with better but costlier methods, said Dr Koh.

"These advances can improve lifespans and the quality of life, but they come at a price," he said.

For instance, total knee replacement surgeries - which were not widely available in the past - have become more common for those aged 65 and above over the last 20 years. In 1999, there were 187 patients for 100,000 people aged 65 and above having this surgery; this rose to 499 patients in 2019, according to Dr Koh.

Meanwhile, operating costs may also increase over time, said Dr Koh, adding that manpower accounts for 60 per cent of healthcare costs.

“Eventually, increases in manpower cost will translate into higher overall healthcare cost,” he said.

However, he noted that the Government moderates the increase in healthcare costs to ensure that the system remains “affordable and sustainable”.

These include investments in medical infrastructure, fee benchmarks for common surgical procedures and substantial subsidies through MediShield Life, MediSave and MediFund.

The Government encourages Singaporeans to lead healthy lifestyles and go for regular health screening, said Dr Koh. It has also established agencies - one to evaluate health technologies and issue guidances on drugs and other technologies and another to secure better drug prices and other supplies as well as streamline and reduce supply chain costs.

“While there are measures we can do to manage healthcare costs, there is unfortunately no silver bullet. We will need a sustained effort over many years and for all stakeholders to play their part and do so together. 

“We will ensure that Singaporeans will always have access to good quality healthcare that is appropriate and affordable,” said Dr Koh.